Celebrating Female Community Health Volunteers

female community health volunteers in Nepal

In their striking blue and red uniforms, Nepal’s 50,000 Female Community Health Volunteers (FCGVs) are a familiar, trusted force on the frontline of family planning and maternal and child health services.

An inspiring example of the power of volunteering to build solidarity and inclusion, FIGO has been proud to partner with the FCHV programme as part of our pospartum intrauterine device (IUD) initiative in Nepal.

With a small monthly allowance given through the FCHV programme, volunteers organise regular mothers group meetings across their community, and provide comprehensive counselling. Although the retirement age is supposed to be 60, many have volunteered for decades - and continue to stay active.  

In partnership with National Member Society NESOG (Nepal Society Of Obstetricians and Gynaecologists), FIGO formally engaged with FCHVs in support of the Nepalese government’s pledge to extend family planning access across the country.

On a recent project visit to Kerabari Birthing Centre, we met Sabitra Chapagainm who has worked as an FCHV for more than 25 years:

“Women here have many problems. Some have unwanted pregnancies and want to have an abortion, but they are too shy to share the news. This leads to complications, with many women losing their lives.

Equally, in some communities women who get pregnant before marriage are not accepted, and so the girl is afraid. We FCHVs encourage all the girls and women in our communities to talk to us about these kinds of problems, and assure them that confidentiality would be maintained. We also teach them about various family planning methods in order to avoid abortion.

We visit each pregnant woman in the community at least four times, in order to make sure that she is healthy and eating a healthy diet. We go on repeat postnatal follow up visits, and support mothers with breastfeeding if they are able.

Our work can be life-saving. Initially when we started, I remember the rate of neonatal deaths was high, two or three babies each month. Recently we have had no record of maternal and neonatal death.

FCHVs have such strong community ties that they are often engaged to support other programmes – as with FIGO’s postpartum family project project, beginning with a pilot collaboration in Morang, Province 1.

They have made an extraordinary contribution to the project in Nepal, helping more women to make the contraceptive choice that is right for them, and building sustainability going forward.

Asked why postpartum IUD counselling and insertion is a valuable addition to family planning options in her community, Sabitra explained:

“Everyone has liked the postpartum IUD project. The best part is that an IUD can be inserted within 10 minutes immediately after delivery. Some women in our community have already had one inserted and many will have it re-insert after the delivery of their baby.

The most important part of the method is that for the women who do not want to have any more babies, they can use it confidently and relax for up to 12 years.”

At the recent Nairobi Summit, FIGO reaffirmed our commitment to sexual and reproductive health as a part of universal health coverage (UHC). We know that increasing access to quality, rights-based contraceptive care is essential for empowering women to make informed decisions about their sexual and reproductive health, and has a direct impact on the reduction of maternal mortality.

We also know that the challenges women face in achieving quality of care are not ‘OBGYN problems’ – they are challenges we must tackle together.

Putting local partnerships at the heart of our postpartum family planning work is having a long-term impact, and contributing directly to Sustainable Development Goal 3.7, while volunteering can help build a more equitable, inclusive world. As Sabitra explained,

“Everyone views us with respect and we really feel proud of this. In my 26 years of the volunteering I never felt low or bad ever. Our community trusts us fully, and because of this they even call us at midnight, giving us every opportunity to serve.”

FIGO is grateful to all our partners for their expertise and commitment. We celebrate Sabitra, alongside her colleagues, and the role we all have to play in ensuring every woman’s active participation in their own health and rights.

To learn more about FIGO’s commitment, read our response to the Nairobi Summit here.