National 11 (Spotlight Weekly)

A Successful Partnership

A project launched jointly by the European Commission and the United Nations Population Fund fosters awareness and communication

By A CORRESSPONDENT

Many adolescents and youths in various districts do not hesitate to talk about sexual and reproductive health matters with friends, family members and the wider community these days. Thanks to the support given by the United Nations Population Fund (UNFPA) and the European Commission (EC) under the Reproductive Health Initiative (RHI), the youths now have the opportunity to learn about a vital aspect of health. Launched by the Family Planning Association of Nepal (FPAN), the program enhances the knowledge of adolescents and youths.

RHI Seminar : Fruitful deliberation

FPAN studies have shown that lack of knowledge of and communication about sexual and reproductive health among adolescents has an adverse effect on society. Through 15 youth information centers, the FPAN and World Population Foundation (WPF)\ International Planned Parenthood Federation (IPPF) address the needs of people aged 13-24 years by bringing them together.

"After participating in the FPAN program for some time, I can now easily discuss sexual and reproductive health matters with my friends and other community members," said Shova Shrestha, peer educator. "The people in the community trust me and often seek my advice on confidential issues."

In Nepal’s traditional society, talking about sexual matters and reproductive health in public was long considered taboo. But things have changed. "We meet with our group of girls to discuss reproductive health, diseases, STD, HIV\AIDS, pregnancy and menstruation," said Chitra Kumari Dahal and Sandya Bista, adolescent girls group facilitators. "When we started the class, most of the girls had no idea why and how menstruation occurs and how to take proper care during the period.

According to the national census, adolescents comprise 24 percent of Nepal’s 23.3 million population. With their reproductive life ahead of them, they are a vulnerable and under-served group. Even in urban areas, adolescents are unaware about reproductive health.

"By promoting healthy life-styles and RH habits among adolescents and youth, it is possible to contribute to improving the well-being of a nation," said Wilma H. Goppel, technical coordinator and senior liaison officer of EC RHI Brussels office. "Adolescent and youth sexual and reproductive health is a very much neglected area of reproductive health in most countries."

Women : Under focus

After the introduction of various programs in the health sector, Nepal has made significant progress in reducing fertility and mortality levels during the past decade. The government has prepared policies to enhance reproductive health activities. But physical, political and social factors continue to hinder the implementation of these policies and the population growth rate is still high. According to reports, Nepal’s reproductive health
indicators are among the worst in Asia.

"With a growing number of adolescents and youth having shown an interest to acquire knowledge on the sexual and reproductive health, there is a need for more centers to provide facilities," said Vijayanti Karki of Aamaa Milan Kendra\Royal Tropical Institute.

Although youths comprise such a large portion of the population, only a small fragment know about reproductive health. A large number of youths are vulnerable to HIV\AIDS and other diseases. "After the initiative of the program, we have made tremendous success to inform large number of youth about the sexual and reproductive health," said the FPAN’s Hari Khanal, presenting a paper on reaching rural adolescent with SRH information and service.

The RHI is a regional initiative that is being implemented in seven countries in Asia. Initiated in February 1999, the project funded five innovative projects based in the communities. "RHI covers most of the eight components identified in the national reproductive health strategy. The achievements of the RHI are satisfying. The statistics show positive changes since RHI interventions because people are aware of the service available, communities are mobilized and local participation is well established," said Dr. Laxmi Raj Pathak, director-general of the Department of Health Services.

Under the initiative, Aama Milan Kendra and Royal Tropical Institute run a project in strengthening community access to reproductive health services. Environment Health and Development Advisory Group and DISVI International cooperation, FPAN\World Population Foundation and International Planned Parenthood Federation, Public Health Trust-Nepal and Italian Association for Women in Development, Sunaula Parivar Nepal and Marie Stopes International and RHI Umbrella Project\United Nations Population Fund and Royal Tropical Institute are the partners of various five projects related to reproductive health.

"The Reproductive Health Initiative-Asia is a regional program, of which Nepal is one project," said J. Bill Musoke, UNFPA representative to Nepal. "Activities under the RHI in Nepal started in February 1999 and the first phase of the initiative will end in December 2002. The objective of this seminar is to share the achievements and lessons learnt during the three and half years of implementation. We felt that the achievements and lessons learnt should be shared with a larger audience, as they could be valuable lessons for other organizations working in reproductive health and advocacy," he said.

"I would further like to appreciate the close collaboration between the government, RHI Nepal partner NGOs and other partners. The achievements and lessons learnt . are a collaborative effort of many partners and stakeholders, not to forget the communities. At all levels the projects benefited from the support and collaboration extended by the government. The European Commission deserves a special word of thanks, since without their financial support the projects would not even have started," said Musoke.

The project has shown that the active participation of donors, government agencies and non-governmental organizations is necessary to make progress in the area of reproductive health. Community mobilization is an effective way of generating awareness about sexual and reproductive health among adolescents.Efforts have also been made for counseling. "We have yet to increase the participation of men in safe motherhood," said Jyotsna Tamang, Centre for Research on Environment, Health and Population Activities. "This is because ignorance, indifference and exclusion of males in the RH."

According to studies, the social status of women and girls is very low in most parts of the country. Social and cultural traditions impair the health of women, who have limited decision-making power in important family matters, including their own health. The participation of the men in the process makes change.
In a country where large numbers of women are yet to get the basic health facilities and many youth remain unaware of reproductive health issues due to lack of education opportunities and to cultural inhibitions. "We must mobilize the community to achieve our target," said Shiba Hari Maharjan, presenting a paper on community ownership the key to program.

The EC\UNFPA Reproductive Health Initiative in Nepal has shown the way to integrate the non-governmental organizations, civil society and community based system with the government-based programs. This is what the participants expressed at the RHI dissemination seminar.