“उमाकुण्ड स्वास्थ्य प्रवर्धन परियोजना–रामेछाप”

Umakunda Health Promotion Project- Ramechhap

PROJECT BRIEF

1.0    Background

ChildAid Network (CAN) has been working in Umakunda, Gokulganga and other rural municipality of Ramechhap for a long period. It has been supporting in improving health, education, livelihood and community development.

In 2019, CAN identified the need of integrated health promotion activities for improving health and wellbeing of the mothers and children in this area. CAN recoginsed the need of health promotion activities both at the schools and communities. The activities have to be tied with the public heath structure and system for increasing access of health care and sustainability.

Women and children’s health are mostly neglected in Nepal.  Their right to access proper information and services are mostly dominated.  Women and adolescent girls face disparities in health and social care across Nepal, especially in rural parts Nepal. Child care is also poor due to improper knowledge, skills and access. Green Tara Nepal (GTN) has been working for health promotion since its establishment. Umakunda Health Promotion (UHP) is expected to address these problems in collaboration with schools, FCHVs, local health facilities and rural municipalities.

2.0    Context and significance of the project

Health problems among the mothers and children remain a major issue of Nepal. The disparity in health indicators between the urban and rural areas is very high. Women face challenges in receiving proper care during pregnancy, delivery and post-partum period. They still problems in accessing family planning services of their choice in the remote part of Nepal. This is exacerbated by the fact that women are disempowered in these communities. Likewise, children face a lot problems from their birth related to essential newborn care, breast feeding, child care, oral hygiene (dental care) and proper nutrition.

Household level decision-making process is complex in Nepal and women cannot decide themselves to go to health facility.  Menstruation is a social stigma in Nepal and face a lot of challenges and disparities in accessing health care, education and dignified life. In addition, women in rural parts face transportation barriers in order to receive prompt care from the health facilities.  They are unable to receive prompt care even after reaching to health facility due to lack of health workers or instruments.  As a result, children, adolescent girls and women are facing problems in their life time. Particularly the people from marginalized and vulnerable group face more problems. Therefore, attention requires to pay towards quality health services, but also to demand and access to services.

GTN’s unique Health Promotion (HP) approach addresses demand for services by increasing knowledge of SRHRs as a human right amongst the most marginalized women. This empowers them within the social system to demand these rights.  GTN’s intervention, therefore, target both supply side and demand creation. Health Promotion (HP) approach is not well established in Ramechhap. Outreach clinics or home visits are lacking. Female Community Health Volunteers (FCHVs) to provide outreach and education in each area with no mentoring. This leads to the failure in local health governmental systems.

Health promotion plays a vital role in transforming the health to individuals, society and the healthcare system by promoting mobilizing change, including preventative health care. The following key issues justifies the need of this project.

Basically, this project aims to address the following issues.

·      Increased individual awareness and agency leading to changes in social norms

·      Train and mobilise local resources

·      Women group and FCHV mobilisation for RH and gender roles

·      Engage schoolchildren/child club members for promoting oral and menstrual hygiene

·      Changes in social norms

·      Empower women leadership in local rural municipalities

1.5    Strategies:

Health promotion approach will be a key strategy targeting both at the community and schools in the catchment area. We will follow Individual, Family and Community (IFC) model while implementing the intervention. We also will coordinate with the governmental health facilities, schools and local political leaders.

Considering local needs and priorities, we have come in conclusion to focus on health promotion activities, where GTN has a long experience. Despite multiple needs of the communities, this project will target on selective and high impact interventions.  The project aims to improve i) personal hygiene of the children including oral hygiene, ii) sexual and reproductive health of the adolescent girls including menstrual hygiene and iii) reproductive health of the married women including pregnancy (Antenatal, delivery, post-natal) and family planning.

• Scalable at GON resources and system
• Identical to existing health and education system of Nepal.
• Covering the issues and needs of the targeted populations (mothers, children, left behind population)
• Promoting evidence-based healthy behaviours
• Fostering coordination, collaboration and partnership   

Target population

This project covers all seven wards of Umakunda Rural Municipality. This focuses to 18254 people, eight health facilities, 46 schools, 69 FCHVs. Women of reproductive age, children and adolescent girls are primary beneficiaries. 

Objectives of the Project

This project aims to achieve the following four results: 

1.     Result one: Identification of health needs

Synthesized local evidence/ identifying general health needs of individuals, families and communities through stakeholder meetings, focus group discussions and project area excursions.

2.     Result two: Increased level of Awareness

 Improved awareness and promoting basic health care, particularly,

i)              Oral hygiene and dental care,

ii)            Menstruation hygiene,

iii)           Adolescent Sexual and Reproductive Health (ASRH) and

iv)          Safe motherhood (Antenatal, intra-partum and post-partum care) including family planning.

3.     Result three: Enhanced mobilisation and capacity of local resources

Mobilising local resources - FCHVs, HFOMC, HPs

4.     Result four: Improved coordination and partnership of local health facilities, schools and government offices.

Improved coordination among various institutions and stakeholders for better health care and facilities.

5.     Fighting with Covid-19 and promoting Social-distancing, Use of Masks and use of Sanitiser (SMS) and hygiene:

Supporting health facilities, schools and FCHVs to fight with Covid-19

Project Duration:

Officially, this project is effective from 1st January 2020 and valid until 31st December 2020. Due to crisis of Covid-19, field level activities is started from April 2020.  Due to lockdown community targeted activities were planned only from July 2020.

Major activities

• Needs Assessment/ Situation Analysis
• Awareness Raising
• Women's group formed/mobilised
• School menstruation hygiene promotion
• Planning and orientation meeting with school headmasters on Covid-19
• Enhanced mobilisation and capacity of local resources
• FCHV meeting
• HFOMC orientation and training
• Improving coordiantion and Partnerships
• Health post level monthly meeting
• Orientation to elected political leaders from targeted wards
• Fighting with Covid-19 and promoting hygiene
• Support to FCHVs
• Support to health facility and quarentines
• Support to schools
• Promotion and communication
• Monitoring, Evaluation and Reporting
• GTN Project monitoring
• SWC monitoring
• Joint  Monitoring DPAC (District Project Advisory Committee)/ GTN / CAN team
• Staff training, orientation and monthly meeting

Organisational detail:

Green Tara Nepal, a non-governmental, apolitical and non-profit making non-governmental organization, established in 2007. It works in research, publications, advocacy, training and social mobilization in a holistic community development approach.

Contact:

Mr. Deepak Dhungel, Chairperson

Mr. Ram Chandra Silwal, Country Director

Green Tara Nepal (GTN)

Kathmandu Metropolish-4, Lamtangin Marg, Baluwatar, Kathmandu

977-1-4432698, email: info@greentara.org.np Web: www.greentara.org.np