Project Details

Rural Health Promotion Project

events

Ramechhap Rural Health Promotion Project 

PROJECT BRIEF 

Background: 

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. 

Target Population: 

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.

Objectives 

Activities

Covid-19: 

- Increase awareness of Covid-19 symptoms and prevention protocols. - Improve the capacity of the health system to 

manage Covid-19 cases.

- Distributed materials to health posts, community health units, hospitals, FCHVs, ward offices, HGMs and schools e.g. water filters, sanitisers, disinfectants, PPE, surgical gloves, face masks, thermometers, thermal guns, BP instrument sets, and pulse oximeters. 

- Conducted miking, radio programmes, debates, quizzes and health exhibitions to increase awareness of 

symptoms and prevention methods. 

- Provided local health facilities with equipment such as oxygen cylinders, oxygen masks, flow metres, 

nebulizers and spirometers. 

- Mothers informed about following Covid-19 protocols and proper handwashing technique at HMGs. 

- Assisted with introduction of school Covid-19 protocols. 

- Allocated clinically trained health promotors to assist with human resource gaps when Covid caseloads were high.

Dental Health: 

- Screen school children for dental caries and 

provide treatment. 

Increase awareness of oral hygiene importance and proper brushing 

technique.

- Conducted 165 screenings events in 85 schools to measure students’ height and weight and identify any dental or eye problems. 

- 3 dental health camps held in which 1,200 patients were examined and 700 were treated. 

- Spread awareness of oral health using large banners and audiovisual methods. 

- Child Clubs in 85 schools were mobilized of which 78




were newly formed. These were utilised to teach proper brushing technique and raise awareness of oral health importance. 

- Selected primary school children provided with toothpaste to encourage tooth brushing.

Menstrual Health and Hygiene: 

- Increase knowledge of menstrual health and hygiene amongst 

adolescents. 

- Improve WASH 

facilities and access to sanitary products.

- Utilised school nurses and female teachers to improve awareness of menstrual health and hygiene, and 

promote use of clean sanitary pads among students. - Coordinated with schools to build incinerators to safely dispose of pads. 

- Provided training for teachers on five key issues: menstrual hygiene, dental health, nutrition, mobilization of child clubs, and importance of first aid kits.

Maternal, Child and Reproductive Health: - Increase understanding of the importance of 

exclusive breastfeeding. - Increase awareness of safe motherhood 

practices including 

prenatal care, 

institutional delivery, postnatal care, and 

vaccination. 

- Increase awareness of and access to family 

planning services.

- 85 FCHVs provided training on safe motherhood, family planning, nutrition and Covid-19 prevention methods. 

- HMG meetings held where information on these issues was shared. 452 mothers participated. 

- FCHV Day held to celebrate and raises awareness of the important role of FCHVs. 

- Hired and trained health promoters. 

- During lockdowns, health promoters visited women’s group members’ houses to counsel pregnant and 

lactating mothers. 

- Promoted HMG participation to young married women and new mothers.

Nutrition: 

- Increase awareness of the importance of healthy eating and reduce 

consumption of junk food in schools.

- Held PTA meetings to increase parents' awareness of healthy eating and need to reduce junk food 

consumption among their children. 

- Utilized Child Clubs to promote healthy eating among peers and control junk food consumption. 

- Some Child Clubs have also developed a meal schedule and monitoring strategy.

WASH: 

- Increase awareness of hygienic practices among children.

- 33 schools identified for WASH support of which 25 were provided with electric water filters to help with the water purification process and the remaining 8 were supported with toilet/pavement maintenance.



- Make toilet facilities more hygienic and well maintained.

- Child Clubs used to raise awareness of hygiene and sanitation activities in schools.



Key Achievements: 

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. 

Contact Details: 

Ram Chandra Silwal, Country Director; Green Tara Nepal, 

GPO 8974, CPC 158, 

Kathmandu, Nepal 

Metropolis-4, Baluwatar, Kathmandu 

Phone: 01-4432698 

Email: info@greentara.org.np 

Website: www.greentara.org.np