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Roundup: Female Community Health Volunteers: Saviors of Nepali Women and Children By Wang Haijing

Posted on: Monday, 5 December 2005, 09:00 CST

Roundup: Female Community Health Volunteers: saviors of Nepali women and children

by Wang Haijing

KATHMANDU, Dec. 4 (Xinhua) -- After the introduction of Female Community Health Volunteers (FCHVs) Program in Nepal 16 years ago, Nepal's rural population's access to modern health system has drastically increased. These female health volunteers are the saviors of women and children offering basic health services at the grass root level.

"Majority of health problems prevailing in the country particularly in the rural communities is related to the health of women and children. High infant and child mortality, low coverage of maternal and child health services are some the examples that indicate the poor health status of women and children. Recognizing the importance of peoples' participation especially women's participation in promoting health of the people, the government initiated Female Community Health Program in 1989," said Ramhari Aryal, joint secretary of the Ministry of Health and Population.

As the country does not have well-equipped health network, children and women do not get proper medicines in proper time even for curable disease. The National Neonatal Strategy 2004 estimated that nearly 30,000 children die each year in Nepal during their first month of life, with two-thirds of these dying in their first week.

In Nepal, over 80 percent of deliveries take place at home. Births attended by skilled birth attendants are as low as 11 percent.

The access of rural population to formal health sector is still low, and the nation's target to reduce high infant mortality rate and high maternal mortality rate is taken up by 48,307 registered FCHVs who are alert all the time as front-runners in grass root health sector.

According to the Ministry of Health and Population, the FCHVs are selected by local mothers' group with the help of local health personnel and are provided 18 days of basic training on selected primary health care components.

After the completion of basic training, FCHVs are provided with a kit box free of cost, consisting of paracetamol, tincher iodine, gentian violet, condoms, pills cycle, cotton, bandages, scissors, a soap case with soap and a towel. The FCHVs are also provided with manuals, flip chart, ward register, FCHV bags, signboard and identity card.

The role of the FCHVs is mainly focused on motivation and education of local mothers and community members for the promotion of safe motherhood, child health, family planning and other community health service.

In addition to other activities, FCHVs play major role in distributing Vitamin A capsules twice a year to more than 3 million children (age 6 -59 months) in a single day and administer the polio drops to 4.2 million children (age 0-59 months) in nation wide immunization campaign saving lives of more than 60,000 children.

Unlike other paid health post staffs, women volunteers are encouraged by the respect given by the rural society.

"I am encouraged by the respect and regards shown by people towards me. I am invited in almost all functions. I cannot compare this recognition with money," Gopi Kumari, a FCHV, told Xinhua.

Although they are regarded as volunteers, FCHVs, mostly women above 40 years old with grand children, have changed the overall health status in the country.

According to the Ministry of Health and Population, a total of 4.8 million persons have contacted FCHVs for information and services related to family planning, safe motherhood, control of diarrhea, acute respiratory infection in 2005. This year, out of the total services provided by health facilities to patients, 24 percent were provided by FCHVs.

"FCHVs are the backbone of national health service of Nepal. United Nations International Children's Emergency Fund (UNICEF) has been supporting to provide training to them," said Junko Sazaki, Nepali representative of UNICEF.

"We cannot imagine the public health system without FCHVs," said Astaratna Tuladhar, head of the Kavre District health service office. "They are the primary resources as they have access to every nook and corner of the country."

As 16 years have already passed since the launching of this program, there is a challenge now for its sustainability.

Most of the FCHVs are old and they need some nominal support from the government and other donor communities if not the regular salary or pensions. The government has already initiated the FCHV Endowment Fund. According the Department of Health Services, the fund is set up in 432 villages, 11 municipalities in 13 districts to support minimal financial requirements of FCHVs.

At a time when about the 60 percent of rural population is yet to have access to modern heath services with high prevalence of infant mortality, maternal mortality, illiteracy among women, these volunteers' work as lifeline in rural Nepal with a mission to offer health service to children and women.

Source: Xinhua News Agency - CEIS

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