Women's health in Nepal

Asmita Shakya, Nepal

Project Manager, Masters in Child Development & Gender Socialization, Bachelors in Public Health, Certificate Level in General Medicine

Being born in an urban city of Nepal, I feel lucky and very happy about what I have in my life.  However, at times I also feel sad when I have explored and worked in the rural communities of Nepal. You can see many good things in rural communities and at the same time feel upset when people share their stories with me.

I was overcome with tears after seeing older women who have a stage IV uterine prolapse for more than 15 years with wounds and bleeding. I also witnessed women who had a ring pessary in place for 20 years without it being removed due to the cost (NPR 25) and walking distance (2-3 hours walking distance) to receive health services. Another woman was left behind to raise her children as her husband took a second marriage due to her prolapse interfering with their sexual relationship. I was stunned when I heard that one husband angrily took his wife away from the operation theater before she was going to have surgery (vaginal hysterectomy) for stage III prolapse. He said he would blame her if anything happened so that she couldn’t look after him or the children. He didn’t even try to understand the pain and discomfort his wife was facing

In some rural communities girls are stopped from attending school because they have to look after their younger siblings and do the housework. Many women are unaware about their reproductive rights and some husbands refuse to wear condoms.  Women often have to walk 2-3 hours while pregnant to visit a health post and I was told of one lady giving birth on the side of the road on her way there. 

However, the Nepal Government is trying to solve these problems by providing free health services and medicines but there are many challenges. The geographical situation, illiteracy, no road access, insufficient number of health facilities, poverty, centralization of all services and traditional/cultural beliefs create hurdles for uplifting women’s health and reducing the major causes for maternal and child mortality.

Through my work travels, the happiest thing I heard was the community children’s club success addressing child marriage in the rural community. Additionally, the Female Community Health Volunteers (FCHVs) are doing great work in rural areas in providing education and awareness about women’s health. Many Government sectors, INGOs, NGOs, CBOs and media are working to solve the problems. Slowly people are changing but it still takes a very long time!!!!

Until all women have access to an education, have increased awareness about their rights, are given opportunities and are involved in decision making, women’s health will not improve!!!