- - -
Stories

Stories

Latest stories from IPPF

Spotlight

A selection of stories from across the Federation

 "Stigma, myths and cultural practices can have a damaging effect on sexual  health, family planning and women’s rights"

Nepal

Story

How cultural traditions affect women’s health

11 August 2017

High up in the mountains of central northern Nepal, not far from the Tibetan border

Filter our stories by:

 "Stigma, myths and cultural practices can have a damaging effect on sexual  health, family planning and women’s rights"
story

| 11 August 2017

How cultural traditions affect women’s health

High up in the mountains of central northern Nepal, not far from the Tibetan border, lies the  district of Rasuwa. The people here are  mainly ethnic Tamang and Sherpa, two indigenous  groups with cultural traditions stretching back centuries But these rich cultural traditions can come hand-in-hand with severe social problems,  compounded by entrenched poverty and very low literacy rates.  Binu Koraila is a health facility mentor for the Family Planning Association of Nepal (FPAN)  in Rasuwa. "Stigma, myths and cultural practices can have a damaging effect on sexual  health, family planning and women’s rights", she says.  Misconceptions about contraception are widespread. “People think the intrauterine coil will  go into the brain or will fall out. They think the contraceptive implant will penetrate into the  muscles.” Funeral rites present another problem. “Men who want a vasectomy need permission from their parents,” she explains. “But it’s thought that men who have had vasectomies won’t be able to perform the rituals after their parent’s death: parents think that God won’t accept that, so they don’t allow men to have vasectomies.” The culture here is strongly patriarchal. Among the Tamang, marriage involves boys or men picking out young girls from their communities.Early and forced marriage is widespread among the Tamang. If chosen, the girls have no choice but to get married. “If a boy likes a girl, they can just snatch them and take them to their house,” Binu says. Some girls are as young as 13 years old. “The girls don’t know enough about family planning, so there is a lot of teenage pregnancy.” Early marriage and teenage pregnancy can create all kinds of physical, emotional, social and economic problems for girls and their families. For many, their bodies are not well developed enough for childbirth, and maternal mortality remains a major problem in Nepal, at 258 deaths per 100,000 live births, according to UNFPA data. Their large families also suffer because there is not enough food and money to go around. “Women are the worst affected,” Binu says. Parents and husbands keep strict control of women’s access to contraception. “If they want to use contraception, women tend to need consent from their parents or husbands. “I have seen cases where if a woman gets contraceptive implant services, they get beaten by their father-in-law and husband. One woman asked to have her implant removed because she had been beaten by her husband.” Binu’s role is to deliver sexual health and family planning advice and services to villages across Rasuwa district: “I go to remote places, where people are marginalised and don’t know about family planning.” She also trains government health workers on family planning, and mentors them after they return from training in Kathmandu to Rasuwa. As well as delivering health services, the FPAN team have been working hard to change perceptions. “Recently we had a health camp at Gatland,” she explains. "After two hours of counselling one client requested an IUD. After months there was a rumour in Gatlang that her coil had fallen out. The FPAN volunteer went to the woman’s house and asked if this was true. She said, ‘No, I’m really comfortable with that service.’ After that, the client went door to door and told others how happy she was with it and that they should take it at the next family planning camp. “After four or five months, we went back to the Gatlang camp and at that time another eight women took the IUD.” These numbers might seem small but they are far less so when viewed against the wall of stigma and myth that can obstruct contraception use here, as in so many rural areas of Nepal. The involvement of committed, passionate health mentors and volunteers is vital to show people how important it is to take sexual health and family planning seriously: the benefits are felt not just by women and their families, but by entire communities.

 "Stigma, myths and cultural practices can have a damaging effect on sexual  health, family planning and women’s rights"
story

| 25 June 2022

How cultural traditions affect women’s health

High up in the mountains of central northern Nepal, not far from the Tibetan border, lies the  district of Rasuwa. The people here are  mainly ethnic Tamang and Sherpa, two indigenous  groups with cultural traditions stretching back centuries But these rich cultural traditions can come hand-in-hand with severe social problems,  compounded by entrenched poverty and very low literacy rates.  Binu Koraila is a health facility mentor for the Family Planning Association of Nepal (FPAN)  in Rasuwa. "Stigma, myths and cultural practices can have a damaging effect on sexual  health, family planning and women’s rights", she says.  Misconceptions about contraception are widespread. “People think the intrauterine coil will  go into the brain or will fall out. They think the contraceptive implant will penetrate into the  muscles.” Funeral rites present another problem. “Men who want a vasectomy need permission from their parents,” she explains. “But it’s thought that men who have had vasectomies won’t be able to perform the rituals after their parent’s death: parents think that God won’t accept that, so they don’t allow men to have vasectomies.” The culture here is strongly patriarchal. Among the Tamang, marriage involves boys or men picking out young girls from their communities.Early and forced marriage is widespread among the Tamang. If chosen, the girls have no choice but to get married. “If a boy likes a girl, they can just snatch them and take them to their house,” Binu says. Some girls are as young as 13 years old. “The girls don’t know enough about family planning, so there is a lot of teenage pregnancy.” Early marriage and teenage pregnancy can create all kinds of physical, emotional, social and economic problems for girls and their families. For many, their bodies are not well developed enough for childbirth, and maternal mortality remains a major problem in Nepal, at 258 deaths per 100,000 live births, according to UNFPA data. Their large families also suffer because there is not enough food and money to go around. “Women are the worst affected,” Binu says. Parents and husbands keep strict control of women’s access to contraception. “If they want to use contraception, women tend to need consent from their parents or husbands. “I have seen cases where if a woman gets contraceptive implant services, they get beaten by their father-in-law and husband. One woman asked to have her implant removed because she had been beaten by her husband.” Binu’s role is to deliver sexual health and family planning advice and services to villages across Rasuwa district: “I go to remote places, where people are marginalised and don’t know about family planning.” She also trains government health workers on family planning, and mentors them after they return from training in Kathmandu to Rasuwa. As well as delivering health services, the FPAN team have been working hard to change perceptions. “Recently we had a health camp at Gatland,” she explains. "After two hours of counselling one client requested an IUD. After months there was a rumour in Gatlang that her coil had fallen out. The FPAN volunteer went to the woman’s house and asked if this was true. She said, ‘No, I’m really comfortable with that service.’ After that, the client went door to door and told others how happy she was with it and that they should take it at the next family planning camp. “After four or five months, we went back to the Gatlang camp and at that time another eight women took the IUD.” These numbers might seem small but they are far less so when viewed against the wall of stigma and myth that can obstruct contraception use here, as in so many rural areas of Nepal. The involvement of committed, passionate health mentors and volunteers is vital to show people how important it is to take sexual health and family planning seriously: the benefits are felt not just by women and their families, but by entire communities.

Waiting for an ambulance that never arrives: childbirth without medical help in rural Nepal
story

| 11 August 2017

Waiting for an ambulance that never arrives: childbirth without medical help in rural Nepal

 “When I was about to give birth, we called for an ambulance or a vehicle to help but even after five hours of calling, no vehicle arrived,” recalls 32-year-old Mona Shrestha. “The birth was difficult. For five hours I had to suffer from delivery complications.” Mona’s story is a familiar one for women in rural Nepal. Like thousands of women across the country, she lives in a small, remote village, at the end of a winding, potholed road. There are no permanent medical facilities or staff based in the village of Bakultar: medical camps occasionally arrive to dispense services, but they are few and far between. Life here is tough. The main livelihood is farming: both men and women toil in the fields during the day, and in the mornings and evenings, women take care of their children and carry out household chores. The nearest birthing centre is an hour’s drive away. Few families can afford to rent a seat in a car, and so are forced to do the journey on foot. For pregnant women walking in the searing heat, this journey can be arduous, even life-threatening. “Fifteen years ago, there was a woman who helped women give birth here, but she’s no longer here,” Mona says. “It’s difficult for women.” Giving birth without medical help can cause severe problems for women and babies, and even death. Infant mortality remains a major problem in Nepal, and maternal mortality is one of the leading causes of death among women. Only 36% of births are attended by a doctor, nurse or midwife.  A traumatic birth can cause long-term physical, psychological, social and economic problems from which women might never recover. Access to contraception and other family planning services, too, involves walking miles to the nearest health clinic. Mona says she used to use the contraceptive injection, but now uses an intrauterine device. Like many villages in Nepal, Bakultar is awash with myths and gossip about the side-effects of contraception. “There are so many side effects to these devices – I’ve heard the coil can cause cancer,” Mona says. “This is why we want to have permanent family planning like sterilisation, for both men and women.” These complaints heard frequently in villages like Bakultar. As well as access to facilities and contraception, people here desperately need access to education on contraception and sexual health and reproductive rights. Misinformation as well as a lack of information are both major problems. “It would be really helpful to have family planning services nearby,” says Mona.

Waiting for an ambulance that never arrives: childbirth without medical help in rural Nepal
story

| 25 June 2022

Waiting for an ambulance that never arrives: childbirth without medical help in rural Nepal

 “When I was about to give birth, we called for an ambulance or a vehicle to help but even after five hours of calling, no vehicle arrived,” recalls 32-year-old Mona Shrestha. “The birth was difficult. For five hours I had to suffer from delivery complications.” Mona’s story is a familiar one for women in rural Nepal. Like thousands of women across the country, she lives in a small, remote village, at the end of a winding, potholed road. There are no permanent medical facilities or staff based in the village of Bakultar: medical camps occasionally arrive to dispense services, but they are few and far between. Life here is tough. The main livelihood is farming: both men and women toil in the fields during the day, and in the mornings and evenings, women take care of their children and carry out household chores. The nearest birthing centre is an hour’s drive away. Few families can afford to rent a seat in a car, and so are forced to do the journey on foot. For pregnant women walking in the searing heat, this journey can be arduous, even life-threatening. “Fifteen years ago, there was a woman who helped women give birth here, but she’s no longer here,” Mona says. “It’s difficult for women.” Giving birth without medical help can cause severe problems for women and babies, and even death. Infant mortality remains a major problem in Nepal, and maternal mortality is one of the leading causes of death among women. Only 36% of births are attended by a doctor, nurse or midwife.  A traumatic birth can cause long-term physical, psychological, social and economic problems from which women might never recover. Access to contraception and other family planning services, too, involves walking miles to the nearest health clinic. Mona says she used to use the contraceptive injection, but now uses an intrauterine device. Like many villages in Nepal, Bakultar is awash with myths and gossip about the side-effects of contraception. “There are so many side effects to these devices – I’ve heard the coil can cause cancer,” Mona says. “This is why we want to have permanent family planning like sterilisation, for both men and women.” These complaints heard frequently in villages like Bakultar. As well as access to facilities and contraception, people here desperately need access to education on contraception and sexual health and reproductive rights. Misinformation as well as a lack of information are both major problems. “It would be really helpful to have family planning services nearby,” says Mona.

Non-governmental organisation in Maldives establishes a family planning clinic
story

| 11 January 2017

Helping families bond together

Mariyam a 25-year-old woman, who lived in Addu Atoll in Maldives, was having a battle of wits with Ahmed, her young three year old. He threw temper tantrums and just couldn’t be disciplined. Thankfully, one day Mariyam attended a session on better parenting skills organised by Society of Health & Education (SHE). SHE was the first non-governmental organisation in Maldives to establish a family planning clinic where couples could get information, education and counselling to plan their families. It also provides psycho-social support and counselling to children and adults. Through various approaches such as play therapy, children as well as adults are helped to develop life skills and cope with the grief, anger, anguish and possible abuse in their life. During the session on parenting, Mariyam requested for help in dealing with Ahmed. Thereafter through extended telephonic counselling sessions; it was revealed that Mariyam was currently pregnant with her fourth child. Her husband worked away from home and visited occasionally during holidays. Her pregnancy, combined with childcare needs at home, was taking a toll on Mariyam, making her feel weak and irritable, even overwhelmed at times. Understanding this, the counsellor suggested that she set aside a time to play with her son every day. When Mariyam put it into practice, she discovered that all her son wanted from her was some attention. The counsellor then helped her and her husband explore different family planning options when her husband came visiting the household. Together they decided to adopt a family planning option once Mariyam had delivered. He also decided to stay on the island for a few months and work at his father’s carpentry in order to help his wife to look after the children post-delivery. The couple visited SHE clinic for counselling on contraceptives post delivery and Mariyam has been a client ever since.

Non-governmental organisation in Maldives establishes a family planning clinic
story

| 25 June 2022

Helping families bond together

Mariyam a 25-year-old woman, who lived in Addu Atoll in Maldives, was having a battle of wits with Ahmed, her young three year old. He threw temper tantrums and just couldn’t be disciplined. Thankfully, one day Mariyam attended a session on better parenting skills organised by Society of Health & Education (SHE). SHE was the first non-governmental organisation in Maldives to establish a family planning clinic where couples could get information, education and counselling to plan their families. It also provides psycho-social support and counselling to children and adults. Through various approaches such as play therapy, children as well as adults are helped to develop life skills and cope with the grief, anger, anguish and possible abuse in their life. During the session on parenting, Mariyam requested for help in dealing with Ahmed. Thereafter through extended telephonic counselling sessions; it was revealed that Mariyam was currently pregnant with her fourth child. Her husband worked away from home and visited occasionally during holidays. Her pregnancy, combined with childcare needs at home, was taking a toll on Mariyam, making her feel weak and irritable, even overwhelmed at times. Understanding this, the counsellor suggested that she set aside a time to play with her son every day. When Mariyam put it into practice, she discovered that all her son wanted from her was some attention. The counsellor then helped her and her husband explore different family planning options when her husband came visiting the household. Together they decided to adopt a family planning option once Mariyam had delivered. He also decided to stay on the island for a few months and work at his father’s carpentry in order to help his wife to look after the children post-delivery. The couple visited SHE clinic for counselling on contraceptives post delivery and Mariyam has been a client ever since.

Women’s collective pools money and resources to get a clinic in their area.
story

| 11 January 2017

Changing lives across generations

Indumati, her (now departed) mother-in-law and her three daughters-in-law represent three generations of women in Maharashtra, India who have benefitted from the services of Family Planning Association of India. All three generations have been a part of women’s collectives’ movement encouraging women to participate in the socio-economic life of the family and community. Becoming a member of the women’s collectives helped Indumati to step beyond the boundaries of her home and begin participating in the community life of the village. Be it cleanliness drives in the village or celebrating all festivals with equal fervour created spaces for the women to contribute to the social wellbeing of the village. The next stop was micro-savings for economic independence. When the women realised that the women of their and neighbouring villages don’t have any healthcare services, they approached Family Planning Association of India (FPAI) to start a clinic in their area. When FPAI agreed the women’s group pooled money and contributed towards the building of the clinic. With increased access to healthcare services came increased awareness. Most women’s group imparted training on SRHR to the collective members. Some collective members even began to stock the contraceptives provided by FPAI so that women could access them in privacy and confidentiality. Indumati has three sons and one daughter. Each of her three sons has two children each. Her daughters-in-law were able to get information and adopted family planning methods due to her involvement with the women’s collectives. The inter-generational impact of access to family planning services is clearly visible in her household.

Women’s collective pools money and resources to get a clinic in their area.
story

| 25 June 2022

Changing lives across generations

Indumati, her (now departed) mother-in-law and her three daughters-in-law represent three generations of women in Maharashtra, India who have benefitted from the services of Family Planning Association of India. All three generations have been a part of women’s collectives’ movement encouraging women to participate in the socio-economic life of the family and community. Becoming a member of the women’s collectives helped Indumati to step beyond the boundaries of her home and begin participating in the community life of the village. Be it cleanliness drives in the village or celebrating all festivals with equal fervour created spaces for the women to contribute to the social wellbeing of the village. The next stop was micro-savings for economic independence. When the women realised that the women of their and neighbouring villages don’t have any healthcare services, they approached Family Planning Association of India (FPAI) to start a clinic in their area. When FPAI agreed the women’s group pooled money and contributed towards the building of the clinic. With increased access to healthcare services came increased awareness. Most women’s group imparted training on SRHR to the collective members. Some collective members even began to stock the contraceptives provided by FPAI so that women could access them in privacy and confidentiality. Indumati has three sons and one daughter. Each of her three sons has two children each. Her daughters-in-law were able to get information and adopted family planning methods due to her involvement with the women’s collectives. The inter-generational impact of access to family planning services is clearly visible in her household.

Karma Pem’s Story
story

| 11 January 2017

Reconstructing life after de-addiction

Karma Pem, a mother of four boys, had the world on a silver platter till it lost it all and found it again after blood, sweat and tears. She had a cushy job in the Ministry of External Affairs in Thimphu, Bhutan. When dignitaries from other countries visited the Royal Kingdom of Bhutan, Karma would be a part of the team assigned to them. Yet due to her addiction to alcohol, she has been to her personal hell and back. She spent considerable years of her life in an alcoholic stupor. Initially, she tried to manage her addiction with periods of sobriety especially at work but eventually she was asked to leave her job. This fuelled her downward spiral into the deeper addiction bringing her literally to the streets. “Once my husband even found me begging on the street,” says Karma Pem. After trying to cope with her bouts of drunkenness, Karma’s husband left her taking their boys away from the mother. “My mother stood by me as a pillar. She never once abandoned me, no matter what I did. She contacted RENEW to find a solution to my addiction. Through them, she found a de-addiction centre in India. She persuaded me to go there and get enrolled. My mother’s persistent efforts brought me back from the brink of personal annihilation.” adds Karma. Out of her four sons and two of them are recovering addicts. Her own recovery prompted Karma to motivate her sons to go through rehabilitation and pursue their studies. One of her sons is an upcoming football player. Today, Karma has been clean for about seven years. She is determined to rebuild her life and take control of her destiny. Today she is employed in RENEW’s livelihood’s centre

Karma Pem’s Story
story

| 25 June 2022

Reconstructing life after de-addiction

Karma Pem, a mother of four boys, had the world on a silver platter till it lost it all and found it again after blood, sweat and tears. She had a cushy job in the Ministry of External Affairs in Thimphu, Bhutan. When dignitaries from other countries visited the Royal Kingdom of Bhutan, Karma would be a part of the team assigned to them. Yet due to her addiction to alcohol, she has been to her personal hell and back. She spent considerable years of her life in an alcoholic stupor. Initially, she tried to manage her addiction with periods of sobriety especially at work but eventually she was asked to leave her job. This fuelled her downward spiral into the deeper addiction bringing her literally to the streets. “Once my husband even found me begging on the street,” says Karma Pem. After trying to cope with her bouts of drunkenness, Karma’s husband left her taking their boys away from the mother. “My mother stood by me as a pillar. She never once abandoned me, no matter what I did. She contacted RENEW to find a solution to my addiction. Through them, she found a de-addiction centre in India. She persuaded me to go there and get enrolled. My mother’s persistent efforts brought me back from the brink of personal annihilation.” adds Karma. Out of her four sons and two of them are recovering addicts. Her own recovery prompted Karma to motivate her sons to go through rehabilitation and pursue their studies. One of her sons is an upcoming football player. Today, Karma has been clean for about seven years. She is determined to rebuild her life and take control of her destiny. Today she is employed in RENEW’s livelihood’s centre

Community health worker provide information and counselling on contraception
story

| 11 January 2017

Meeting the unmet need for contraceptives

Rashida, a young 23-year-old woman, hails from a remote village in Barisal, Bangladesh. Barisal and its neighbouring areas are near the sea shore where one has to live with the constantly changing shoreline and increasing water levels. The search for high ground drives the villagers further inland increasing their remoteness and isolation. Every year Rashida’s village is cut-off for months during the monsoons, making it even more difficult for her access healthcare and other services. As a mother to two young children, she doesn’t want another pregnancy. “Between my household chores and taking care of these two feisty children, I have very little time left for anything else”, says Rashida. While she needs to use contraceptives, she isn’t able to take time out for a long trek to the nearest health centre. Recognising the needs of women of reproductive age like Rashida, Family Planning Association of Bangladesh (FPAB) conducts outreach camps in remote and hard to reach areas, where sexual and reproductive healthcare services such as antenatal checkups, contraceptive provision and other related services are offered. Such camps most often than not mean the difference between planned pregnancies as opposed to unintended ones. At these camps, the Reproductive Health Promoter (RHP) who is the community health worker of FPAB, provides information and counselling on contraception and birth spacing. The RHP is supported by a paramedic and a medical officer for service delivery. It was in one such camp that Rashida opted for an injectable contraceptive. “I finally have the freedom and means to choose if I want another child or not”, says Rashida with a big smile.

Community health worker provide information and counselling on contraception
story

| 25 June 2022

Meeting the unmet need for contraceptives

Rashida, a young 23-year-old woman, hails from a remote village in Barisal, Bangladesh. Barisal and its neighbouring areas are near the sea shore where one has to live with the constantly changing shoreline and increasing water levels. The search for high ground drives the villagers further inland increasing their remoteness and isolation. Every year Rashida’s village is cut-off for months during the monsoons, making it even more difficult for her access healthcare and other services. As a mother to two young children, she doesn’t want another pregnancy. “Between my household chores and taking care of these two feisty children, I have very little time left for anything else”, says Rashida. While she needs to use contraceptives, she isn’t able to take time out for a long trek to the nearest health centre. Recognising the needs of women of reproductive age like Rashida, Family Planning Association of Bangladesh (FPAB) conducts outreach camps in remote and hard to reach areas, where sexual and reproductive healthcare services such as antenatal checkups, contraceptive provision and other related services are offered. Such camps most often than not mean the difference between planned pregnancies as opposed to unintended ones. At these camps, the Reproductive Health Promoter (RHP) who is the community health worker of FPAB, provides information and counselling on contraception and birth spacing. The RHP is supported by a paramedic and a medical officer for service delivery. It was in one such camp that Rashida opted for an injectable contraceptive. “I finally have the freedom and means to choose if I want another child or not”, says Rashida with a big smile.

 "Stigma, myths and cultural practices can have a damaging effect on sexual  health, family planning and women’s rights"
story

| 11 August 2017

How cultural traditions affect women’s health

High up in the mountains of central northern Nepal, not far from the Tibetan border, lies the  district of Rasuwa. The people here are  mainly ethnic Tamang and Sherpa, two indigenous  groups with cultural traditions stretching back centuries But these rich cultural traditions can come hand-in-hand with severe social problems,  compounded by entrenched poverty and very low literacy rates.  Binu Koraila is a health facility mentor for the Family Planning Association of Nepal (FPAN)  in Rasuwa. "Stigma, myths and cultural practices can have a damaging effect on sexual  health, family planning and women’s rights", she says.  Misconceptions about contraception are widespread. “People think the intrauterine coil will  go into the brain or will fall out. They think the contraceptive implant will penetrate into the  muscles.” Funeral rites present another problem. “Men who want a vasectomy need permission from their parents,” she explains. “But it’s thought that men who have had vasectomies won’t be able to perform the rituals after their parent’s death: parents think that God won’t accept that, so they don’t allow men to have vasectomies.” The culture here is strongly patriarchal. Among the Tamang, marriage involves boys or men picking out young girls from their communities.Early and forced marriage is widespread among the Tamang. If chosen, the girls have no choice but to get married. “If a boy likes a girl, they can just snatch them and take them to their house,” Binu says. Some girls are as young as 13 years old. “The girls don’t know enough about family planning, so there is a lot of teenage pregnancy.” Early marriage and teenage pregnancy can create all kinds of physical, emotional, social and economic problems for girls and their families. For many, their bodies are not well developed enough for childbirth, and maternal mortality remains a major problem in Nepal, at 258 deaths per 100,000 live births, according to UNFPA data. Their large families also suffer because there is not enough food and money to go around. “Women are the worst affected,” Binu says. Parents and husbands keep strict control of women’s access to contraception. “If they want to use contraception, women tend to need consent from their parents or husbands. “I have seen cases where if a woman gets contraceptive implant services, they get beaten by their father-in-law and husband. One woman asked to have her implant removed because she had been beaten by her husband.” Binu’s role is to deliver sexual health and family planning advice and services to villages across Rasuwa district: “I go to remote places, where people are marginalised and don’t know about family planning.” She also trains government health workers on family planning, and mentors them after they return from training in Kathmandu to Rasuwa. As well as delivering health services, the FPAN team have been working hard to change perceptions. “Recently we had a health camp at Gatland,” she explains. "After two hours of counselling one client requested an IUD. After months there was a rumour in Gatlang that her coil had fallen out. The FPAN volunteer went to the woman’s house and asked if this was true. She said, ‘No, I’m really comfortable with that service.’ After that, the client went door to door and told others how happy she was with it and that they should take it at the next family planning camp. “After four or five months, we went back to the Gatlang camp and at that time another eight women took the IUD.” These numbers might seem small but they are far less so when viewed against the wall of stigma and myth that can obstruct contraception use here, as in so many rural areas of Nepal. The involvement of committed, passionate health mentors and volunteers is vital to show people how important it is to take sexual health and family planning seriously: the benefits are felt not just by women and their families, but by entire communities.

 "Stigma, myths and cultural practices can have a damaging effect on sexual  health, family planning and women’s rights"
story

| 25 June 2022

How cultural traditions affect women’s health

High up in the mountains of central northern Nepal, not far from the Tibetan border, lies the  district of Rasuwa. The people here are  mainly ethnic Tamang and Sherpa, two indigenous  groups with cultural traditions stretching back centuries But these rich cultural traditions can come hand-in-hand with severe social problems,  compounded by entrenched poverty and very low literacy rates.  Binu Koraila is a health facility mentor for the Family Planning Association of Nepal (FPAN)  in Rasuwa. "Stigma, myths and cultural practices can have a damaging effect on sexual  health, family planning and women’s rights", she says.  Misconceptions about contraception are widespread. “People think the intrauterine coil will  go into the brain or will fall out. They think the contraceptive implant will penetrate into the  muscles.” Funeral rites present another problem. “Men who want a vasectomy need permission from their parents,” she explains. “But it’s thought that men who have had vasectomies won’t be able to perform the rituals after their parent’s death: parents think that God won’t accept that, so they don’t allow men to have vasectomies.” The culture here is strongly patriarchal. Among the Tamang, marriage involves boys or men picking out young girls from their communities.Early and forced marriage is widespread among the Tamang. If chosen, the girls have no choice but to get married. “If a boy likes a girl, they can just snatch them and take them to their house,” Binu says. Some girls are as young as 13 years old. “The girls don’t know enough about family planning, so there is a lot of teenage pregnancy.” Early marriage and teenage pregnancy can create all kinds of physical, emotional, social and economic problems for girls and their families. For many, their bodies are not well developed enough for childbirth, and maternal mortality remains a major problem in Nepal, at 258 deaths per 100,000 live births, according to UNFPA data. Their large families also suffer because there is not enough food and money to go around. “Women are the worst affected,” Binu says. Parents and husbands keep strict control of women’s access to contraception. “If they want to use contraception, women tend to need consent from their parents or husbands. “I have seen cases where if a woman gets contraceptive implant services, they get beaten by their father-in-law and husband. One woman asked to have her implant removed because she had been beaten by her husband.” Binu’s role is to deliver sexual health and family planning advice and services to villages across Rasuwa district: “I go to remote places, where people are marginalised and don’t know about family planning.” She also trains government health workers on family planning, and mentors them after they return from training in Kathmandu to Rasuwa. As well as delivering health services, the FPAN team have been working hard to change perceptions. “Recently we had a health camp at Gatland,” she explains. "After two hours of counselling one client requested an IUD. After months there was a rumour in Gatlang that her coil had fallen out. The FPAN volunteer went to the woman’s house and asked if this was true. She said, ‘No, I’m really comfortable with that service.’ After that, the client went door to door and told others how happy she was with it and that they should take it at the next family planning camp. “After four or five months, we went back to the Gatlang camp and at that time another eight women took the IUD.” These numbers might seem small but they are far less so when viewed against the wall of stigma and myth that can obstruct contraception use here, as in so many rural areas of Nepal. The involvement of committed, passionate health mentors and volunteers is vital to show people how important it is to take sexual health and family planning seriously: the benefits are felt not just by women and their families, but by entire communities.

Waiting for an ambulance that never arrives: childbirth without medical help in rural Nepal
story

| 11 August 2017

Waiting for an ambulance that never arrives: childbirth without medical help in rural Nepal

 “When I was about to give birth, we called for an ambulance or a vehicle to help but even after five hours of calling, no vehicle arrived,” recalls 32-year-old Mona Shrestha. “The birth was difficult. For five hours I had to suffer from delivery complications.” Mona’s story is a familiar one for women in rural Nepal. Like thousands of women across the country, she lives in a small, remote village, at the end of a winding, potholed road. There are no permanent medical facilities or staff based in the village of Bakultar: medical camps occasionally arrive to dispense services, but they are few and far between. Life here is tough. The main livelihood is farming: both men and women toil in the fields during the day, and in the mornings and evenings, women take care of their children and carry out household chores. The nearest birthing centre is an hour’s drive away. Few families can afford to rent a seat in a car, and so are forced to do the journey on foot. For pregnant women walking in the searing heat, this journey can be arduous, even life-threatening. “Fifteen years ago, there was a woman who helped women give birth here, but she’s no longer here,” Mona says. “It’s difficult for women.” Giving birth without medical help can cause severe problems for women and babies, and even death. Infant mortality remains a major problem in Nepal, and maternal mortality is one of the leading causes of death among women. Only 36% of births are attended by a doctor, nurse or midwife.  A traumatic birth can cause long-term physical, psychological, social and economic problems from which women might never recover. Access to contraception and other family planning services, too, involves walking miles to the nearest health clinic. Mona says she used to use the contraceptive injection, but now uses an intrauterine device. Like many villages in Nepal, Bakultar is awash with myths and gossip about the side-effects of contraception. “There are so many side effects to these devices – I’ve heard the coil can cause cancer,” Mona says. “This is why we want to have permanent family planning like sterilisation, for both men and women.” These complaints heard frequently in villages like Bakultar. As well as access to facilities and contraception, people here desperately need access to education on contraception and sexual health and reproductive rights. Misinformation as well as a lack of information are both major problems. “It would be really helpful to have family planning services nearby,” says Mona.

Waiting for an ambulance that never arrives: childbirth without medical help in rural Nepal
story

| 25 June 2022

Waiting for an ambulance that never arrives: childbirth without medical help in rural Nepal

 “When I was about to give birth, we called for an ambulance or a vehicle to help but even after five hours of calling, no vehicle arrived,” recalls 32-year-old Mona Shrestha. “The birth was difficult. For five hours I had to suffer from delivery complications.” Mona’s story is a familiar one for women in rural Nepal. Like thousands of women across the country, she lives in a small, remote village, at the end of a winding, potholed road. There are no permanent medical facilities or staff based in the village of Bakultar: medical camps occasionally arrive to dispense services, but they are few and far between. Life here is tough. The main livelihood is farming: both men and women toil in the fields during the day, and in the mornings and evenings, women take care of their children and carry out household chores. The nearest birthing centre is an hour’s drive away. Few families can afford to rent a seat in a car, and so are forced to do the journey on foot. For pregnant women walking in the searing heat, this journey can be arduous, even life-threatening. “Fifteen years ago, there was a woman who helped women give birth here, but she’s no longer here,” Mona says. “It’s difficult for women.” Giving birth without medical help can cause severe problems for women and babies, and even death. Infant mortality remains a major problem in Nepal, and maternal mortality is one of the leading causes of death among women. Only 36% of births are attended by a doctor, nurse or midwife.  A traumatic birth can cause long-term physical, psychological, social and economic problems from which women might never recover. Access to contraception and other family planning services, too, involves walking miles to the nearest health clinic. Mona says she used to use the contraceptive injection, but now uses an intrauterine device. Like many villages in Nepal, Bakultar is awash with myths and gossip about the side-effects of contraception. “There are so many side effects to these devices – I’ve heard the coil can cause cancer,” Mona says. “This is why we want to have permanent family planning like sterilisation, for both men and women.” These complaints heard frequently in villages like Bakultar. As well as access to facilities and contraception, people here desperately need access to education on contraception and sexual health and reproductive rights. Misinformation as well as a lack of information are both major problems. “It would be really helpful to have family planning services nearby,” says Mona.

Non-governmental organisation in Maldives establishes a family planning clinic
story

| 11 January 2017

Helping families bond together

Mariyam a 25-year-old woman, who lived in Addu Atoll in Maldives, was having a battle of wits with Ahmed, her young three year old. He threw temper tantrums and just couldn’t be disciplined. Thankfully, one day Mariyam attended a session on better parenting skills organised by Society of Health & Education (SHE). SHE was the first non-governmental organisation in Maldives to establish a family planning clinic where couples could get information, education and counselling to plan their families. It also provides psycho-social support and counselling to children and adults. Through various approaches such as play therapy, children as well as adults are helped to develop life skills and cope with the grief, anger, anguish and possible abuse in their life. During the session on parenting, Mariyam requested for help in dealing with Ahmed. Thereafter through extended telephonic counselling sessions; it was revealed that Mariyam was currently pregnant with her fourth child. Her husband worked away from home and visited occasionally during holidays. Her pregnancy, combined with childcare needs at home, was taking a toll on Mariyam, making her feel weak and irritable, even overwhelmed at times. Understanding this, the counsellor suggested that she set aside a time to play with her son every day. When Mariyam put it into practice, she discovered that all her son wanted from her was some attention. The counsellor then helped her and her husband explore different family planning options when her husband came visiting the household. Together they decided to adopt a family planning option once Mariyam had delivered. He also decided to stay on the island for a few months and work at his father’s carpentry in order to help his wife to look after the children post-delivery. The couple visited SHE clinic for counselling on contraceptives post delivery and Mariyam has been a client ever since.

Non-governmental organisation in Maldives establishes a family planning clinic
story

| 25 June 2022

Helping families bond together

Mariyam a 25-year-old woman, who lived in Addu Atoll in Maldives, was having a battle of wits with Ahmed, her young three year old. He threw temper tantrums and just couldn’t be disciplined. Thankfully, one day Mariyam attended a session on better parenting skills organised by Society of Health & Education (SHE). SHE was the first non-governmental organisation in Maldives to establish a family planning clinic where couples could get information, education and counselling to plan their families. It also provides psycho-social support and counselling to children and adults. Through various approaches such as play therapy, children as well as adults are helped to develop life skills and cope with the grief, anger, anguish and possible abuse in their life. During the session on parenting, Mariyam requested for help in dealing with Ahmed. Thereafter through extended telephonic counselling sessions; it was revealed that Mariyam was currently pregnant with her fourth child. Her husband worked away from home and visited occasionally during holidays. Her pregnancy, combined with childcare needs at home, was taking a toll on Mariyam, making her feel weak and irritable, even overwhelmed at times. Understanding this, the counsellor suggested that she set aside a time to play with her son every day. When Mariyam put it into practice, she discovered that all her son wanted from her was some attention. The counsellor then helped her and her husband explore different family planning options when her husband came visiting the household. Together they decided to adopt a family planning option once Mariyam had delivered. He also decided to stay on the island for a few months and work at his father’s carpentry in order to help his wife to look after the children post-delivery. The couple visited SHE clinic for counselling on contraceptives post delivery and Mariyam has been a client ever since.

Women’s collective pools money and resources to get a clinic in their area.
story

| 11 January 2017

Changing lives across generations

Indumati, her (now departed) mother-in-law and her three daughters-in-law represent three generations of women in Maharashtra, India who have benefitted from the services of Family Planning Association of India. All three generations have been a part of women’s collectives’ movement encouraging women to participate in the socio-economic life of the family and community. Becoming a member of the women’s collectives helped Indumati to step beyond the boundaries of her home and begin participating in the community life of the village. Be it cleanliness drives in the village or celebrating all festivals with equal fervour created spaces for the women to contribute to the social wellbeing of the village. The next stop was micro-savings for economic independence. When the women realised that the women of their and neighbouring villages don’t have any healthcare services, they approached Family Planning Association of India (FPAI) to start a clinic in their area. When FPAI agreed the women’s group pooled money and contributed towards the building of the clinic. With increased access to healthcare services came increased awareness. Most women’s group imparted training on SRHR to the collective members. Some collective members even began to stock the contraceptives provided by FPAI so that women could access them in privacy and confidentiality. Indumati has three sons and one daughter. Each of her three sons has two children each. Her daughters-in-law were able to get information and adopted family planning methods due to her involvement with the women’s collectives. The inter-generational impact of access to family planning services is clearly visible in her household.

Women’s collective pools money and resources to get a clinic in their area.
story

| 25 June 2022

Changing lives across generations

Indumati, her (now departed) mother-in-law and her three daughters-in-law represent three generations of women in Maharashtra, India who have benefitted from the services of Family Planning Association of India. All three generations have been a part of women’s collectives’ movement encouraging women to participate in the socio-economic life of the family and community. Becoming a member of the women’s collectives helped Indumati to step beyond the boundaries of her home and begin participating in the community life of the village. Be it cleanliness drives in the village or celebrating all festivals with equal fervour created spaces for the women to contribute to the social wellbeing of the village. The next stop was micro-savings for economic independence. When the women realised that the women of their and neighbouring villages don’t have any healthcare services, they approached Family Planning Association of India (FPAI) to start a clinic in their area. When FPAI agreed the women’s group pooled money and contributed towards the building of the clinic. With increased access to healthcare services came increased awareness. Most women’s group imparted training on SRHR to the collective members. Some collective members even began to stock the contraceptives provided by FPAI so that women could access them in privacy and confidentiality. Indumati has three sons and one daughter. Each of her three sons has two children each. Her daughters-in-law were able to get information and adopted family planning methods due to her involvement with the women’s collectives. The inter-generational impact of access to family planning services is clearly visible in her household.

Karma Pem’s Story
story

| 11 January 2017

Reconstructing life after de-addiction

Karma Pem, a mother of four boys, had the world on a silver platter till it lost it all and found it again after blood, sweat and tears. She had a cushy job in the Ministry of External Affairs in Thimphu, Bhutan. When dignitaries from other countries visited the Royal Kingdom of Bhutan, Karma would be a part of the team assigned to them. Yet due to her addiction to alcohol, she has been to her personal hell and back. She spent considerable years of her life in an alcoholic stupor. Initially, she tried to manage her addiction with periods of sobriety especially at work but eventually she was asked to leave her job. This fuelled her downward spiral into the deeper addiction bringing her literally to the streets. “Once my husband even found me begging on the street,” says Karma Pem. After trying to cope with her bouts of drunkenness, Karma’s husband left her taking their boys away from the mother. “My mother stood by me as a pillar. She never once abandoned me, no matter what I did. She contacted RENEW to find a solution to my addiction. Through them, she found a de-addiction centre in India. She persuaded me to go there and get enrolled. My mother’s persistent efforts brought me back from the brink of personal annihilation.” adds Karma. Out of her four sons and two of them are recovering addicts. Her own recovery prompted Karma to motivate her sons to go through rehabilitation and pursue their studies. One of her sons is an upcoming football player. Today, Karma has been clean for about seven years. She is determined to rebuild her life and take control of her destiny. Today she is employed in RENEW’s livelihood’s centre

Karma Pem’s Story
story

| 25 June 2022

Reconstructing life after de-addiction

Karma Pem, a mother of four boys, had the world on a silver platter till it lost it all and found it again after blood, sweat and tears. She had a cushy job in the Ministry of External Affairs in Thimphu, Bhutan. When dignitaries from other countries visited the Royal Kingdom of Bhutan, Karma would be a part of the team assigned to them. Yet due to her addiction to alcohol, she has been to her personal hell and back. She spent considerable years of her life in an alcoholic stupor. Initially, she tried to manage her addiction with periods of sobriety especially at work but eventually she was asked to leave her job. This fuelled her downward spiral into the deeper addiction bringing her literally to the streets. “Once my husband even found me begging on the street,” says Karma Pem. After trying to cope with her bouts of drunkenness, Karma’s husband left her taking their boys away from the mother. “My mother stood by me as a pillar. She never once abandoned me, no matter what I did. She contacted RENEW to find a solution to my addiction. Through them, she found a de-addiction centre in India. She persuaded me to go there and get enrolled. My mother’s persistent efforts brought me back from the brink of personal annihilation.” adds Karma. Out of her four sons and two of them are recovering addicts. Her own recovery prompted Karma to motivate her sons to go through rehabilitation and pursue their studies. One of her sons is an upcoming football player. Today, Karma has been clean for about seven years. She is determined to rebuild her life and take control of her destiny. Today she is employed in RENEW’s livelihood’s centre

Community health worker provide information and counselling on contraception
story

| 11 January 2017

Meeting the unmet need for contraceptives

Rashida, a young 23-year-old woman, hails from a remote village in Barisal, Bangladesh. Barisal and its neighbouring areas are near the sea shore where one has to live with the constantly changing shoreline and increasing water levels. The search for high ground drives the villagers further inland increasing their remoteness and isolation. Every year Rashida’s village is cut-off for months during the monsoons, making it even more difficult for her access healthcare and other services. As a mother to two young children, she doesn’t want another pregnancy. “Between my household chores and taking care of these two feisty children, I have very little time left for anything else”, says Rashida. While she needs to use contraceptives, she isn’t able to take time out for a long trek to the nearest health centre. Recognising the needs of women of reproductive age like Rashida, Family Planning Association of Bangladesh (FPAB) conducts outreach camps in remote and hard to reach areas, where sexual and reproductive healthcare services such as antenatal checkups, contraceptive provision and other related services are offered. Such camps most often than not mean the difference between planned pregnancies as opposed to unintended ones. At these camps, the Reproductive Health Promoter (RHP) who is the community health worker of FPAB, provides information and counselling on contraception and birth spacing. The RHP is supported by a paramedic and a medical officer for service delivery. It was in one such camp that Rashida opted for an injectable contraceptive. “I finally have the freedom and means to choose if I want another child or not”, says Rashida with a big smile.

Community health worker provide information and counselling on contraception
story

| 25 June 2022

Meeting the unmet need for contraceptives

Rashida, a young 23-year-old woman, hails from a remote village in Barisal, Bangladesh. Barisal and its neighbouring areas are near the sea shore where one has to live with the constantly changing shoreline and increasing water levels. The search for high ground drives the villagers further inland increasing their remoteness and isolation. Every year Rashida’s village is cut-off for months during the monsoons, making it even more difficult for her access healthcare and other services. As a mother to two young children, she doesn’t want another pregnancy. “Between my household chores and taking care of these two feisty children, I have very little time left for anything else”, says Rashida. While she needs to use contraceptives, she isn’t able to take time out for a long trek to the nearest health centre. Recognising the needs of women of reproductive age like Rashida, Family Planning Association of Bangladesh (FPAB) conducts outreach camps in remote and hard to reach areas, where sexual and reproductive healthcare services such as antenatal checkups, contraceptive provision and other related services are offered. Such camps most often than not mean the difference between planned pregnancies as opposed to unintended ones. At these camps, the Reproductive Health Promoter (RHP) who is the community health worker of FPAB, provides information and counselling on contraception and birth spacing. The RHP is supported by a paramedic and a medical officer for service delivery. It was in one such camp that Rashida opted for an injectable contraceptive. “I finally have the freedom and means to choose if I want another child or not”, says Rashida with a big smile.