Nepal Sexual and Reproductive Health Project

Team Leaders (2021): Lisa Nakajima, Alana Chambers, Sarah Loughton

Location: Dang District, Nepal

Date and Duration of the project: 2 years

Number of positions: 2

The Nepal Sexual and Reproductive Health Project is a global health initiative with a focus on public health, advocacy and health education in rural communities in Nepal. This project aims to empower youth and improve the overall health of adolescents in rural Nepal by increasing awareness and knowledge around sexual and reproductive health.

In 2015, the UBC Nepal Sickle Cell Disease (SCD) team created a partnership with Creating Possibilities (CP) Nepal to expand SCD screening, diagnosis and treatment in the rural district of Dang, Nepal. CP is a non-profit Nepalese organization whose mission is to empower marginalized girls, youth, and women through education. They have worked closely with the indigenous Tharu communities in Dang, Nepal, where there is a high prevalence of SCD, to improve SCD outcomes via hosting mass screening events, removing barriers to accessing diagnosis and treatment, and educating women and children at schools and mothers’ groups. This year, CP Nepal expressed an interest in sexual and reproductive health as a new area of focus.

This project will focus primarily on education through the creation of culturally sensitive education tools that local community health workers and our partners can use to provide effective comprehensive sexuality education to youth in rural Nepal. In the past year, our team has connected with existing local organizations in Nepal doing similar work on sexual and reproductive health advocacy and literacy to share resources, receive feedback, and ensure community needs are appropriate addressed. We have also created a needs assessment survey that is being distributed to youth in Dang that will guide the project moving forward.

Education

As mentioned above, the primary focus of this project is to increase awareness and understanding of sexual and reproductive health topics among the indigenous Tharu communities through the development of educational materials. There are several social and cultural barriers that prevent many individuals from accessing sexual and reproductive health services. Our hope is to address these barriers by working closely with our partner organizations to develop culturally sensitive educational modules on sexual health topics ie. anatomy, puberty, menstrual hygiene, contraception and family planning, STIs, and gender-based violence. Since there are many organizations doing similar work, our goal is to adapt existing educational materials to meet the needs of the Tharu communities in Dang. Ultimately, we will work with CP Nepal to train local community health workers to deliver these educational modules to their own community members to ensure that these efforts are sustainable long-term. UBC Nepal SCD teams have also participated in “forum theatres” while working in Nepal, which are educational plays in public community spaces. These performances have gathered hundreds of community members, and are a way of educating the communities on various topics. Future teams will collaborate annually with CP Nepal to create a story that teaches the community around sexual and reproductive health topics.

Research

Our research to date has been largely to inform our own approach to this project, with the hopes that ultimately we can use existing knowledge to create sustainable and effective comprehensive sexuality education for youth in rural regions of Nepal. We have conducted background research around the current educational programs, views on sex and sexuality, access and availability of health services, as well as sustainable approaches to knowledge dissemination, such as a training of trainers approach. In rural regions, specifically in the Dang district where CP is based out of, there are limiting resources that impede educational opportunities. This is a common trend, as rural and remote areas are often excluded from programs and learning opportunities that take place in larger cities.

With all of this in mind, we wanted to get an understanding of what the baseline sexual health knowledge is among the youth that CP Nepal work closely with, as well as get an idea of what they would like to learn more about to ensure we meet the needs of the community. This was done through an informal needs assessment survey, structured around the domains of what, where and how sexual health knowledge was being shared; what, where and how youth would like to learn about sexual health; how menstrual health was managed and taught; and a screen for prevalence of violence and sexual assault in these youth. These results are being used to shape the education modules we are working on.

Going forward, we will be applying for ethics approval and performing a more formal survey assessment to be implemented before and after youth participation in our comprehensive sexual and reproductive health modules. These will be qualitative interviews and surveys to determine the effectiveness of knowledge transfer through these modules. These surveys will also inform us on ways to improve and adapt our educational modules each year.

Fundraising

Each year, fundraising efforts by the UBC Nepal SCD teams have supported our partners, Creating Possibilities. Funds raised for this project will go towards the following: training and supporting local community health workers and CP Nepal workers that are working on this project (ie. administration, translation, communication, travel to rural communities, needs assessment survey distributors and data collection, educational workshop facilitators, etc), educational materials, and supplies (ie. stationary, menstrual hygiene products, Red Cycle Bracelet). There are also existing organizations such as Visible Impact that host youth leadership and development programs in Kathmandu that we hope to one day support local youth from Dang to attend. Our team will work closely with the UBC Nepal SCD team to raise funds, organize travel to Nepal and field work, and communicate with CP Nepal. Although these projects are separate, some of the field work may overlap, and it is expected that the teams work together as they are supporting and working closely with the same local organization and communities.

Advocacy

Our team has met with several different organizations in across the globe that advocates for sexual and reproductive health rights in Nepal. There are many different initiatives in Nepal that are working to increase awareness about Comprehensive Sexuality Education, women’s rights and gender equality. Ultimately, our goal is to work closely with existing Nepalese organizations to advocate for increased adolescent sexual and reproductive health services in rural Nepal. Similar to the UBC Nepal SCD team, we will be meeting with local Nepalese doctors and government officials to lobby for improved access to resources and sexual health services in rural Dang, Nepal.