Since female Community Health Volunteers (FCHVs) are the ‘pillars of Nepal’s public health programmes’, would it not be feasible for them to also become advocates for WaSH? With a reported total of 48,604 FCHVs working across the country as change agents for health within their communities, adding WaSH to their remit could make a lot of sense.
Female Community Health Volunteers
With support from health institutions, FCHVs actively work to promote safe motherhood, child health, including immunisation, family planning and several other basic health services. Their role is also a practical one; distributing items such as condoms, ORS packets, vitamin A capsules and oral polio vaccines, as well as administering iron tablets to pregnant women. In addition, FCHVs are responsible for treating pneumonia cases, (referring complex cases on to health institutions).
While WaSH related diseases remain the biggest cause of morbidity and mortality in Nepal, hygiene promotion at a local level is vital. Might these FCHVs, fully trained by the health sector, also offer great potential in the promotion and changing of hygiene behaviour at a local level?
An excellent example of involving FCHVs in WaSH social mobilisation is a project in Sindhuli, Kamalamai; a WaterAid in Nepal project, implemented by our partner CIUD. Since extending their remit to WaSH, these FCHVs have successfully influenced numerous positive hygiene related behaviour changes within their communities.
The benefits of involving FCHVs in WaSH are plentiful. FCHVs are often already known within their communities as effective mobilisers; they are also familiar with local social norms and values and as such are more easily able to influence changes in hygiene behaviour. Living within the community themselves, FCHVs are then able to monitor these new hygiene practices. Enabling and empowering these FCHVs in WaSH related projects then, would surely be a sustainable way of retaining trained personnel at local level.
Given this potential, how do we move forward strategically? I propose that those in the health and WaSH sector in Nepal ask ourselves the following questions:
1. Do we recruit volunteers to promote hygiene at a local level or do we make use of existing FCHVs in a community?
2. Do we use existing FCHVs as change agents in society by engaging them in the promotion of WaSH?
3. Can we strengthen the capacity of the FCHVs by providing them with WaSH related training so that they can become advocates for sanitation and hygiene promotion within each ward of the village/municipality?
4. Do we mobilise FCHVs in making their communities open-defecation-free?
Written by Om Prasad Gautam, Social Development Adviser, WaterAid in Nepal