In-Depth Insights from Nepal
A Report by Mr. Pradip Raj Pant, Program Coordinator, AMDA-MINDS Nepal Office
Published on: December 24, 2024
Reproductive health problems are widely prevalent but highly stigmatized issue across Nepal, and Chure Rural Municipality is no exception. Last year alone, three cases of uterine prolapse, 82 cases of dysfunctional uterine bleeding (DUB), 69 cases of menstrual disorders and 162 cases of pelvic inflammatory diseases (PID) were reported in the rural municipality’s health facilities. However, these numbers only scratch the surface. As Assistant Health Coordinator Mr. Bikram Bohara aptly puts it, “Reproductive health problems in Chure are hidden problems.” Many women suffer in silence, constrained by societal stigma and a lack of awareness. This silent epidemic has created an urgent need for targeted interventions.
The Chure Rural Municipality consists of 138 settlements scattered across hills at an altitude of approximately 1,500 meters, home to around 25,000 people.
Women waiting in line at the reception for the gynecological screening camp
A formative survey conducted during the development of the Improving Health Seeking Behavior of Mothers and Children (IHSBMC) project highlighted the widespread nature of these issues. Focus group discussions with mothers of under-five children and Female Community Health Volunteers (FCHV) revealed a troubling prevalence of conditions such as vaginal discharge syndrome, menstrual disorders, and uterine prolapse and leaving many women to suffer in silence. Early marriages—a common practice in the region—further exacerbate these challenges, as women’s reproductive health deteriorates due to pregnancies at a young age. “Only about 30% of people marry after age 20 years,” noted the health coordinator Mr. Gajendra Bista, emphasizing the link between early marriage and reproductive health complications.
These insights underline the urgent need for targeted interventions in Chure Rural Municipality. Early pregnancies and a lack of awareness exacerbate reproductive health issues, leaving many women to suffer in silence. Specific interventions, such as reproductive health camps, could provide much-needed relief by identifying and addressing these problems.
Recognizing the urgent need for action, IHSBMC, in collaboration with Nepalgunj Medical College (NGMC) Teaching Hospital, organized four one-day free reproductive and child health camps from November 25 to 30, 2024. These camps were strategically located across Chure Rural Municipality to maximize accessibility for the community and aimed to break the cycle of silence and neglect.
Comprehensive Healthcare at the Doorstep
A specialized team from NGMC, including a gynecologist, pediatrician, nurses, lab technicians, and pharmacists, provided a range of services. These included gynecological and pediatric consultations, basic laboratory tests, Visual Inspection with Acetic Acid (VIA) and PAP smear tests, and the distribution of free medicines. The response was overwhelming, with a total of 799 patients benefited from the free health camps. Among them, 183 were males and 616 were females. Of the total attendees, 304 children received pediatric consultation services, while 478 women accessed gynecological consultations. Additionally, 17 males availed general treatment services. Furthermore, 58 women underwent VIA testing, with 12 testing positive and 46 women provided samples for PAP smear tests. And 133 individuals accessed laboratory tests and received treatment recommendations.
The medical team from Nepalgunj Medical College and local stakeholders
Unveiling Hidden Health Issues
The camps revealed a significant burden of reproductive health problems in the community. Among the 474 gynecological cases diagnosed, common conditions included:
• Pelvic Inflammatory Diseases (80 cases)
• Menstrual Disorders (60 cases)
• Vaginal Discharge Syndrome (70 cases)
• Urinary Tract Infections (80 cases)
• Dysfunctional Uterine Bleeding (5 cases)
• Lower abdominal pain syndrome (55 cases)
• Uterine Prolapse- (25 cases)
• Sub Fertility female (2 cases)
• Low back pain (46 cases)
• Anaemia (25 cases)
These findings underscore the importance of regular screening and accessible healthcare services for women in rural areas.
Voices of Change
The initiative received widespread praise from the community, with many women expressing gratitude for the opportunity to access specialized care close to home.
Matisara Nepali, a resident of Ward 3
“I’ve been suffering from lower abdominal pain for a long time. After consulting with the doctors, I learned that I have uterine prolapse and need surgery soon. At least I now know my condition and can act on it.”
Laxmi Pulami, a resident of Ward 2
“I walked 2.5 hours to attend the camp. The doctor examined me, provided medicines, and advised me to rest. Thankfully, there’s nothing serious, and I feel much relieved.”
Challenges and Lessons Learned
Despite the success, the camps faced challenges. Many women were reluctant to undergo VIA testing and/or vaginal examinations due to cultural stigma and shyness, highlighting the need for continued awareness and education. Consequently, doctors focused on symptomatic management for several cases. To ensure sustained impact, follow-up care and counseling are planned, with support from NGMC for further treatment if needed.
A Model for Future Interventions
These health camps have not only addressed immediate healthcare needs but have also sparked a conversation about reproductive health in Chure Rural Municipality. By breaking barriers of stigma with providing accessible care, and breaking the cycle of silence and neglect the initiative has set a precedent for similar interventions in other underserved areas.
Looking ahead, annual reproductive health camps and community awareness programs could play a pivotal role in addressing the hidden burden of reproductive health problems. Empowering women to seek care and fostering a supportive environment are essential steps toward improving health outcomes.
As the IHSBMC project continues its efforts, the success of these health camps serves as a powerful reminder of the transformative impact of accessible healthcare. In the words of one participant, “At least now I know my condition and can act on it.” This is the first step toward a healthier, more informed community.
Writer
Mr. Pradip engages in a meaningful conversation with a child in the village
Pradip Raj Pant, Program Coordinator,
AMDA-MINDS Nepal Office
While working as a medical assistant at a medical university and regional hospitals, he witnessed firsthand that many patients traveling from remote areas for consultations were already in the late stages of their illnesses due to the lack of timely medical care. This experience deeply impressed upon him the importance of health education and accessible healthcare services in underserved regions. Determined to bridge disparities in medical service delivery and support marginalized communities, he decided to transition his career into the field of development. Since 2019, he have been engaged in various projects as a health sector specialist and coordinator at AMDA-MINDS. Hobbies are listening to music, playing chess, and bodybuilding. Master degree in Health Education. Originally from Dhangadhi, Far Western Nepal.
