Ramechhap Rural Health Promotion Project
Poor infrastructure, lack of sanitation facilities in schools, low awareness of health needs and prevention measures, ignorance of health priorities, and lack of access to quality medical care have been identified as concerning issues in the Ramechhap district. There has also been a dearth of health promotion activities in schools and communities targeting students, women, and girls of reproductive age.
Green Tara Nepal (GTN), with support from BMZ/Child Aid Network (CAN), therefore started the Rural Health Promotion Project (RHP) targeting schools, health facilities, and the broader community in two of the rural municipalities of Ramechhap District: Umakunda Rural Municipality (UKRM) and Gokulganga Rural Municipality (GRM).
The project, following on from the Umakunda Health Promotion Project, aims to promote healthy behaviour, especially among school children and mothers, through a safe and health-promoting school environment, community awareness and engagement, and a functioning public health system.
Context and Significance:
Health problems among mothers and children remain a major issue in Nepal, and the disparity in health indicators between urban and rural areas is very high. Women in remote areas face challenges in receiving proper care during pregnancy, delivery and the postpartum period, due to transportation barriers and a lack of human and physical resources at health centres. Women also face difficulties accessing the family planning service of their choice, an issue exacerbated by the fact that they are often disempowered and have limited decision-making power. Children consequently face health challenges as a result of inadequate nutrition at birth and poor newborn care. Health challenges continue into childhood and adolescence related to poor oral hygiene (dental care), inadequate nutrition, lack of WASH facilities at schools, and poor menstrual hygiene.
It is therefore vital to not only provide quality health services, but also to increase awareness of good health practices and improve the demand for, and access to, health services. In doing so, all Nepalese people will be able to lead a healthy and dignified life into old age, even during the Covid-19 crisis.
Health Promotion Strategy:
Health promotion plays a vital role in transforming the health of individuals, society and the healthcare system by promoting preventative healthcare, mobilizing change, and increasing
awareness and demand for services. GTN’s unique health promotion approach aims to increase individual health awareness and agency by increasing knowledge, mobilizing local resources and empowering marginalized groups to demand health rights, whilst also tackling supply-side concerns. The health promotion approach is not well established in Ramechhap with few health promotion activities in schools and the wider community. Female Community Health Volunteers (FCHVs) provide outreach and education in each area but have little training.
The project is being implemented in Umakunda and Gokulganga rural municipalities (RM). Women of reproductive age, children and adolescent girls are primary beneficiaries. 85 schools and 138 Health Mothers Groups (HMG) and 17 health facilities across both RM have been included in project activities so far.
1. Resistance to Covid-19 was strengthened in 83 schools and 13 health care facilities by creating hygienic conditions for infection prevention. Fears were reduced and awareness was raised among the population in both RMs through education.
2. 83 schools have been provided with a health and awareness-raising learning environment in the areas of personal, dental and menstrual hygiene as well as nutrition. Access to health services has been improved for 7,500 students.
3. 2,500 mothers have increased awareness and improved behaviour regarding safe motherhood, family planning and child nutrition, and sexual and reproductive health.
4. The community-based healthcare system is functioning and the degree of coordination between the participants has improved so that adequate services are provided.
Ram Chandra Silwal, Country Director; Green Tara Nepal,
GPO 8974, CPC 158,
Metropolis-4, Baluwatar, Kathmandu