McClair, Tracy

School of Public Health

MSPH

Nepal

Nepal - Nepal Health Communication Capcity Collaborative (HC3)

The Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (JHU∙CCP) specializes in developing and implementing social and behavior change communication (SBCC) programs that improve health outcomes around the world.  As a recipient of a new four-year USAID award in Nepal, JHU∙CCP is seeking a student placement for the summer of 2015.  The overall goal of HC3-Nepal is to work with stakeholders across these three levels to create sustainable family planning improvements within core populations: 1) the Social and Political Environment to garner political commitment and policy change to mobilize resources and services, and to accelerate the implementation of SBCC programs; 2) Service Delivery Systems to strengthen multi-sectoral service delivery and interpersonal communication skills among FP providers; and 3) Community/Individual BCC to help individuals and communities gain the knowledge and skills and develop favorable attitudes to change and practice desired behavior. 

Global Health Mentor: 

Basil Safi, Asia Team Leader adn Administrative Coordinator, JHUCCP

Caroline Jacoby, Senior Program Officer, JHCCP

As I stepped off the plane onto the tarmac at the international airport in Kathmandu, I was filled with excitement and curiosity for what laid ahead of me. Night had fallen by the time I obtained my visa and collected my baggage. I eagerly jumped into a taxi and told the driver which neighborhood I was staying in since there are not precise addresses in Nepal. Stores were closed, streetlights were sparse, and the only light we drove past during the ride came from a door to a small building that offered 24-hour emergency health services. As we drove along the dark streets, I thought about what my friends back home had told me about their experiences in this beautiful country. Nothing I had previously heard prepared me for the incredible journey that transpired.

Before describing the highlights of my field placement in Nepal, I think it is important to mention that my time there was sandwiched between two major events: a devastating earthquake that occurred a few months prior to my arrival and a fuel crisis that began towards the end of my placement due to a blockade of the Indian border. In addition to learning a tremendous amount about global public health and social and behavior change communication (SBCC) programs in developing countries, I also witnessed how natural disasters and the political environment can provide unique challenges for health programs. 

Health Communication Capacity Collaborative (HC3) in Nepal works with government bodies to implement SBCC campaigns focused on increasing family planning uptake among young couples. The major components of the program are media campaigns that aim to generate demand for family planning, government capacity building for SBCC campaigns, and trainings to improve interpersonal communication skills around family planning for health workers and female community health volunteers (FCHVs). During my time at HC3, I principally worked on the FCHV component, but I had exposure to all aspects of the program.

The FCHV program was initiated by Nepal’s Ministry of Health nearly 30 years ago. These women are tasked with delivering specific health messages and providing basic health services to their communities, particularly in the realm of maternal and child health. I analyzed Nepal Demographic and Health Survey (NDHS) 2011 data to address an important research question for HC3: “Is contact by a family planning worker or FCHV associated with contraceptive uptake?” The answer, simply put, is yes. This national-level data analysis is helping shape HC3 programming by focusing their efforts on increasing contacts of family planning workers or FCHVs with young women in their communities. After working with this data, I participated in an NDHS review meeting where I collaborated with local stakeholders and gave suggestions for improving and adding various measures for the 2016 survey.

One of my most enlightening experiences was participating in a field visit to Parbat District with one of my coworkers. In order to reach one of the sub-health posts, my coworker and I hiked up a “hill” (which is the equivalent of a mountain in the US in terms of altitude) for one and a half hours. Not surprisingly, my coworker and I discovered through speaking with locals that it was not a preferred clinic because of its inaccessibility. Throughout our visit, we spoke to young mothers, FCHVs, and health workers at antenatal care clinics, immunization clinics, and health posts. We collected information to get a sense of where HC3 could best reach young mothers with family planning messages and services. It was an amazing experience to traverse the hills, observe life in the villages, and listen to stories of the achievements and challenges of maternal and child health care in their communities.

Not only will I carry new knowledge and skills that I have obtained relating to global public health with me, but I will also hold my wonderful coworkers and friends, and the beautiful colors, delicious cuisine, rich traditions, and stunning mountains of Nepal close to my heart. Engaging in this field placement affirmed my passion for women’s reproductive health, and served as a launch pad for my future career in advancing sexual and reproductive health around the globe.

"Smart Couple" Family Planning Communication Campaign Launch in Kathmandu with my coworkers:

Female Community Health Volunteers (in light blue saris) at the Kaski District "Smart Couple" Family Planning Communication Campaign Launch:

After a hike in the hills to a village and sub-health post in Parbart District:

Immunization Clinic in Parbat District:

HC3 staff in Kathmandu Office on my last day:

People

Stefan Baral, MD MPH,MBA,MSc

Director, Key Populations Program

Joanne Katz, ScD MS,BSc

Associate Chair, Director of Academic Programs

Caitlin Kennedy, PhD MPH,BA

Co-Director, MPH concentration in Social and Behavioral Sciences in Public Health; Associate Director, Center for Qualitative...

Robert Bollinger Jr., MD MPH

Director, Johns Hopkins Center for Clinical Global Health Education (CCGHE); Associate Director, Johns Hopkins Center for Global...

Yukari C. Manabe, MD

Associate Director of Global Health Research and Innovation

Noreen Hynes, MD MPH

Director, Geographic Medicine Center of the Division of Infectious Diseases
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September 2019

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