SAHAN- Birth Preparedness Class (BPC) 
SAHAN-BPC-FCDO-Sub-Award Somalia & Somaliland have one of the highest lifetime risks of maternal deaths in the world, 1 out of every 12 women die due to pregnancy related causes. Ratio estimated to be 732 deaths per 100,000 live births. According to WHO, UNFPA, UNICEF & UN population division the main causes behind maternal mortality is lack of education, lack of accessible health care on time as well as poor nutrition, poverty and misconception about health facility and health care providers. 
The BPC addresses lack of education and aims to increase levels of awareness among illiterate mothers in the community by providing free, fun and informative session during their most preferred time (afternoon/ context specific) in the presence of supportive fellow pregnant mothers. It is designed to increase the uptake of ANC visit i.e. at least 4 visits if no complication occurs and to scale up the number of mothers delivering at the MCH by mitigating delivery related fears and providing a cozy, friendly service at the health facility. It is integrated with fun activities like henna (an inexpensive temporary body art causing pigmentation of the skin worn by Somali women on their hands, and feet mainly during festive occasions). The fun activities are meant to attract mothers' attention and to create a convenient learning environment while preparing for the delivery of the baby. At the end of the class, mothers get an opportunity to tour the delivery room to familiarize themselves with it.
It has been structured as a series of two classes to be held at the MCH once every week. The classes are divided depending on the stage of the mother's pregnancy. The first class is designated for women in 1st and 2nd trimester while the second class is designated for women in 3rd trimester. One class is scheduled on a select Sunday afternoon, between 4:00pm – 6:00pm and the other class, on a Tuesday, same time. 12 women are invited for each class. Female community influencers (FCIs) and TBAs attached to the MCH also attend the session. Each woman will be able to attend at least one class and will be contacted to attend the second class, within her 3rd/4th ANC visit.
The classes cover the 9 key topical issues that concern expectant mothers:
2.	Advanced birth preparedness: i.e. advanced planning and preparation for delivery. (both classes)
3.	Importance of ANC (both classes)
4.	Nutrition during pregnancy: What to eat to ensure that the mother and baby are healthy and food hygiene. (Class 1)
5.	Breast Feeding: Benefits of breastfeeding, early initiation and exclusive breast feeding for up to six months and benefit of colostrum. Ensure that the mother understands how to help the baby to latch onto the breast properly and breastfeeding positions. (Class 1)
6.	Risk of delivering at home/benefit of delivery at a facility (both classes)
7.	When to seek medical attention: Help the mother to understand the importance of early health-seeking in the event of concerns - danger signs of pregnancy. (Both classes) 
8.	Recognizing signs of labour
9.	Labour: How to manage labour pain/pain alleviation techniques, breathing exercises and recognition of the tell-tale signs that baby is coming. (class 2)
10.	Importance of PNC and birth spacing: A brief topic covering the importance of PNC and recommended timing of PNC visit and the significance of birth spacing. The main goal of the program is to improve the health status of the people in Somalia. 

Main objective: Increased utilization of quality and essential maternal health services / 5% increase in ANC4+ utilization within the pilot period and 30% increase in facility delivery utilization within the pilot period.
Specific objectives:
•	To ensure that mothers attending the two classes in the course of pregnancy are linked to ANC attendance (complete 4 ANC visits),
•	 The class is expected to guide pregnant mothers, their spouses and families on how to best prepare for the delivery of the baby and steps to be taken when unexpected complications occur to the women or the baby during pregnancies, and 
•	To alleviate the unknown fear of facility delivery by providing ample information about maternal health and natural pain relief during labor and delivery.

Outcome 1. BPC session adherence / 75% of the pregnant women eligible for the two sessions attend both.
Outcome 2.  Adherence to ANC visits / 5% increase in number of pregnant mothers attending ANC4+
Outcome 3. Facility Delivery / 5% increase in number of mothers giving birth at the health facility.
Outcome 4. Improved practice of healthy behaviours among Women of Reproductive Age / 75% of women who attended BPC practiced 10% of the behaviours discussed
Output 1. Two BPC sessions conducted at every selected health facility weekly
Outout 2. 1,728 Pregnant women reached
Output 3. Follow up for BPC participants / 50 % of participants of BPC receives follow up visits Birth preparedness plan focuses on pregnant women to make advance preparedness with aim of completing ANC visits, access to skilled delivery and prepare for any eventuality on the course of the pregnancy. It will also inform the pregnant women with the knowledge and easy identification on all risk that could be associated to pregnancy in order to reduce maternal mortality and increase positive pregnancy outcome.