HC3-Nepal Baseline Survey: FP Knowledge, Attitudes, Norms, and Practices, 2015

 

To support the Government of Nepal’s effort to build social and behavioral change communication (SBCC) capacity for family planning within the government sector, USAID/Nepal has awarded a five-year integrated national capacity building and family planning program, named Health Communication Capacity Collaborative Nepal (HC3-Nepal). The HC3 program is led by the John Hopkins University Centre for Communication Program (JHUCCP) and works under the leadership of the Ministry of Health and Population’s (MoHP) National Health Education, Information and Communication Center (NHEICC) in coordination with the Family Health Division (FHD). The goal of the HC3-Nepal project is to strengthen the capacity of the NHEICC, FHD, other MoHP entities, and private and NGO partners to design, implement and evaluate high quality strategic family planning SBCC interventions, with the aim of improving health outcomes in Nepal.

 

The general objective of the baseline survey was to establish benchmark level behaviors of study women and men regarding reproduction and related communication so that the findings could be used for building capacity within the MoHP to design and implement evidence-based large-scale FP SBCC programs and to design, implement and evaluate strategic FP SBCC campaign with the goal of improving health outcomes in Nepal. The required information was collected through quantitative method. The populations for the survey were married women aged 18-49 years who were the primary target of the study; and the women’s mother-in-law aged 35-49,husbands aged 18-49 years, and unmarried men and women 15-24 years old residing in the sampled household who were treated as the secondary target group of the study. A total of 3417 individuals from 1940 sampled households were included in the study. This study was conducted for the John Hopkins University Center for Communication Program.

 

Family Planning and Diarrhea Knowledge, Attitudes and Practices (KAP) in GGMS Project Districts: Round III, 2015

 

The overall objective of the study was to assess and compare with baseline and midline the knowledge, attitudes, and practices (KAP) among currently married women of reproductive age (CMWRA) between 16-49 years of age regarding family planning (FP) and oral rehydration solution (ORS).The study was supported by USAID/Nepal through the Ghar Ghar Maa Swasthya (GGMS) project. The study was conducted in 15 districts. A total of 1620 women of reproductive age were included in this study. 

 

Consumer Study on Emergency Contraception among Nepali Urban Women, 2014

 

The aim of the study was to better understand consumer awareness, attitudes towards and use of emergency contraceptive pills (ECP) as part of a choice of all family planning options. The specific objective was to determine behavioral differences between different categories of women: who are unaware of ECP, those who are aware but have never used and those who have used ECP and to formulate strategies to best help these women to increase their understanding and proper use of ECP and make it available to them, when preferred, to avoid unwanted pregnancies. This study was conducted among 1268 women in 25 municipalities of 20 districts. This study was conducted for the FHI 360/ Ghar Ghar Maa Swasthya (GGMS).

 

Global Sanitation Fund’s Mid-Term Outcome Survey, 2014

 

This Mid-term Outcome Survey was conducted with the aim of tracking progress in the initial phase of the GSF/ODF program against the baseline survey that was conducted in 2011. The overall objective of the study was to assess the achievement of the outcome of the program with a focus on cost effectiveness in sanitation and hygiene program. Both the quantitative and qualitative approaches were used to collect information. The quantitative survey was carried out among 800 sampled households, 38 schools from 17 VDCs and 2 municipality areas from 5 study districts: Sunsari, Sindhupalchowk, Bardiya, Arghakhanchi and Bajura. Similarly, qualitative information was collected through 7 focus group discussions with marginalized and disadvantaged groups and 5 in-depth group interviews with VDC/municipality level stakeholders, and 5 in-depth interviews with district level stakeholders. This study was conducted for the UN-Habitat Nepal.

 

Feasibility Study on Use of Misoprostol for Treatment of Incomplete Abortion, 2013

 

The purpose of this feasibility study was to document the Misoprostol use for post abortion care (MPAC) in Nepal. The findings of the study would inform the national safe abortion strategy and provide evidence for alternative and safe method for good quality comprehensive abortion services, even in more remote areas of the country. The study was conducted in two medical colleges and one public hospital. This feasibility study was conducted for Ipas Nepal.

 

Assessment of Knowledge and Skills of Medical Abortion Service Providers, 2013

 

The main objective of this study was to assess the knowledge and skills of Medical Abortion (MA) service providers who received training from Ipas Nepal in Fiscal Year 2012. Information was collected from various categories of providers and stakeholders namely, MA service providers, public health nurses, health facility in-charges, health facility management committee members and female community health volunteers from the study areas. Information was collected from 13 training centers and 16 health facilities of 6 program districts. This assessment study was conducted for Ipas Nepal.

 

Health Care Waste Management Assessment at Sangini Outlets, 2013

 

The overall objective of the survey was to conduct an assessment of health care waste management among CRS's Sangini franchising outlets. This study was conducted in 110 Sangini outlets of Sunsari, Syangja and Mugu districts. This study was conducted for the FHI 360/ Ghar Ghar Maa Swasthya (GGMS) Project.

 

Endline Research for MCH Project in Nepal, 2012

 

The BBC Media Action implemented a Maternal and Child (MCH) Project in 2009 to improve maternal and child health in Nepal. The project aimed to improve the situation of the Nepali women of childbearing age by providing relevant, accurate, accessible and balanced information on basic MCH issues. The overall objective of the endline survey was to assess changes in the levels of knowledge, attitudes and practices (KAP) of women and men aged 15-49 years with respect to maternal and child health after the implementation of the Maternal and Child Health Project. A total of 2300 males and females from 38 rural and 8 urban wards were selected using multi-stage cluster sampling technique for information collection.

 

Follow-on Survey of Community Based Newborn Care Package in Four Districts, 2012

 

The Strategic Objectives of the Community-Based Newborn Care Package (CB-NCP) program are to bring about awareness and household behavioral change towards healthy newborn practices, utilization of the available newborn services and strengthen the quality of the preventive, promotive and curative services from community to health facility level. The assumptions of the program is that this effort will bring positive change in the lives of the newborn, mother, family and community. A piloting of the program had been initiated in 10 districts of the country since 2009/2010. UNICEF is supporting the piloting of the package in three districts, namely Kavre, Chitwan and Dang, and the piloting is a three-year project. The Child Health Division of the MoHP is also piloting the CB-NCP in two other districts (Palpa and Dolakha).

 

The overall objective of the survey was to assess the changes in newborn health care practices and the coverage of the newborn health services provided by the Community Health Workers (MCHW/VHW) and volunteers (FCHVs) after the implementation of CB-NCP program. The study was conducted in the rural areas of Kavre, Chitwan, Dang and Palpa districts. The respondents in the survey were composed of recently delivered women (i.e. women who have delivered a live birth or dead infant of more than 7 months gestation in the past 12 months from the survey date). A total of 2400 recently delivered women (600 from each district) were included in the study. This study was conducted for UNICEF.

 

Family Planning (FP), Maternal and Child Health (MCH), Menstruation and Water Disinfection in 49 Hill and Mountain Districts: Results of a Knowledge, Attitudes, Practices and Product Usage (KAP) Survey, 2012

 

This study was carried out to assess the knowledge, attitudes, and practices among women of reproductive age on contraception, maternal and child health services, menstrual hygiene and water disinfectant in 49 hard to reach districts. The study was supported by USAID/Nepal through the Ghar Ghar Maa Swasthya (GGMS) project. A total of 1800 women of reproductive age (1400 married and 400 unmarried) were included in this study. 

 

Measurement of Providers’ Knowledge and Attitudes towards IUD and MA, 2012

 

Population Services International (PSI) Nepal is currently implementing a 5-year Women’s Health Project (WHP) to improve the reproductive health of women in Nepal, increase contraceptive prevalence rate, decrease the rate of maternal mortality and reduce the fertility rate. The main objective of the study was to obtain a benchmark information on providers’ (doctors, ANMs, staff nurses etc.) perceptions and attitudes towards Intra-uterine device (IUD) and medication abortion (MA) services which can be later used to measure the effectiveness of the Providers Behavior Change program related to IUD and MA services and to make avail of the information that will enable to substantiate WHP indicators. Information was collected from 345 providers (ANM, nurse midwife, staff nurse, medical doctors) from 24 districts.

 

Maternal and Newborn Health (MNH) Activities at Community Level Baseline and Endline Survey in Sindhuli 2011

 

The Maternal and Newborn Health (MNH) Activities at Community Level intervention was initiated in Sindhuli district in early 2009 with the objectives of increasing awareness amongst pregnant women and their families of danger signs during antenatal, delivery and postnatal periods; getting themselves prepared for the delivery and the postnatal care of the mother and essential newborn care.

 

The overall objective of the survey was to collect endline information on knowledge and practices related to maternal and neonatal health among the recently delivered women (RDW) in the district and compare the indicators with that of the baseline. The respondents in both surveys were composed of RDW who had given birth (either a live or still birth) in the last 12 months preceding the survey. A total of 900 RDW were included from 30 clusters (i.e. wards) in both surveys. This study was conducted for Nepal Family Health Program II. 

 

Evaluation of Zinc Program in the Selected Districts of Nepal, 2011

 

The Micronutrient Initiative started providing support to the Child Health Division of the Ministry of Health and Population by expanding and intensifying the zinc program to new three districts namely Sankhuwasabha, Gorkha and Bajura in early 2010. The intensified zinc program has six components namely training to all cadres of health workers and FCHVs, orientation to private pharmacies, introduction of compliance cards, awareness creation through local FM radios, strengthening existing government monitoring and reporting system and ensuring smooth supply of zinc supplements.

 

The study was conducted to assess the effectiveness of zinc program in the three intensified program districts (Sankhuwasabha, Gorkha and Bajura) compared to non-intensified zinc program districts (Taplejung, Tanahun and Bajhang). Data was collected from 1200 mothers of children 2-59 months of age who had diarrhea in one month prior to survey, 110 health facilities, 125 female community health volunteers and 68 private pharmacies using structured and semi-structured questionnaires. Similarly, 6 focus group discussions were conducted among the key influencers in the family and society of the study areas. This study was conducted for the Micronutrient Initiative.

 

Baseline Survey on Knowledge, Attitudes, Beliefs and Practices of PWDs in relation to Sexual Reproductive Health including HIV/AIDS, 2011

 

The main objective of the survey was to understand the situation of persons with disabilities (PWDs) with respect to their knowledge, attitudes, beliefs and practices on sexual and reproductive health including HIV/AIDS. The study was conducted in four districts covered by DPOD. Information was collected from 600 PWDs, 14 community level health facility in-charges/staffs and 19 district level stakeholders from four study districts. This Baseline Survey was conducted for the Disabled People's Organization Denmark (DPOD).

 

Client Experiences with Safe, Legal Induced Abortion, 2011

 

The purpose of this study was to better understand the pathways for women to access safe first trimester induced abortion services and to identify opportunities for community education and mobilization activities. In addition, an overall description of women’s comprehensive abortion experiences was also sought and a comparison of these experiences by provider type, abortion technology, and previous contact with female community health volunteers was conducted. Tandi MSI Clinic, Chitwan, Seti Zonal Hospital and Tikapur PHC in Kailali were identified as sites for this study. A total of 231 women who visited for induced abortion services at

 

Clients of Abortion Services at the Maternity Hospital and MSI Chabel Chucchepati Clinic 2010

 

This study was conducted for Ipas with the objectives of examining the client profile including their context of abortion, contraceptive use, affordability and overall satisfaction with services. Information was collected from 1172 women (392 at Maternity Hospital and 780 at MSI Clinic) who presented themselves at the clinic and received first-trimester abortion (surgical evacuation).

 

A Study on Acceptability and Compliance of Calcium Supplementation in Selected VDCs of Banke District, 2010

 

The main objective of this study was to examine the acceptability and ease of use of two different forms of calcium supplements (tablets and powder) for use by pregnant women to prevent pre-eclampsia/eclampsia.

 

The study employed a crossover trial methodology which included two village development committees (VDCs) of Banke district. The study population consisted of the currently pregnant women in their second trimester residing in the study VDCs at the time of survey, their husbands and mothers-in-law, FCHVs and sub-health post staff of the study VDCs. 97 currently pregnant women, 24 husbands and 25 mothers-in-law were included from two VDCs. In addition, two focus group discussions were conducted among the currently pregnant women of the study VDCs to collect necessary information. This study was conducted for Maternal and Child Health Integrated Program (MCHIP).

 

Baseline Research for MCH Project in Nepal, 2010

 

This Baseline Research was conducted to support BBC World Service Trust in achieving the Project's aims to improve the situation of Nepalese women of childbearing age by providing relevant, accurate, accessible and balanced information on basic MCH issues. The objectives of the research were to establish benchmark on the current knowledge, attitudes and practices on maternal and child health.

 

The populations for the present study were males and females aged 15-49 years. Two thousand and three hundred persons of both sexes from 38 rural and 8 urban wards of 27 program districts were selected using multi-stage cluster sampling technique for information collection. A total of 2300 males and females from 38 rural and eight urban wards were selected using multi-stage cluster sampling technique for information collection.

 

Endline Survey on Knowledge, Attitude and Practices on Safe Motherhood and Neonatal Health, 2009

 

With the aim of reducing maternal and neonatal mortality Equity and Access Program (EAP) has been implementing Maternal and Neonatal Health (MNH) activities in ten districts since February 2006. The purpose of EAP is to increase access to and utilization of safe maternal and newborn health services particularly by poor and socially excluded groups. DFID provides financial support to SSMP through the consortium led by Options.

 

The overall objectives of the study were to collect Endline information on the knowledge, attitude and practices on MNH of the target populations of the project areas at the end of the program, and compare these with the baseline in order to assess the achievements of the program, and examine trends related to SMNH service utilization using service data maintained by the health facilities of the program districts.

 

The study covered eight EAP program districts. A total of 3132 respondents (1566 recently delivered women, 782 mothers-in-law and 784 husbands) were included in the study. Likewise, service data was collected from 101 health facilities in eight program districts. This study was conducted for the Support to the Safe Motherhood Program (SSMP) and Equity and Access Program (EAP).

 

Formative Research for Hesperian Foundation Where There Is No Doctor (WTND) 21^st Century Edition, 2009

 

The Health Learning Material Project of the Institute of Medicine, Kathmandu published the first Nepali version of “Where These Is No Doctor” (WTND) in 1977. So far four reprints with one revised version of WTND have been produced. The Hesperian Foundation intended to prepare a new edition of WTND for which it sought feedback from current and potential users of the book.

 

The overall objective of the study was to find out where and how WTND was distributed and used in what settings as well as for what purposes, to identify new users and contents for the 21^st century version; and to analyze "gaps" in the distribution and use of the current edition. The study was conducted in three districts of Nepal including Kathmandu, Bhaktapur and Kavre. The study included respondents from the key informants, government workers, NGOs, private-voluntary organizations, university teachers and booksellers. In total 10 key informants' interviews, 2 case studies and 24 focus group discussions (FGDs) were carried out. This study was conducted for the Hesperian Foundation, USA.

 

Report on Humanitarian Pandemic Preparedness (H2P): Message Testing, 2009

 

USAID is providing support to the human pandemic preparedness (H2P) initiative to conduct behavioral change and communication activities in preparation for eventual pandemic influenza. The AI.COMM Project of AED is implementing behavior change communication activities in several districts of the country through its partner organizations: Nepal Red Cross Society (NCRS), CARE Nepal and Save the Children USA (SCUSA).

 

The overall objectives of the exercise were to test the proposed message on human pandemic preparedness based on the communities’ ability to perform the behaviors suggested in the message, and to identify factors that would hinder and/or facilitate the performance of the behaviors contained in the messages. The study was conducted in three districts, namely Kathmandu, Rupandehi and Kanchanpur. Six VDCs/municipalities were selected from the three districts, and 60 respondents for IDIs and 12 focus group discussion groups were identified to test the previously prepared messages. This study was conducted for Academy for Educational Development (AED).

 

Baseline Survey for CB-MNH Program in Sindhuli District, 2009

 

The CB-MNH program is planned to be implemented in Sindhuli district from 2009. The specific objectives of the CB-MNH activities are to increase: a) number of women able to identify danger signs during antenatal, delivery, postnatal, and among newborns, b) coverage of ANC, PNC and newborn services, c) use of skilled birth attendants/institutional delivery, and use of misoprostol in home deliveries, d) use of essential newborn care practices, e) number of sick neonates effectively referred to health workers and facilities.

 

The overall objective of the study was to assess the knowledge and practices related to maternal and neonatal health among the recently delivered women prior to promotion and implementation of CB-MNH program. The respondents in the survey was composed of recently delivered women who have given a birth or had a stillbirth preceding 12 months of the baseline survey. A total of 900 recently delivered women were included in the baseline survey. The CB-MNH Baseline Survey was conducted for Nepal Family Health Program II. 

 

A Baseline Survey on Community Based Newborn Care Package in Two Districts in Rural Nepal, 2009

 

The overall objectives of the survey were to assess the current newborn health care practices and the coverage of the newborn health services provided by the community health workers and FCHVs in Bardiya and Dhankuta districts. This study was conducted using 30 cluster sampling design. The sample size comprised of 1260 women who have delivered a live birth or dead infant of more than 7 months gestation in the past 12 months from the survey date. This study was conducted for Save the Children USA.

Maternal and Newborn Care Baseline Survey, 2008

 

With the aim of reducing maternal and neonatal mortality, UNICEF is currently supporting a Maternal and Neonatal Health (MNH) Care Project in eight districts. The overall objective of the study was to assess the knowledge and practices related to maternal and neonatal health care at the household as well as the community level of the project districts.

 

The study was conducted in Kavre, Dang and Humla districts and the information was collected using quantitative techniques. The respondents comprised of women who had given birth in the two years preceding the survey, their husbands and mothers-in-law (MIL), DACAW frontline workers (village facilitators, and community mobilizers) and female community health volunteers (FCHVs). The sample design utilized a cluster sampling to select the required number of sample population. Thirty clusters were selected randomly from each district in the first stage followed by households in the second stage. A total of 1780 women, 1768 MIL and 1778 husbands were interviewed. Likewise, 30 FCHVs and 180 DACAW frontline workers were included in the study. This study was conducted for UNICEF.

 

<Baseline Study on the Access and Utilization of Basic Services (health and education) in the Selected Programme Districts, 2008

 

Since 2001, ESP and its implementing partners have implemented diverse projects on governance and social inclusion theme. ESP is taking an innovative approach to addressing the problems of governance in Nepal. In particular, it seeks to avoid the common problem experienced by many donor-funded projects of poor national ownership and the imposition of external ideas. ESP has a wide range of partnership base from rights holder organizations to civil society networks, professional NGOs and a strategic governance institution. ESP is planning along with the Dalit NGO Federation to capacitate and ensure access to basic services (health and education) particularly to the local Dalit communities in its ten programme districts.

 

The overall objective of this study was to obtain baseline information on the access and utilization of health and educational services of the Dalit population in the ESP areas. The study was conducted in 50 village development committees/municipalities of 10 programme districts. A total of 4000 Dalit households, and 2,293 mothers of children below five years of age from the sampled households were included in the study. Similarly, 292 members of school management committees from 98 sampled schools and 140 members of health facility management committees from 47 sampled health facilities were also included in the study. This study was conducted for the Enabling State Programme (ESP)/DFID.

 

Baseline and Follow up Surveys of Community-Based Maternal Neonatal Care Work in Jhapa, Banke and Kanchanpur Districts, 2007

 

The Community-Based Maternal Neonatal Care (CB-MNC) Program was introduced in three districts (in 2005 in Jhapa and Banke; and in 2006 in Kanchanpur), to demonstrate an integrated implementation framework including several elements (some of them are new, some of them strengthened versions of existing programs). As well as implementing or strengthening existing programs such as 'iron intensification' and the 'birth preparedness package' (BPP), CB-MNC was intended to demonstrate the feasibility of a community-based approach to prevention of postpartum hemorrhage (the most important cause of maternal deaths in Nepal), introducing oral misoprostol distributed by Female Community Health Volunteers (FCHVs). Other novel elements included, in Kanchanpur, screening for low-birth-weight (LBW) and providing more intensive follow-up care to the cases identified (this aspect of the work was implemented under the USAID-funded ACCESS project). The program area includes rural portions of the three districts. The target populations are pregnant women and newborns. Baseline surveys were carried out in 2005 in Jhapa and Banke, and in 2006 in Kanchanpur. 

 

The overall objective of the follow-up surveys was to collect information on knowledge, attitudes and practices of maternal and newborn care among recently delivered women (RDW) and their family in the pilot areas and compare these values with baseline survey results.

 

The cluster sampling design was used to select the required number of sample population from the study areas. The methodology adopted in the follow up survey was similar to that of baseline survey. The respondents in both the baseline and follow up surveys composed of RDW who had given birth in the past 12 months regardless of whether the infant is currently alive or dead including stillbirths, their husbands, and mothers-in-law (MIL). A total of 900 RDW from each of the Jhapa and Kanchanpur and 840 from Banke were included in both the baseline and follow up surveys. Likewise, about 300 husbands and MIL of the interviewed RDW were included from each district during both surveys.

 

Assessment of RH Training conducted for Health Workers and Volunteers under the PARHI Project (NEP/03/PO4), 2007

 

The Government of Nepal is implementing Population and Reproductive Health Integrated (PARHI) Project which includes Reproductive Health (RH) and Population and Development Strategy (PDS) intervention with the technical and financial support from UNFPA in six districts, namely Saptari, Mahottari, Rautahat, Kapilvastu, Dang and Dadeldhura. The PARHI project was specifically designed to improve utilization of quality RH services and address population related issues. PARHI envisaged strengthening RH service delivery in its program districts through knowledge/skills based training for service providers, provision of supplies and equipment and increasing the number of family planning service delivery points with increased family planning method mix. The RH services planned to improve through training included maternal/neonatal care, family planning services, RTI/STI and HIV/AIDS prevention and adolescent sexual and reproductive health.

 

The overall objective of the study was to assess the effectiveness of UNFPA-supported RH and PDS related trainings conducted for the health service providers and FCHVs as well as the personnel of other implementing partner organization. A total of 66 health facilities (6 primary health care centers, 12 health posts and 48 subhealth posts) functioning at district level and below were selected from six program districts. The respondents at the district consisted of 4 D/PHO, 22 trainers (ToT), 195 health service providers and 198 FCHVs. Similarly, 648 clients who visited the sampled health facility at the time of survey were also intercepted. A total of 160 clients who had received RH services on the survey day were observed by the trained staff to record the quality of services provided by the health providers. Likewise, 85 participants who had received PDS trainings were interviewed from six program districts. In addition, RH service facility inventory of each of the sampled health facilities was also taken.

 

Assessment of Pull System in Health Logistic Management, 2007

 

The MoHP introduced Logistic System Improvement Plan (LSIP) in 1994 with the objective of strengthening and rationalizing existing logistic management system. In 2002/03 KfW, in coordination with DoHS/LMD and NFHP/JSI Nepal started funding to construct the district storerooms, and this strengthened the capacity of district to implement Pull System. As a tool for an effective and efficient logistic management, Pull System was introduced in 2003 with an ultimate the objectives of ensuring the year-round availability of essential drugs at community level, minimizing the wastage and expiry of drugs, and ensuring rational use of drugs. Pull system is a distribution system in which each lower level health facility decides how much to order (pull) not exceeding maximum stock level of essential health commodities from the upper level (district store) on the quarterly basis using LMIS form.

 

The overall objective of the assessment was to assess compliance as well as measure improvements in the logistics management after introducing pull system. The study was conducted using both the qualitative as well as quantitative methods. In addition, record or data on logistics maintained by the district offices and health facilities were also collected. The study was conducted in three program (Siraha, Rautahat and Bara) and one non-program (Saptari) districts. A total of 40 health facilities from program and 20 from non-program districts were selected randomly to collect necessary information. This study was conducted for the Nepal Family Health Program (NFHP).

 

Assessment of the Support for the FCHVs, 2007

 

The female community health volunteers (FCHV) program was initiated in 1988 by the Ministry of Health and Population. The FCHV program is considered as one of the successful community based health programs of Nepal, which aims to enhance the primary health care network at the grassroots level. Presently, over 48,500 FCHVs are engaged in educating local mothers and community members for the promotion of safe motherhood, child health, family planning and other community based health activities. At least one FCHV is working in each of the nine wards of the 3,914 Village Development Committees (VDCs) of the 75 districts of the country.

 

The overall objective of this study was to examine types of support being received by FCHVs from various sectors including the Mothers’ Group and to recommend measures to improve the FCHV support system that in turn would lead to the enhanced performance of the FCHVs and thereby make the FCHV program more effective. The study was conducted in six districts, namely Terhathum, Sarlahi, Chitwan, Kapilvastu, Salyan and Bajhang. Information was collected from different stakeholders at the central, district and the community level. Altogether, 403 in-depth interviews with community level and 33 with district level stakeholders, and 35 focus group discussions with Mothers’ Groups were conducted in the study districts. This study was conducted for the Ministry of Health and Population and UNICEF.

 

A Survey of Coverage and Compliance of Zinc in Diarrhea in Rautahat and Parbat Districts, 2007

 

MoHP decided to add zinc as a prescribed treatment of diarrhea – a new yet effective treatment that reduces the duration and severity of diarrhea episodes. The use of zinc also helps children to develop immunity and additionally helps in reduction of pneumonia. Realizing the importance of zinc in diarrhea treatment Child Health Division of Department of Health Services with the support of Nepal Family Health Program initiated zinc program in Rautahat and Parbat, a terai and hill district respectively, in late 2006 with a plan for implementing in another 23 districts with the support of UNICEF, PSI and other partners.

 

The main objective of this survey was to assess the coverage and compliance of zinc in diarrhea program in Rautahat and Parbat districts. The cluster sampling design was used to select the required number of sample population from the study districts. Thirty clusters were selected from each district. The respondents in the study were the mother of under five children, FCHVs and other health staff of the sampled areas. A total of 571 mothers whose children were reported to have been suffered from diarrhea in one month prior to the survey date were included in the study. Six hundred children (300 from each district) from these 571 mothers had diarrhea within the reference period of one month. Likewise, 59 health workers (30 in Rautahat and 29 in Parbat) and 120 FCHVs (60 from each district) from the sampled clusters were included in the study. This study was conducted for Child Health Division, Department of Health Services, MoHP and Nepal Family Health Program.

 

Assessing the Effects of the PLA/RLG on Contraceptive Use among Members of Marginalized Populations in Nepal, 2006

 

The Sadbyawahar Swastha Pariwar (Valued Behaviors for Healthy Families) was implemented in 58 VDCs of Sunsari, Dhanusha, Siraha, and Banke districts. The overall goal of the project was to expand family planning use and reproductive health practices among the poor and marginalized populations (married women and men of reproductive age) including Dalits and Muslims mainly by increasing knowledge, access and quality of services. The project incorporated the Nepal Family Health Program (NFHP) radio drama serial Gyan Nai Shakti Ho (Knowledge is Power) into Participatory Literacy Appraisal (PLA) classes. The participants of these classes met six times a week over a period of seven months. One or two sessions each week, they functioned as a Radio Listeners Group (RLG) and the remaining sessions were devoted to literacy instruction for the participants.

 

The overall objective of the study was to assess the effects of the PLA RLG activities for promoting contraceptive use among the people of marginalized groups of Nepal, mainly Dalits and Muslims. The study aimed to assess whether participants of the PLA RLGs were more likely to use a modern contraceptive method than those who did not participate and to what extent the program messages were diffused from the PLA RLGs to other members of the community.

 

The study collected retrospective data from a matched sample of intervention and comparison in the four project districts. A total of 59 intervention and 20 comparison wards were randomly selected. Respondents of the study were PLA RLG members of the program areas, non-members of the same areas and other selected women from non-program areas. All of the respondents were currently married women aged 15-49. A total of 1,679 respondents including 839 PLA RLG members of Cycle 1 and Cycle 2 and 420 each of non-PLA RLG members from program wards and control areas were included in the study. This study was conducted for Save the Children US.

 

A Study on Radio Listeners’ Group, 2006

 

The Radio Health Programs (RHP) of Nepal Family Health Program (NFHP) were designed, written and produced with technical support and management of the Behavior Change Communication (BCC) Team of NFHP in close coordination with National Health Education Information and Communication Center (NHEICC), Family Health Division (FHD) and National Health Training Center (NHTC) and other partner organizations. Both programs were launched in March 2004 and, since then, have been broadcast nationally on Radio Nepal as MOHP programs.

 

The overall objective of the study was to assess the added-value of the radio listeners’ groups to the Radio Health Program (RHP). The study was conducted in three districts namely Siraha, Dhanusha and Mahottari using a 30-cluster sampling design technique. Structured interviews and focus group discussion techniques were used to collect information from the Radio Listeners Group (RLG) members, non-RLG members and the respondents of control areas. A total of 1,367 currently married women aged 15-49 years were included in the study. Of which 467 were the RLG members, 450 non-members from the RLG wards and 450 residents of non-RLG wards. In addition, 12 focus group discussions (6 among RLG members, three each among non-members residing RLG wards and women of non-RLG wards) were conducted. This study was conducted for NFHP.

 

Baseline Survey for CB-MNC Program in Kanchanpur District, 2006

 

The overall objective of the baseline survey was to establish benchmarks for selected indicators of knowledge and practices of maternal and newborn care among recently delivered women (RDW) and their family in Kanchanpur district that will be used to evaluate the Community-Based Maternal and Neonatal Care Program (CB-MNC).

 

Information required for the purpose of the study was collected using quantitative techniques. The respondents in the survey comprised of recently delivered women (RDW) who had given birth in the past 12 months regardless of whether the infant is currently alive or dead including stillbirths, their husbands, mothers-in-law (MIL) and fathers-in-law (FIL). About 1,750 of RDW and their family members (husbands, mothers-in-law and fathers-in-law) were included in the study. This study was conducted for Nepal Family Health Program (NFHP).

 

A Study on the FCHV Endowment Fund, 2006

 

The overall objective of the study was to find out contribution of the Endowment Fund to the FCHV program. Information was collected using qualitative techniques such as focus group discussions, in-depth interviews, and case studies. The study was conducted in six districts (3 each from the hills and terai) covering all five-development regions of the country where FCHV Endowment Fund Program is being implemented.

 

Information required for the purpose of the study was collected from different stakeholders at the center, district and at the VDC levels. Altogether 307 in-depth interviews with key persons at the district and VDC/municipality level, and 24 focus group discussions among FCHVs from the sampled VDCs were organized. In addition, case studies on the success and failures of the Endowment Fund Schemes were examined in order to find out the factors behind the success and failure. This study was conducted for the Family Health Division, Ministry of Health and Population and Nepal Family Health Program.

 

Baseline Survey for CB-MNC Program in Jhapa and Banke Districts, 2005

 

The overall objective of the baseline survey was to establish benchmarks for selected indicators of knowledge and practices of maternal and newborn care among recently delivered women (RDW) and their family in Jhapa and Banke districts that will be used to evaluate the Community-Based Maternal and Neonatal Care Program (CB-MNC).

 

The study was carried out in the rural areas of Jhapa and Banke districts. Information required for the purpose of the study was collected using quantitative techniques. The respondents in the survey composed of recently delivered women (RDW) who had given birth in the past 12 months regardless of whether the infant is currently alive or dead including stillbirths, their husbands, mothers-in-law (MIL) and fathers-in-law (FIL). Approximately 1800 each of RDW and their family members (husbands, mothers-in-law and fathers-in-law) were included from two study districts. This study was conducted for Nepal Family Health Program (NFHP).

 

Nepal Family Health Program Mid-Term Survey, 2005

 

The overall objective of the mid-term survey was to assess the progress made by Nepal Family Health Program in its program districts in achieving its goals and objectives and to obtain recommendations for further improvement of the program activities. This study was conducted in all 17-core program districts of NFHP. A total of 2,144 currently married women of reproductive age (15-49 years old) were included in the study from 2,046 households. This study was conducted for Nepal Family Health Program (NFHP).

 

Baseline Study on Perception of Health Services, 2005

 

The objective of the study was to establish the benchmark estimates on the perceived quality of health services in the program districts. The study was carried out in the health facilities (district hospitals, primary health care centers, health posts and subhealth posts) of Achham, Surkhet, Jumla, Doti, Dandeldhura, Bardiya and Dhading districts. A total of 62 health facilities (7 district hospitals, 4 PHCC, 17 HP and 34 SHP) were selected for the study purposes. Information was collected by interviewing the health facility management committee members and clients or users of the health facilities. This study was conducted for the GTZ Health Sector Support Program.

 

Evaluation/KAP Study on Health in Dolakha and Ramechhap Districts, 2005

 

The study was carried out in Dolakha and Ramechhap districts, the project areas of RHDP. The main purpose of this study was to verify and measure the purpose and output level indicators included in the log frame of the Project Document. Basically the study assessed the changes in accessibility of different strata of population to health services, and health-seeking behavior of the people related to health, hygiene, sanitation and diarrheal diseases. A total of 1,080 households from 14 sampled Village Development Committees of two-program districts were interviewed. This study was commissioned by the Rural Health Development Project (RHDP), Swiss Agency for Development and Cooperation.

 

Pre-testing of Printed IEC Materials, 2003

 

The objective of the study was to pre-test the IEC materials on Sun Quality Health Network, family planning brochure and spacing family planning methods (oral pills, condoms and Sangini) developed by PSI/Nepal. The outcome of the pre-test was expected to serve inputs in refining the IEC materials before their actual use. The study also examined participants’ level of message comprehensiveness, attractiveness and appropriateness of the materials. Six types of IEC materials were pre-tested using Focus Group Discussion (FGD) guidelines in the small towns or semi-urban areas of Bhaktapur, Kathmandu, Dhading and Rautahat districts. This study was conducted for PSI/Nepal.

 

Pre-testing of Number One Condom TV Spots, 2003

 

The overall objective of the pre-test was to find out the comprehensibility, appropriateness and effectiveness of the Number One Condom TV spots developed by PSI/Nepal. The Number One Condom TV spots were pre-tested in the semi-urban areas of Kathmandu Valley among the adolescents and youth of both sexes. The study was also conducted for PSI/Nepal.

 

Pre-testing of Number One Condom Radio Spots, 2003

 

The objective of the study was to pre-test the radio spots of the Number One Condom developed by Population Services International (PSI) aiming to provide inputs for improving radio spots before putting them into actual use. Information was collected using Focus Group Discussion (FGD) Guide The study examined participants’ level of message comprehension, opinion regarding attractiveness, and appropriateness of radio spots and their suggestions for each of the spots. A total of three different radio spots were pre-tested in semi-urban areas of Kathmandu Valley. This study was conducted for Population Services (PSI) Nepal.

 

Final Evaluation Survey for Trachoma Awareness Study in Kailali and Kanchanpur Districts, 2003

 

The overall objective of the study was to monitor and evaluate the trachoma campaign of the BBC World Service Trust and Nepal Netra Jyoti Sangh implemented in Kailali and Kanchanpur districts. The study was based on the primary sources of information. As in the baseline survey, the study was conducted in 6 VDCs of Kailali and 4 VDCs of Kanchanpur district. A total of 1,501 households were identified - 915 from Kailali and 586 from Kanchanpur district. From these households, 894 fathers and 1445 mothers having children below 10 years of age, and 785 adolescents (384 boys and 401 girls) aged 10-16 years of age were included in the final survey. The study was commissioned by the BBC World Service Trust, UK. 

 

Final Survey for the Maternal and Neonatal Health Program in Two Districts of Nepal, 2003

 

The overall objective of the study was to measure the impact of the SUMATA campaign in Nepal - SUMATA is a Nepali acronym that translates into “Care, Share and Prepare”. The SUMATA campaign is based on the Safe Motherhood IEC/BCC strategy and the specific activities under the SUMATA campaign include:  a) Radio spots and jingles, b) Print materials – posters, danglers, c) Street Theater, d) TV drama, e) Job Aid for MCHWs, and f) Jeevan Suraksha (Birth Preparedness Package). This study was conducted in Lalitpur and Baglung districts.

 

Information were collected from 1,798 population including: a) currently pregnant women, their husbands, mothers-in-law and sisters-in-law, b) maternal and child health workers, c) village health workers, d) assistant health workers, e) female community health volunteers, f) traditional birth assistants, and g) community leaders. The study was conducted for the Ministry of Health and Johns Hopkins University/ Center for Communication Program, Baltimore, USA.

 

National Family Health Program (NFHP) BCC Formative Research and Evaluation Study, 2003

 

The overall objective of the study was to collect the baseline information from the program areas of Nepal Family Health Program (NFHP) core districts in order to provide inputs for BCC strategy development.

 

The survey was conducted in five districts of the 17 districts covered by NFHP namely Siraha, Bara, Nawalparasi, Banke and Kailali. The sample design utilized a stratified multi-stage probability sampling. All women of reproductive age (WRA 15-49 years) living in the sampled households were considered as eligible respondents to acquire information. Similarly, about 25% of the total households selected for the interview of WRA were sub-sampled to interview male respondents who were the husbands of the interviewed WRA. Same percentage of mothers-in-law (MIL) of the interviewed women were also selected for interview. Thus, a total of 2,191 WRA, 585 husbands and 577 MIL were interviewed from 2,191 sampled households. Similarly, 292 female community health volunteers and 62 supervisors were also included in the study.

 

Evaluation Study on Reproductive Health Awareness, Attitudes and Practice of Women in the World Neighbors Supported Project Areas of Mahottari District, Nepal and Jagatpur Village, Bihar, India, 2003

 

This study was conducted in the project areas supported by World Neighbors (Belgachhi Village Development Committee of Mahottari district and Jagatpur Village, Bihar, India) with the overall objective to assess changes on the level of knowledge, attitudes and practice of women on reproductive health after the program intervention. A total of 1,954 (844 from Nepal and 1,010 from India) currently married women of reproductive age (15-49 years old) were interviewed to generate necessary information. The survey focused on women's reproductive health issues such as fertility, preference for children, family planning knowledge and its use including maternal and neonatal health. Information on the involvement of local people in women's group, utilization of household resources for reproductive health problems and women's role in decision-making was also collected. The survey results have provided a basis for evaluating the program activities and the achievements made during two years period.

 

Equal Access to New Information and Communication Technology (NICT) for HIV/AIDS Prevention and Empowerment of Women and Girls in Nepal, 2003

 

UNDP Asia-Pacific in partnership with Equal Access, USA, a non-governmental organization has designed a regional project to pilot an innovative use of new digital satellite-based technology as a means to deliver development information to information-poor communities. The project aims at bringing positive changes in the lives of communities, in particular women, adolescent girls and young people by enhancing their access to information at their doorsteps through digital satellite based radio communication.

 

The in-country monitoring team of Valley Research Group (VaRG) has been collaborating with Equal Access; San Francisco Center for AIDS Prevention, University of California; and the University of Texas at El Paso project monitoring and impact assessment. One of the main tasks consisted of conducting a representative baseline survey of the pilot districts.

 

The overall objective of the baseline survey was to obtain information on the present level of knowledge, attitude and practice on STIs, HIV/AIDS, and women empowerment in the six pilot districts, findings of which was to serve inputs in developing appropriate messages to address the stipulated issues, and in establishing the benchmark information that could be compared with the final assessment for establishing the impact of project interventions.

 

This study covered six districts namely, Morang, Dhanusha, Mahottari, Parsa, Makawanpur and Chitwan. These districts were selected on the basis of the number of listening groups formed by the partner NGOs in the six program districts. Five listening groups were selected at random from each study district. A total of 30 listening groups were identified and 887 listener group members comprising adolescents, and adult males and females were interviewed. In order to gain qualitative insights for complementing the quantitative data collected from baseline survey, qualitative information was also collected by organizing and facilitating 19 Focus Group Discussions (FGDs).

 

A Study on Assessing the Effectiveness of the Adolescent Sexual Health Education Program, 2003

 

The overall objective of the study was to assess the effectiveness of adolescent sexual health education program implemented by the National Health Education, Information and Communication Center (NHEICC) of Ministry of Health (MOH). NHEICC has implemented Adolescent Sexual Health Education Program (ASHEP) with technical assistance from UNFPA in 55 districts of the country since 1998. The main purpose of this program was to provide knowledge on adolescent reproductive health to the students directly by health care providers. Under this program, health service providers of PHCC/HP/SHP and high school students intended to interact each other on the adolescent reproductive health issues using different IEC materials developed by NHEICC/MOH.

 

Information was collected from health facilities (primary health care centers, health posts and subhealth posts) personnel involved in ARH program, adolescent students and teachers of the sampled health facilities and schools of 10 districts representing both ecological and development regions. Forty-eight health facilities, 60 program schools and 60 non-program schools were selected for information collection. A total of 48 health personnel, 57 teachers involved in ASHEP, and 600 students from each of the program and control schools were included in the study. Besides, concerned officials at District Health Offices/District Public Health Offices were also included to obtain feedback on IEC materials and program itself. This study was conducted for UNFPA.

 

Assessment of ‘Strengthening Drug Management at District Level (SDMD) Program, 2002

 

The main objectives of the study were to assess the achievement of the SDMD program particularly on the extent of application of SDMD training exposure in health workers’ day-to-day work; prescribing, dispensing, quantification, storekeeping, and drug use practices; and providing recommendations for further strengthening the SDMD training program. A total of 48 health facilities from four districts (2 program and 2 control districts) were selected for information collection and the information was generated through observation, interviews with health service providers, trainees and trainers, clients visiting health facility and through review of the service data. This assessment study was conducted for Management Sciences for Health (MSH), USA.

 

Evaluation Study of the Effectiveness of Communication Action Groups to Enable Women to Communicate on Reproductive Health Issues, 2002

 

This evaluation study was conducted for CEDPA Nepal with the objective of evaluating the effectiveness of the Communication Action Groups (CAGs) in enabling women’s communication on reproductive health with each other and with their spouses in the three REWARD project districts namely, Udayapur, Doti, and Kailali. A total of 949 respondents from different categories (CAG leader, CAG member, community leaders and husbands of CAG leaders and members) from of 36 CAGs from the three districts furnished information for the study. 

 

Pretest, Monitoring and Post-test of Birth Preparedness Package (BPP) in Selected VDCs of Kailali District, 2002

 

The MNH/Nepal program proposed an integrated strategy to improve maternal and neonatal survival with the goal to improve pregnancy outcomes for mothers and their newborns.

 

Under the MNH Program, CEDPA/Nepal developed th