Overview of women's health in Nepal

Women in Nepal face discrimination and marginalization in the family, society, and state. As a result, in a country where the health system is already poor, the level of women's health and education is particularly low. To compound the problem, many districts of Nepal are remote, making access to health services and information very limited. In fact, only 15% of the Nepali population has access to health services.

Reproductive and maternal health is of particular concern among Nepali women. In rural Nepal, the key role of a woman is bearing children, particularly sons. Early and excessive childbearing weakens women, many of whom die or are chronically disabled from complications of pregnancy. It is not uncommon for Nepali women to experience a prolapsed uterus following birth. The prolapse is often due to recommencing, too soon, the expected workload, which is demanding and strenuous. Often, the prolapse remains untreated for an extended amount of time. Pregnancy is taken as a natural process and God's gift for which medical care is regarded as unnecessary. In fact, the Human Development Report (1996) reported that only 6% of births are attended by trained personnel.

Undeniably, there are other women's health issues that need attention. There is a high incidence of HIV/AIDS in Nepal, and the discriminatory nature of the society greatly hinders a woman's ability to protect herself form such diseases, even from her husband. The discrimination propagates low levels of self worth and body awareness. Nutrition, as well, needs attention as chronic malnutrition occurs in 63% of the population. In most of rural Nepal, people have very little knowledge about the causes and preventive measures of various health and nutritional problems and in the national health policy and programs, women's health issues remain inappropriately addressed. Therefore, it is imperative to provide primary health care facilities and to make communities aware of their basic rights to health. It is also of fundamental importance that the Nepali woman is well educated on health issues so that she may be empowered to take control over her body and so that her family may benefit and learn from her knowledge. Considering the conditions that Nepali women face, it is critical that women are educated about and have full access to appropriate knowledge and skills for self-help, such as information about locally available medicinal herbs and plants and the traditional techniques of their usage. It is also vital that women have access to and control over healthcare services from a women's rights perspective.

Goals of WOREC's community-based women's health program

• To improve the health of Nepali women with special attention to those with little or no access to healthcare services.
• To provide training on leadership development and women's health to women's groups.
• Advocacy with local communities around health issues, including the right to health.
• To empower the people, particularly women, of the targeted VDCs, and enable them to exercise their basic human rights.
• To create space and strengthen networking for interaction and solidarity among local women in regard to their health problems and rights.

Community-based health activities

• Women's health training to local community groups
• Strengthening the community health centre and women's health resource centres in Udayapur.
• Advocacy against violence against women and about women's rights at the local and national levels
• Build a strong community-based information dissemination mechanism and women's health networks for social change through collective empowerment and social mobilization
• To mainstream the issues and health needs of marginalized communities (i.e. Dalit communities) into the health programs of WOREC through awareness campaigns about rights and advocacy around citizenship