Taking a health sector initiative “to scale” and making it sustainable is a challenging development goal. Ambitious, but achievable. In Nepal, the Ministry of Health and Population has succeeded in bringing maternal and child health information and health services to every community in the country. This, in spite of the fact that the majority of Nepal’s 29 million people live in rural and often remote areas, far from any health service facility.
The Female Community Health Volunteer program, with the support of USAID and other partners, has built upon existing country resources to organize, train and supply a powerful “workforce” of approximately 50,000 women—each elected by her community, who contributes her time and effort to care for those in her village.
Doctors at the central/federal level drive a cascading series of trainings which pass vital knowledge to ever larger groups of health services workers at the various organizational and geographical levels of the Department of Health Services. At the final tiers, Health Post and Sub-Health Post staff train the volunteers from the surrounding areas. It is sort of like what would happen if a snowball was rolled off the summit of Nepal’s Mt. Everest… it would grow in size as it rolled downward, resulting in something extraordinarily large by the time it reached the base.
At “Ama Samuha” mothers’ group meetings which volunteers hold each month, they act as health promoters covering topics such as the benefits of proper diet during pregnancy and how certain traditional beliefs can result in life-threatening situations during and after delivery. They also serve as health providers who, at their home or during house-calls, treat among other things the primary causes of childhood mortality (diarrhea and pneumonia) and administer vitamin A, which by itself saves the lives of an average of 15,000 children annually.
During the filming of the video embedded in this post, Director of International Communications Margy Bailey, Chief of Party of the Nepal Family Health Program Ashoke Shrestha, Health Program Officer Deepak Paudel, USAID Nepal Development Outreach and Communications Specialist Stuti Basnyet and I met truly selfless heroes like Laxmi Sharma from Damachaur village and Amrica KC from Marke ward in Salyan district. In no small part due to their commitment and that of the rest of the cadre of Female Community Health Volunteers, Nepal’s maternal and child mortality rates have dropped significantly. Under President Obama’s Global Health Initiative (GHI)—the next chapter in the way the U.S. Government conducts global health activities—Nepal, which is one of eight GHI focus countries, is expected to achieve its national 2015 health indicator targets.