Against All Odds: Putting Knowledge into Action

In Nepal, the average age of marriage for both men and women has been stagnant at 18 since 2011, despite policies passed by the government which raised the minimum age to 20 years old.

Nepal currently has the third-highest rate of child marriage in South Asia. The Nepal Demographic Health Survey (NDHS) 2016 data shows that 39.5 percent of girls in Nepal marry by the age of 18, while seven percent are married by the age of 15. Rama Nepali, a resident of Chatradev-8, Argakhanchi District, who once aspired to become a teacher, falls under that 10 percent. Married at 15, Rama gave birth to her first child at the age of 16, and her second at 19.

She explains that continuing her education was impossible after the birth of her first child; “My first child was born two days before my eighth-grade final exam. I wanted to continue my studies, but my fate had something else planned for me. My family thought it was best for me to quit my studies, and stay at home to take care of my baby while my husband went abroad to earn money”.

Things changed when the Nepal CRS Company brought the USAID-supported Remote Area Initiative (RAI) program to Rama’s village. The program informed Rama and other women in her community about family planning methods, child health, and women’s reproductive health. More importantly, the program became a platform for Rama and her peers to share their experiences with common struggles related to women’s health issues and to develop self-confidence through learning and group support.

“This program is an opportunity for women like us. We women have a lot of problems, and many don’t share these things at home,” says Rama. “This program has brought all women together where we can learn about our health and share our stories. Any kind of knowledge is useful; whether it is taught in school or acquired via practices and mistakes.” Rama’s outlook towards life gradually changed once she started attending the RAI program’s Women’s Group Meetings. She believes that participating in the meeting gave her new confidence and she learned about various family planning methods available.

The women in Rama’s village used to share the myths and misconception about the side effects of hormonal contraceptives. Some would say that they suffered from severe headache or bellyache; some would explain how these methods would eventually lead to infertility. Because of this fear, Rama and her husband would rely on the use of condoms. “Before the program, I was scared of using contraceptives thinking it would eventually lead to degrading of my health. But after Neelam Pandey, the Community Change Agent (CCA) informed me about the benefits during a group meeting I adopted implant,” asserts Rama. “The CCA cleared all my doubts and fear, I then started sharing this information with my husband”. The couple then felt using implant would be more safe and economic.

Rama recognizes the importance of putting knowledge to action and encourages her fellow female community members to attend and actively participate in meetings; “Some women don’t want to attend the meeting saying they have other things to do, but I encourage and convince them to come to the meeting. When the CCA informs me about the next session, I spread the information to all the village members a day before”.

When asked why she encourages other women to participate in the meetings, Rama says that the program has brought the community women together to learn, discuss, and adopt the knowledge into their lives. “There are many programs similar to the RAI Women’s Group Meeting, but what sets this one apart is that the CCAs encourage the women to actively participate. There’s an opportunity for discussion, to build self-confidence and gain knowledge”.

Rama has decided to continue her studies and become a teacher in the future. She is also actively advocating for the use of family planning methods and speaks out against child marriage in her village. “If we move forward, our kids and the future generation will learn from us and can live a happy, healthy life,” Rama proudly states.

RAI is a community-based initiative started in 2014 as a part of the USAID-funded Ghar Ghar Ma Swasthya (GGMS), or Healthy Homes project. The project aims to promote and create demand for family planning, maternal and child health services, uterus prolapse treatment, and general health and hygiene in rural, hard-to-reach areas. The second phase of RAI started in 2018 and operates in Tanahu, Terhathum, Argakhachi, and Ramechhap. CCAs are all local women, trained by the Nepal CRS Company to promote community health via group meetings and community events.