Details
Binita Shahi* is a young mother living Kalikot, in the remote and mountainous Karnali Province in Western Nepal. Poverty, limited access to healthcare, education, and poor infrastructure are some of the many challenges faced in the region. In addition, caste, ethnic and gender inequalities, and deeply patriarchal structures have contributed to many women and girls being unable to achieve optimal health. Child marriage is still commonly practiced in Kalikot, where nearly 40% of girls aged 15-19 are already married. HealthBridge is working in this region with our partner International Nepal Fellowship (INF) to improve sexual and reproductive health outcomes in the community.
Binita is now 19 years old, married, and has a baby. Her parents are illiterate and poor and they could not afford the luxury of educating her above grade 8. Instead, as the eldest daughter, she had to support her family in household chores. Binita didn't understand the concept of child marriage. She recalls,
"I didn't know what marriage was. My parents told me that I didn't have to go to school anymore and found a groom who would keep me happy. They promised me new clothes and ornaments. No one told me it wasn't the right time to get married."
Within a year of her marriage, she became pregnant and gave birth to a child who is now 10 months old. Since her wedding, Binita lives in a joint family with her mother-in-law, siblings-in-law, husband, and her child. As the only daughter-in-law, she has many responsibilities, including household chores and farming. After her marriage, Binita’s life revolved around her family, and she became isolated from society, shy, and afraid of social events. She lacked the confidence to participate in group discussions and other social activities, fearing judgment from others.
During her pregnancy, she heard about the Mothers Group. These meetings are organized in the local community on a monthly basis by Female Community Health Volunteers (FCHVs) to educate pregnant women and new mothers on best practices to maintain their own and their child’s health. Binita’s mother-in-law was not supportive, and Binita was too shy to insist on participating herself. During her pregnancy, Binita did not attend any antenatal care checkups at the health center and she did not take the necessary iron, folic acid and calcium supplements recommended for pregnant women. She was also not afforded any special food or meals and ate the same regular diet as the rest of her family members. Finally, during her ninth month of pregnancy, Binita went to the health center when she experienced labor pains. She delivered her child at Pankha Birthing Center, Ward No. 9, where her baby was born with a low birth weight, weighing only 1800 grams. Afterwards, Binita did not receive counselling on how to properly care for an infant, and her baby often fell ill due to lack of proper care and nutrition.
One day, the local INF community facilitator, Ms. Kalpana Pokhrel, visited Binita's house and noticed the unhealthy child. INF staff had the opportunity to observe the condition of Binita's daughter and they concluded that the child was malnourished. The staff counseled Binita and her in-laws to visit the nearby health center. After the health worker examined the child, they explained that the baby was underweight due to a lack of nutritious food and care for Binita during her pregnancy. The health worker provided supplemental food in the form of ready-to-use therapeutic food and started further treatment. Following the health worker's prescription, the baby was taken for check-ups every 15 days and with the proper diet and treatment, her weight began to normalize.
Further conversation revealed that Binita had never attended the Mothers Group meetings and Binita was invited to join the discussions with other mothers. At first Binita was hesitant to join the Mothers Group meetings. However, INF staff, along with the local FCHV, visited Binita's home and counselled her and her family about the importance of joining the Mothers Group.
It has now been six months since Binita joined the Mothers Group meetings. During this time, she has learned about the importance of family planning, antenatal and postnatal checkups, and precautions before, during, and after delivery. She can now confidently introduce herself and explain the significance of birth spacing and sexual reproductive health services. Binita says,
"I have learned about the importance of Sexual Reproductive Health education and services. I will maintain birth spacing by using family planning methods. I have also become aware of the issue of child marriage, and I will advise others not to engage in it. I have opened a Chhori Surakshya Khata (Daughter Protection Bank Account) for my daughter and I will provide her with a good education and allow her to marry after she is an adult and is financially independent."
Story By:
Ms. Kalpana Pokhrel
INF Community Facilitator
*Binita Shahi is a fictional name
