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Reproductive health and gender equality

LIFE Nepal has been implementing “The Complete Safe Motherhood Programme” with the technical and financial support from UNFPA in seven Palikas i.e., Gaur, Gujra and Yamunamai of Rautahat; Malangwa, Godaita, and Kaudena in Salrahi and Janakpurdham in Dhanusha of Madhesh Province, Nepal. This programme is contributing four major outcomes such as i) Sexual and reproductive health, ii) Adolescents and youth, iii) Gender equality and empowerment of women, and iv.) Population dynamics of UNFPA.

Contributing to the above mentioned outcomes, in this period, 28 stakeholders (government and EDPs) informed about UNFPA WP 2022, 309 participants received orientation and became aware of safe motherhood road map, 136 palikas participated in Safe Motherhood Road Map workshop, 29 Health Coordinators from flood affected palikas of Madhesh province participated and received MISP training, 158 elected local representatives oriented on safe motherhood road map, 14 health officials from 7 priority palikas (Gaur, Gujra and Yamunamai in Rautahat, Malangwa, Godaita and Kaudena in Salrahi and Janakpurdham SMC in Dhanusha) attended the RH/FP review workshops through this programme. Finally, 2 palikas initiated the Zero Home Delivery campaign. In addition, 4 annual health review meeting supported, 2 HR support provided to PHLMC, 8 FM stations engaged to broadcast messages on safe motherhood, 20 messages produced and broadcasted on safe motherhood in different language, 7 events supported to mark the National FP Day, and 36 health personnel oriented on forecasting and quantification.

Also, 88 youths participated in the seven steps local level planning process orientation, one event supported to celebrate the International Youth Day. Similarly, a series of events supported to mark International Women’s Day, 16 Days Campaign, and the IDGC. Furthermore, 4 Protection/GBV Network meetings supported in Madhesh Province. Ultimately, 4 Palikas developed gender equality and social inclusion policy. Likewise, 34 persons from OCMC, safe house, protection network members trained on basic humanitarian principles and safe GBV referral during emergencies, 316 FCHVs oriented on GBV, SRHR and harmful practices and survivor centered services, one TA supported to MoWCYS, 7 Palikas supported to celebrate World Population Day, 7 sensitization workshops held on 2021 Population and Housing Census preliminary data use for planning process.
Access
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Challenges
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Good Practice and Learning
– Mayors/deputy mayors, elected representatives, government officials developed a road map for safe motherhood like to ensure a well-equipped birthing center with skilled and enough manpower, to discourage child marriage practices and promotion of complete ANC and PNC visits as per the government protocol for one day workshop.
– A provincial health and nutrition cluster coordination/ RH sub-cluster meeting decided Typhoid Vaccination should be 100 %, near expiry Covid Vaccine should be managed soon, indicators should be set for safe motherhood and nutrition that will support provincial government to declare complete safe motherhood province and Malnutrition free province, and material supported by EDPs in hospitals should be managed well.
– The first meeting of Provincial Supply Chain Management Technical Working Group decided that for Covid -19 Vaccine a letter should be sent to the Ministry of Social Development, data entry system should be properly managed at e-LMIS reporting in relation to reach the national goal (35%) as it was less in Rautahat and Parsa districts. The second meeting decided to train store focal person in all districts so everything about stock management should be done through the e-LMIS system. Similarly, Oxytocin is needed in all birthing centers so to manage temperature IEC material should be managed prepared and available IEC Material from USAID should be pasted in all health office and birthing center. Third meeting decided for conducting focus group discussion of mental health, nutrition group and PHLMC, continuation of the digital family folder activities in four palikas, motivating Covid vaccination low performing palikas and ensuring their progress and sending letter to the palikas for formation and functionality of the emergency medical team to facilitate the vulnerable during flood and emergencies. The fourth meeting quoted that e-LMIS reporting rate was good in the Madhesh Province as compared to other provinces and the main reason behind the good e-LMIS reporting rate is to regular follow up in pallikas.
– At the closing ceremony of the rally when International Women’s Day, there was a valuable speech from the member of the Province Planning Commission, Honorable Pramila Singh and the secretary of the Ministry of Women, Children, Youth and Sports Mr, Keshab Prasad Bimali. Hon. Pramila Singh pointed out, “Gender-based violence is a national issue and the government should formulate plans and choose the best way of implementing them to address the national priority”. Likewise, Mr. Bimali highlighted poor exercise of women’s rights in Madhesh Province and emphasized on the need of coordinated actions among all stakeholders to minimize gender inequalities. Alao Mr. Bimali highlighted “there is no better way out than working in a team with like-minded stakeholders.” This event helped the like-minded stakeholders working in Dhanusha Districts, such as government, non-government, non-profit, and private groups to work in an integrated way.
– Through the thematic group meeting of MoWCYS a technical team was formed to follow up and update RPM tool. It was decided that GBV thematic group meeting should be organized 2/2 weeks (Virtually) and once in a month (Physically). Similarly, the meeting decided to update the referral mechanism tool as soon as possible and update the GBV control guidelines if needed and finalize it for further processing.
– Both Palikas (Godaita and Gujara) committed to co-financing the zero-home delivery campaign from next AWPB. The zero-home delivery campaign was kicked off in both wards of the Palikas. However, the newly elected representatives at local level are seeking technical guidance to declare safe motherhood palika.
– GESI policy was handed over to the Mayor of the Kaudena rural municipalities and to the deputy mayor of the Gujara municipality due to the absence of the mayor in Gujara municipality. They committed to discuss and pass the policy through municipal assembly after making the executive boards of the palika awareness about the policy. However, regular follow up is essential for the endorsement and implementation.
– Rautahat OCMC committed to funding the similar orientation program to the ward executive members in palika for the effective GBV referral mechanism in the district.
– The interaction program among local level policy makers, health service providers and community level health advocates helped to bridge the gap between them to strengthen the 5 modern methods of family planning services in the communities. The gathering also helped to identify the unserved population and bring out the status of marginalized communities in terms of FP/RH services, such as single women, poor families, Dalit, Muslims, disability, LGBTIQ. It was suggested that all the health facilities should be equipped and have trained human resources to provide all the 5 modern methods of family planning services. In addition, FCHVs should be supplied with the basic but essential FP commodities, such as pills and condoms, to ensure timely resupply of those in the communities.
– Third thematic group meeting agreed to prepare a GBV resource person rooster in Madhesh province and make it readily available to related agencies and authorities to facilitate further training and orientation sessions, finalize the GBV prevention guideline, which is being drafted by MoWYCS, update about the program to be organized for the children’s day and world suicide prevention day and invite for the successful participation from the meeting attendees in the program, and orient the thematic group members about referral process and case management guidelines and the strategic plan against child marriage.
– In RH/FP review and planning workshop, local level elected representatives in priority palikas agreed to prioritize health, especially RH/FP programs, in the upcoming annual work plan and budget. They also agreed to fulfill the vacant nursing staff positions through Public Service Commission in coordination with provincial authorities and to operationalize and functionalize five modern FP services at least in the birthing centers now onwards and periodically extend to other health facilities as well as establishment of birthing centers in the strategic locations within the palika territory. Some palikas are ready to operationalize BEONC site and have already allocated budget in the current fiscal year and regularize the meeting of the health facility operation and management committee.
– Two local heroes, local community level youth activists working to end child marriage and GBV (Ms. Kamli Sada and Ms. Kazal Jha) shared their experiences with the diverse group of participants for 16 days campaign.
– Executive members of local government gained the knowledge on how to use Census data to make informed decisions in evidence based local level planning and budgeting process. The event also advocated at local level with the elected representatives and government officials for the best use of census data while planning activities and implementing policies for informed decision making.
Project Area:

Eight districts i.e., Saptari, Siraha, Dhanusha, Mahottari, Sarlahi, Rautahat, Bara, and Parsa of Madhesh Province

Target Group

Youth, adolescents, women, and local governments

Programme Duration:

February 2022-December 2023

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