c. teller, a. tamang, s. neupaney, d. bajracharya, c. green
DESCRIPTION
`. Changing RH Behavior in Nepal. Through Women’s Discussion and Action Groups. C. Teller, A. Tamang, S. Neupaney, D. Bajracharya, C. Green Presented at APHA Meeting, San Francisco, November 2003. Background to the Nepal Red Cross Society/CEDPA ENABLE Project. - PowerPoint PPT PresentationTRANSCRIPT
C. Teller, A. Tamang, S. Neupaney, D. Bajracharya, C. Green Presented at APHA Meeting, San Francisco, November 2003
Through Women’s
Discussion and Action Groups
Changing RH Behavior in Nepal`
Background to the Nepal Red Cross Society/CEDPA
ENABLE Project
•Built on ACCESS Project aimed at non-clinical FP services
•ENABLE works to create an enabling environment for women’s decision making •Mix of clinical and non-clinical RH/SM/CH services provided by auxiliary nurse midwives
Overview of Communication Action Groups (CAGs)
• 495 active groups with 9,900 members
• Leaders trained by NRCS staff
• Mobilize communities
What is a Communication Action
Group?A group of 20 married rural
women between 15-49 years of
age who...
Meet once a month todiscuss RH and other
issues
Practice the behaviorsthey learn about
Operate savings and credit schemes
Advocate practicingRH/FP and other behaviors
4
3
2
1
Doti150 CAGs
Udayapur240 CAGs
Kailali105 CAGs
Nepal
Number and Distribution of Groups
Kathmandu
What kind of support does a CAG receive?
Training for group leaders and members
Participation/facilitation byhealth workers in monthly meetings
Info and access to RH services through direct delivery and referrals
Support for exchange visits between CAGs
2002 Evaluation
Quantitative: surveys with 949 CAG leaders, members, husbands, and community influentials
Qualitative: 25 focus groups with: CAG leaders and members, husbands, male educators, depot holders, and fieldworkers
Improved communication
Empowered women
Increased women’s participation
CAG Results
Ability to Communicate Information Frequently
0
10
20
30
40
50
60
70
With communitymembers
With family members
%
CAG leaders
CAG members
Actions Taken after Joining CAG
0
20
40
60
80
100
Householddecisionmaking
Active incommunity
Control over life
% CAG leaders
CAG members
Condom Discussion with Spouses by Leaders and
Members
0
20
40
60
80
CAG leaders CAG members
%
Discuss
Initiatediscussion
Trends in Contraceptive Prevalence in CAG Districts
7
23 2622
33
44
61
33
0
10
20
30
40
50
60
70
Doti Udayapur Kailali Rural Nepal(DHS)
%
1993
2001
Husbands saw more change in their wives than the women saw
051015
202530
3540
%
Personalsanitary
practices
Participatecommunitydiscussions
husbands seeingchange in wives
wives seeing changein themselves
Focus Group Quotes on Women’s Empowerment
“Before we were like birds inside a cage, but now we have developed
wings.”
“The community now respects us after we
have solved their problems. Therefore we
have benefited personally.”
Focus Group Quotes on Expanded Capacity to Solve
Problems
“If someone has a problem admitting her child to school or paying the fees, we help
her.”
“Before, women had to give birth in the hay. These days
they are allowed to give birth on a bed.”
Husbands praise their wives and the work they’ve been doing
• “We benefit from their knowledge and feel they should be active in community activities.”
• “If our parents criticize our wives, we explain the importance of their activities.”
• “They have the right to make their decisions and we should give them the chance to do so.”
Future Directions• Overwhelming support for continuation
and expansion by members, husbands, leaders
• Further training on other RH issues requested by members
• Savings and credit program should be expanded as it helps women gain approval