The Start Strong Project – Three Month Update

The Start Strong project, match funded by the UK Government, launched three months ago and we’re delighted to share with you an update on the activities delivered so far. The aim of the project is to improve maternal healthcare and reduce malnutrition amongst 1,000 vulnerable women and their children in Rugin and Bichhaya, Bajura District, Far West Nepal. Over the course of 36 months, PHASE Nepal will provide support to families living in these remote communities in order to reduce maternal mortality rates, enhance agricultural productivity and reduce malnutrition.  

Prior to the project beginning, a baseline survey was conducted which aimed to speak to all mothers in the villages who had children aged 6-59 months. This is one of the first times this style of survey had been done, as usually a third of the population would be interviewed as a sample. This has meant that we have much better data on the communities and project participants. As a result, it is clear that the project has already begun having an impact on these communities and we are thrilled to share with you the progress made so far. 

Mountainous areas of Nepal offer many challenges for the delivery of primary healthcare. Many villages are very difficult to reach and are not accessible by road. Weak healthcare structures and operational challenges in remote areas has meant that women receive limited training and support throughout their pregnancy. As a result, one of our key activities has been to improve maternal healthcare knowledge and behaviours, as well as improve awareness of the first 1,000 days practice amongst 1,000 women. So far, 57 pregnant women have received antenatal care visits, 22 deliveries were conducted by the skilled health personnel and 32 mothers received postnatal care services. Antenatal, intra-natal and postnatal care services provided by PHASE health workers at health institution and outreach clinics will continue throughout the remainder of the project. 

Over the past three months, 30 children within the project area have been identified as severely malnourished and have therefore been entered into a food supplement programme. In addition, healthy baby competitions, health education services and outreach activities have been initiated. Medicine needs were also established and as a result, medicine has been procured and delivered to the project site. These activities will continue into the next phase of the project with children identified as malnourished continuing to receive healthy food supplements and further medicines supplied to the two communities. Furthermore, a total of 87 ‘door to door visits’ have been conducted by PHASE health workers, who have delivered health education and health services to those who cannot access to health facilities. As a result, 816 individuals have directly benefitted.  

Farming is the main livelihood activity for 66% of people in Nepal and is crucial for remote rural communities. Being able to grow good yields of nutritious food enables farmers to feed their families well and increase economic independence by selling to others. However, challenging farming conditions and an unpredictable climate results in low yields and produce lacking in nutritional value. Therefore, the Start Strong Project will aim to increase the availability of high value foods and diet diversification through agricultural activities with 625 women. So far, a selection of beneficiaries has been identified to take part in mushroom cultivation activities and these individuals have begun their training. This training includes all the necessary guidance, advice and materials needed to produce a nutritious source of food for entire families. During the next phase of the project, poultry rearing and seed distribution activities will also begin.  

Limited community knowledge of good nutrition has contributed to high rates of malnutrition in the Far West of Nepal. Before the project began, it was estimated that 49.5% of children aged 6-59 months would be identified as malnourished, however, following our baseline survey, 70.2% of children were in fact identified as malnourished, highlighting an even greater need within these communities. In order to reduce these levels and embed nutritional expertise and knowledge in the community, six meetings have been held with local Female Community Health Volunteers covering the subject of maternal health and childcare, along with a further six meetings with the health facilities management committee. Throughout the next phase of the project, monthly meetings with key stakeholders will continue to take place, delivering information and advice on maternal health, childcare and other aspects of nutrition. 

The activities conducted during these first three months will continue throughout the remainder of the project, with several other equally vital initiatives beginning during the next phase of delivery. Finally, a huge thank you to everyone who donated to the Start Strong UK Aid Match Appeal last year. Thanks to your support, important progress is underway within these vulnerable communities. We look forward to providing further updates over the next few months as this exciting project continues to change lives in Nepal.