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| Even the youngest in Lalit's village wanted to hear about family planning |
On our first day at Manma hospital, I was introduced to the District Health officer (DHO) and formally asked permission to undertake the health needs assessment (the formality of the occasion being somewhat out of sync with our surroundings). The idea is to gain a detailed insight into the family planning use and potential unmet need of the locals in Kalikot district.
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| Dr Kate and Lalit meet with Manma DHO |
We divided into groups (family carefully divided to avoid family feuds!), each with a translator, either Lalit or Maghraj, and set to work in the hospital. Patients and relatives were asked if they would participate in a questionnaire, using Nepalese wording that they would understand.
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| Carrying out our interviews in Manma Hospital with Lalit acting as translator, Christine as interrogator and Chris as scribe. |
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This man was lucky enough to "naturally" have a 3 year gap in between each child...
We did wonder if his wife hadn't had a slight influence on that... |
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| Kate and Maghraj interviewing a health worker in Manma hospital |
Over a few days we interviewed about 100 men and women form all reproductive age groups. When we got to Lalit’s village, people were so intrigued and keen that we had to rope off an area for crowd control! I am relatively used to the lack of personal space in Nepal, but even for me it was overwhelming and at times intimidating.
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| This couple told us that had they known about family planning, they would not have had 10 children |
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| Maghraj trying to cordon off the inquisitive crowds, a lot of enthusiasm for family planning in Lalit's village! |
Most women came with a small baby on their back and the hoards of children were a sure sign of little or poor family planning. Sadly, the general impression is that couples use little or no family planning, and often far too late; in many cases after more than 10 pregnancies and significant infant mortality.
We encountered so many misconceptions about side-effects, and after interviewing many health workers realised this is likely due to lack of training of the healthcare providers.
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| Trying to get privacy in Lalit's village was, to say the least, trying... |
Gathering the data allowed us a unique insight into the mindset of the Nepalese. The huge number of clamouring children left us exhausted and overwhelmed. Certainly the need for improved services can be in no doubt, and I am pleased that the team was able to see this for themselves.
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| Was it the white faces or the family planning that attracted the crowds, we don't know but the interviews got done! |
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