Overview

This is a three-year project aimed at addressing critical health challenges faced by women, children, and adolescent girls in western Nepal. The project seeks to enhance access to sexual and reproductive health (SRH) services, including family planning, through a dual approach: improving the quality of care and promoting community-based health education.

The initiative will promote equitable access to SRH services for all, particularly marginalized populations, by mobilizing local health workers and community volunteers. Key activities will include health promotion at the community level, increased household-level health screenings and early interventions, and upgrading infrastructure and service delivery at local Health Posts.

In the targeted remote areas, health services are often inadequate or entirely lacking. Without targeted investment in both the demand and supply sides of healthcare, including infrastructure, training, and community outreach, existing systems cannot meet the rising health needs—particularly those of women and girls.

• Duration of project: 36 months (Starting from 1^st August 2025)
• Funding Agency: Else Kröner-Fresenius Foundation (EKFS)
• Implementing Agency: Karuna Deutschland e.V. and Green Tara Nepal
• Collaboration with: Tribeni Municipality, Bajura

Objectives

The project ensures that 5,000 women, newborns, children, and adolescents of Tribeni municipality, Bajura have access to high-quality maternal, newborn, and child health care, which will be pursued through the following three sub-goals:

• a. Strengthening the health system by equipping health centers with the necessary resources;
• b. Improving service quality through targeted capacity development of health personnel and administrative structures within the facilities;
• c. Expanding access to health services, including family planning, through community- based health promotion measures.

Sustainability in improving the health of mothers and children will be achieved through the deployment of local health workers, the identification of health risks in the communities, and the implementation of preventive medical checkups directly on-site.

Outputs and Activities

Stated objectives will be achieved through the following three key outcomes and activities.

Outcome 1: Health System Strengthening

Strengthened delivery of safe, hygienic, and reliable MNCH and family planning services through improved health system infrastructure, capacity, and coordination.

Outcome 2: Service Quality Improvement

Increased access to high-quality MNCH and family planning services, enabling more women to utilize essential healthcare services effectively.

Outcome 3: Community-Based Health Promotion

Empowerment of women to access sexual and reproductive health services—including family planning—through enhanced community engagement, education, and health promotion initiatives.

4.0 Activities

Activities Related to Outcome 1: Health System Strengthening

• Refurbishment of Facilities: Upgrade existing health infrastructure to provide safe, hygienic environments for two birthing centers, ante- and postnatal care, and secure storage of medical supplies. This includes provision of non-medical items, room partitioning, and necessary repairs.
• Provision of Equipment and Orientation: Supply essential medical equipment and consumables to Health Posts, and provide orientation to staff on their proper use to ensure safety and effectiveness.
• Training and Capacity Building: Train and support health workers and Health Facility Operation & Management Committees (HFOMCs) to help Health Posts meet the Government of Nepal’s minimum service standards. Focus areas include WASH facilities, infection prevention, waste management, birthing services, family planning, and maternal care.
• Service Level Improvement Goal: By the project’s end, all Health Posts are expected to achieve at least 80% compliance with national minimum service standards, up from under 50%, with a commitment to reaching 100% within six additional months.

Activities Related to Outcome 2: Service Quality Improvement

• Mobile Outreach Services: Deploy trained nurses to remote villages to deliver vital maternal health services, including ultrasound, anemia screening, and urine protein testing. These outreach services will supplement facility-based care and reach women in their homes.
• Cervical Cancer Screening: Implement Visual Inspection with Acetic Acid (VIA) screening programs for women of reproductive age to detect cervical abnormalities early.
• Uterine Prolapse Support: Provide screening and culturally appropriate support for the management of uterine prolapse, including integration of traditional healing approaches where appropriate.
• Strengthening Referral Systems: Partner with referral facilities to reduce barriers in accessing higher-level care for mothers, newborns, children, and adolescents, especially in emergencies or for specialized treatments.

Activities Related to Outcome 3: Community-Based Health Promotion

• FCHV Support Meetings: Facilitate regular meetings for Female Community Health Volunteers (FCHVs) to plan activities, share experiences, and strengthen peer support networks.
• Mothers' Group Engagement: Organize community Mothers' Group meetings to raise awareness about the importance of maternal and child health services, and how to access them.
• Information Dissemination: Distribute health information booklets and introduce a ‘Mother Card’ to help women monitor and manage their reproductive health needs.
• Male Engagement: Conduct Male Health Promotion Group meetings to increase men’s understanding of women’s health issues and encourage supportive behaviors within families.
• HFOMC Strengthening: Build the capacity of HFOMCs to develop and monitor annual health plans and budgets, ensure full staffing at Health Posts, and maintain regular management oversight.
• Municipal-Level Advocacy: Collaborate with Rural Municipalities to advocate for appropriate budget allocation and planning, ensuring the long-term sustainability of services at each Health Post.