Bring healthcare to thousands in rural Nepal

Himalayan HealthCare (HHC) with financial support from Chao Foundation carried out 5 days Adolescent and Sexual Reproductive Health Training to 15 government health providers of 6 rural municipalities namely Hariharpurgadhi, Ghyanglekh, Phikkal of Sindhuli district, Rubi valley and Galchi of Dhading district and Rapti Municipality of Chitwan district. The training was held at HHC office in Kathmandu from 13^th to 17^th November and was conducted by lead trainers Ms. Satyawati B from Family Planning Association of Nepal (FPAN), Mr. Shrikrishna B, Senior Trainer and Mr. Basant C from Bagmati Province Health Training Division.

The main objective of the training was to increase the availability and access to information to health providers about adolescent health and development, provide opportunities to build skills to increase accessibility and utilization of adolescent health and counselling services for adolescents, and to create safe and supportive environments for adolescents in order to improve their legal, social and economic status and rights.

The training started with introductory program, norms to be followed by the participants, expectation goal, objective and outcomes of the training was discussed.

Adolescence is the period of transition from childhood to adulthood. In this stage, various physical and psychological developments occur. It is also the transition period from puberty to legal adulthood. The UN define adolescents as the 10–19-year-old (early adolescence 10-14; late adolescence 15-19), among youth: 15-24 year old. Sexual and reproductive health (SRH) is a state of complete physical, mental and social wellbeing in all matters relating to the reproductive system. It implies that people are able to have a satisfying and safe sex life, the capability to reproduce, and the freedom to decide if, when, and how often to do so. Sexual and reproductive health rights (SRHRs) are human rights. The right to sexual and reproductive health implies that people are able to enjoy a mutually satisfying and safe relationship, free from coercion or violence and without fear of infection or pregnancy, and that they are able to regulate their fertility without adverse or dangerous. Adolescent sexual and reproductive health (ASRH) is a healthy state in terms of the system, function and reproductive processes of a teenager.

Topics covered during the training:

1. Sexual and reproductive health rights
2. Value clarification on ASRH
3. Interests, concerns, problems and needs of adolescents towards sexual and reproductive health
4. Effective communications
5. Psychosocial counselling for adolescents
6. Changes in characteristics in adolescents (physical, mental, hormonal, and sexual)
7. FP methods for adolescents (discussion of suitable FP methods for adolescents)
8. Human Sexual orientation, and discussion on sex, sexual and sexuality
9. HIV aids, STIs/RTIs services to adolescents
10. Mental health for adolescents
11. Nutrition for adolescents
12. Discussion update data
13. Record/reporting system of adolescent services
14. QI tools and certifications of adolescent-friendly sites

Methods of Training:

• Power point presentation (PPTs)
• Standard guidelines and required job aids with complete sets of manuals
• Required handouts of updated data
• Many real case studies and role plays in specific conditions
• Preferential and multiple-choice questionnaires
• Varieties of group activities in different contents session-wise
• Varieties of family planning methods with the complete set of family planning choice kit box, medical eligibility criteria wheel (MEC), DMT tools,
• BP measuring sets, thermometers, pulse oximeters,
• Varieties of standard stationary materials for different activities, like newsprint, meta cards, sticky notes, markers, highlighters, etc.

 Outcome of Training:

• The five-day ASRH training was successfully conducted with active participation from health workers representing various facilities from Hariharpurgadhi, Ghyanglek, Phikkal RM from Sindhuli, Galchhi & Rubi Valley RM from Dhading, and Rapti Municipality from Chitwan. Key messages on ASRH, family planning methods, adolescent concerns, andadolescent-friendly health services were emphasized throughout the sessions. Interactive methods such as group work, role plays, demonstrations, and daily review, games helped reinforce learning and encourage participants engagement.
  
  
• Participants gained improved knowledge on Sexual and Reproductive Health Rights, effective communication, adolescent counselling, and service delivery standards.They demonstrated a better understanding of the needs, challenges and concerns faced by adolescents and the importance of creating demand for SRH services within their communities.

• Overall, the training enhanced participants’ technical skills and confidence to provide adolescent-friendly services, contributing to improved SRH outcomes for adolescents in their respectiveareas.

• The participants were evaluated pre- and post-training by the trainers. The pre-training evaluation was to assess their existing knowledge and skills and to help identify areas that need improvement so that the right training can be designed. The pre-training score was in between 30% to 65% whereas the post training score was 85% to 95%.

 List of Participants: 

1. Swastika S, ANM, Hariharpurgadhi
2. Ishika R, AHW, Hariharpurgadhi
3. Ramnath M, Senior AHW, Ghyanglek
4. Tapesh R, Senior AHW, Ghyanglek
5. Ramala K, ANM, Phikkal
6. Dipa R M, Staff Nurse, Phikkal
7. Durga P P, Senior AWH, Rapti
8. Ramnath S, Senior AHW, Rapti
9. Samina P, ANM, Rapti
10. Buddhiman T, Senior AHW, Galchi
11. Dammari, K D, Senior ANM, Galchi
12. Ramesh B, AHW, Galchi
13. Tenzing D G, Health Assistant, Rubi Valley
14. Jaya P B, Health Assistant, Rubi Valley
15. Pasharam S R, Health Assitant, Rubi Valley