Responding to reproductive health needs: a participatory approach for analysis and action

This guide from the Lessons From the Field series outlines two training workshops held in Nepal in 1997-98 to help NGO staff understand health from a gender sensitive point of view, analyze current reproductive health (RH) activities, use participatory tools, and develop realistic action plans. The training programme was based on a community-based needs assessment in the Ramechhap, Sindhupalchowk and Kavre districts, aimed at gaining knowledge of some of the RH and gender issues and concerns of women in the communities. Among the service-related reproductive health issues the following stood out: women were not accessing prenatal care and assisted delivery leading to increased maternal and infant morbidity and mortality; women wished to limit family size; unsafe abortion methods; prolapse was a common health problem in all communities visited along with reproductive and urinary tract infections; HIV a growing concern. This was all seen in a gender perspective and it was found that women had low status and constrained gender roles, there were problems with domestic violence and trafficking of girls and women. In order to address outcomes of the assessment the organisation World Neighbors developed a program strategy for training and supporting a team of experienced health workers. The aim of the programme was to enable participants understanding and discussion of RH from a gender perspective; describe and analyze their current activities in terms of a RH/gender approach and identify possible strategies; gain skills in the use of participatory tools and analysis; and develop an action plan. The guide goes through all the methods used in the training workshops in an easy-access manner and includes 15 practical exercises.