Pushing Boundaries

PART 3: Interactive Engagement Means Better MNCH

Suchi Gaur, Ph.D., HOPE’s Communication Specialist in South-East Asia, visited outlying regions of Nepal where Project HOPE is working to improve health for mothers and children in the most challenging geographic conditions. This is the third of a three-part blog series about her experiences.

Crippled by poverty, seclusion and lack of access, Raksirang Village Development Committee (VDC) in the Makwanpur district of Nepal is also a region plagued with poor maternal and neonatal child health indicators. Project HOPE’s SPARSH-M program is responding through a local team and social mobilizers to train community health workers and health post in-charges as well as educating the community to help bridge gaps between access, quality service and demand.

The participatory nature of the trainings have been immensely valuable in raising the consciousness of women in this VDC, one of the five in which the program operates. One of the highlights of the program has been revitalizing mothers meetings to be more engaging. Recently, I participated in one of these meetings.

The frontline community health worker (FCHV) led a discussion on diarrhea and preventing infections in children, which resulted in great responsiveness and interaction among the mothers in attendance. The program creates awareness and aims to improve practices on quality maternal, neonatal, child health and hygiene services, prompting participants to adopt actionable behaviors. With poor infrastructure, lack of adequate water sources and absence of immediate health services, the fact that most people had a water tank outside their hut for washing hands showed a need for change.

The community women are excited, asking the FCHV for more details. They look forward to the sessions and also push other women to join in.

The Social Mobilizer is a key player in activating these mothers meetings,
traveling from house to house, engaging in conversations, making sure
pregnant, lactating mothers are provided with the best health services and information.

The social Mobilizer is a key player in activating these mothers meetings, traveling from house to house, engaging in conversations, making sure pregnant, lactating mothers are provided with the best health services and information. Despite the community’s overall reluctant attitude towards health services, the rigorous engagement of the Social Mobilizer and his facilitation in the field has made many community members actively seek services. Home visits are an important way to keep the community active and involved in health behavior change. The local team works with local government officials to advocate the successes of SPARSH-M at the institutional level in an effort to scale up good practices throughout the region.

At the end of the session, the nurse provided infants with food while she discussed the challenges she faces. Even though resources are scarce, growing access to urban markets creates a major challenge in preventing young children from getting addicted to fast food and sodas. I was surprised that despite a lack of adequate resources, people were wasting money on unhealthy snacks.

Even though resources are scarce,
growing access to urban markets creates a major challenge in
preventing young children from getting addicted to fast food and sodas.

As I walked down the hill to start the journey back, I realized that in a place where disasters had happened and services were still inadequate, a program like SPARSH-M can provide access and information to even the remotest and least resourced region in Nepal. In a region where basic education, early marriage and multiple pregnancies during adolescence is common, the importance of maternal, neonatal and nutritional education is essential. A program like ours is pushing boundaries.