1.”Strengthening the primary health care system and community health services damaged by the earthquake project in Sindhupalchok District, Nepal”

This project which has duration from February 2016 to January 2018, has been implemented in 23 VDCs of Sindhupalchok district by CDECF for which financial as well as technical support has been provided by MdM-France. MoU of the project was signed on Aug 16, 2016. During starting days of the project, activities were carried out in slow pace, as it took time in getting approval from National Reconstruction Authority and Social Welfare Council. After the approval, project has good take off from May to Dec 2016.

The overall objective of the project is to improve the health system disaster resilience and strengthen community physical and mental health services for this project has been intervening at community as well as health facility level. Project is conducting all of its activities in a close coordination with local women cooperative and governmental health facilities. Project community facilitator conducts a regular health education class in to the mother group meeting in a monthly basis. Monthly women group meeting is organized not only for saving and credit activities but also to deliver health related message. Various classes have been delivering in meeting in to all wards of each VDC. Sessions are more focused on the SRH, GBV, WASH, psychosocial and financial literacy related issues. Reproductive health, WASH, DRR, Psychosocial support and Micro-finance are the major component of the project. To improve RH, ANM as well as CF will conduct awareness session on RH related issues on regular basis. Similarly, PSO provide counseling service as well as conduct school and community level awareness program to improve psychosocial wellbeing. To improve status of WASH, intensive activities are being carried out at 2 VDCs where activities like awareness program on WASH, support in toilet construction and repairing and rehabilitation of drinking water schemes are being carried out. To improve disaster resilience capacity of community people, disaster risk reduction activities with the major focus on LDRMP is being carried out in 4 VDC of the district. To improve service delivery by health facilities, different types of trainings, equipment and logistic support, on the job training, supportive supervision, building, repairing and maintenance of HF buildings, etc. has been carried out by the project. Project MFO provides regular support to the women cooperative smooth operation of the Cooperatives which is center for women empowerment. To strengthen Cooperatives, initiation has been taken for their sustainability. To make cooperatives sustainable, project is giving efforts to empower umbrella organizations of Cooperatives. Cooperative is also center for OEF. Cooperative member can receive loan at lower interest of receive money from OEF which will ultimately reduce delay in seeking and reaching care. Rs. 60, 000 rupees as an Obstetric Emergency Fund in to all target VDCs is another innovative stimulus from project side. Prospect of OEF is to limit the number of maternal and

neonatal deaths that has been happening as a result of economic constraints. On the other hand most of maternal and neonatal death occurs as a result of lack of family interest to go to health facility if a complication arise during pregnancy and post natal period. All the women member of cooperative are eligible to get the OEF services but the service is available only those women who suffer from pregnancy related complication. One should have to be a member of women cooperative to get the OEF service. This is only because to create a motive among women to be involved in to the women cooperatives. Together with OEF issue of FCHV fund as well as birth preparedness is always highlighted in the center awareness sessions. Those who are not eligible to use OEF, can get help from FCHV fund as 25% of FCHV fund is for issuing loan in case of emergency situation. Use of OEF is good sign that people are being aware to go to HF for delivery but it also shows the couple were not prepared for child birth. Therefore, those couple who can arrange the money by themselves are motivated for birth preparedness rather than using OEF and needy people who cannot arrange the money, OEF can help them in need.