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The Value of Sustainable
Protocol to Address
Uterine Prolapse in Nepal

Health
Camp, Education, and
Employment Strategy
POP Prevalence


POP-weakness in pelvic floor, organs
in pelvic cavity shift downward



5 Types of POP



Millions of women in every country



Currently no accurate stat capture

50% of Women Who Give Birth
50% of Women in Menopause
POP Prevalence




POP-weakness in pelvic floor, organs
in pelvic cavity shift downward
5 Types of POP

 Millions


of women in every country

Currently no accurate stat capture

50% of Women Who Give Birth
50% of Women in Menopause
POP Prevalence




POP-weakness in pelvic floor, organs
in pelvic cavity shift downward
5 Types of POP

 Millions


of women in every country

Currently no accurate stat capture

50% of Women Who Give Birth
50% of Women in Menopause
POP Prevalence




POP-weakness in pelvic floor, organs
in pelvic cavity shift downward
5 Types of POP

 Millions


of women in every country

Currently no accurate stat capture

50% of Women Who Give Birth
50% of Women in Menopause
POP Prevalence




POP-weakness in pelvic floor, organs
in pelvic cavity shift downward
5 Types of POP

 Millions


of women in every country

Currently no accurate stat capture

50% of Women Who Give Birth
50% of Women in Menopause
Nepal UP Statistics
 600,000

Women with UP

 44%

of Women 20-29 have UP

 14%

of Women under 20 have UP

Nepal Government Initiative to
Increase Awareness
Nepal UP Statistics
 600,000

Women with UP

 44%

of Women 20-29 have UP

 14%

of Women under 20 have UP

Nepal Government Initiative to
Increase Awareness
Nepal UP Statistics
 600,000

Women with UP

 44%

of Women 20-29 have UP

 14%

of Women under 20 have UP

Nepal Government Initiative to
Increase Awareness
Nepal UP Statistics
 600,000

Women with UP

 44%

of Women 20-29 have UP

 14%

of Women under 20 have UP

Nepal Government Initiative to
Increase Awareness
Women Won’t Admit UP
Physical
Social

& Emotional Impact

Impact

Intimate

Impact

STIGMA
Women Won’t Admit UP
Physical

Social

& Emotional Impact

Impact

Intimate

Impact

STIGMA
Women Won’t Admit UP
Physical
Social

& Emotional Impact

Impact

Intimate

Impact

STIGMA
Women Won’t Admit UP
Physical
Social

& Emotional Impact

Impact

Intimate

Impact

STIGMA
Heavy
Early

Lifting

Pregnancy

Multiple

Childbirths

Improper

Birthing Practices

Inadequate

Period

Post Birthing Rest

Causal Factors
Heavy Lifting

Causal Factors
Early Pregnancy

Causal Factors
Multiple Childbirths

Causal Factors
Improper Birthing Practices

Causal Factors
Inadequate Post Birthing Rest
Period

Causal Factors
Healthcamps Norm
**NO**
FOLLOWUP
CARE

Status Quo Must Change
OBJECTIVE
Sustainable Program
WHEN-Nepal; Palpa District, Bhalayatar

Phase I-Bhalayatar
One Multi-purposed Structure
Additional Considerations
Income Generation
 UP-Awareness,

Diagnostics,
Treatment, Followup

 Village-Financial,

Social, Health,
Gender Balancing, Awareness
Education, Stigma Reduction

Outcome Measures
Project Team Members
Sherrie Palm*APOPS
Deepali Thapa*HCN
Suveckshya Shah*HCN
Pushkar Silwal*HCN
Pushpalata Panday*HCN
Sunita Sharma*HCN
Ali Borazjani*GIRHL
Lumbini Medical College
Bhalayatar Community
Resources:
Concept Note, Hamro Chahana Nepal, August 2013.
Ministry of Health and Population, Nepal, New ERA, and ICF International,2012.
Nepal Demographic and Health Survey (UNFPA & IoM), Katmandu, 2011.
Uterine Prolapse, Mobile Camp Approach and Body Politics in Nepal, Madhusdan
Subedi, Dhaulagiri Journel of Sociology and Anthropology, Vol 4, 2010.
Uterine Prolapse: Experts Scorn Health Camp
Surgeries, Ekantipur.com, 9/14/2011.

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Himalayan Policy Research Conference 2013

Hinweis der Redaktion

  1. Excited to be here. 3rd yr @ HPRC-lunch-today share vision of project moving forward for UP in Nepal.
  2. POP basics-Global Prevalence significant -50/50 85+ million women had given birth in US as of 2009 US Census-childbirth leading cause.
  3. Define POP-Variety of reasons weak/damage to pelvic floor muscle, organs drop
  4. UTERUS, bladder, rectum, intestines, vagina
  5. POP prevalence grossly underestimated in all countries
  6. currently no routine screening protocol, no accurate stat capture
  7. Nepal only country in world w/gov’t POP Awareness initiative
  8. 200,000 in need of immediate surgery
  9. Guestimate-women don’t disclose because of stigma
  10. Damage sustained by young women giving birth is significant
  11. Stigma keeps POP shrouded in secrecy in all countries
  12. Vaginal/rectal pain & pressure, vaginal tissue bulge, urinary/fecal incontinence
  13. Mother-in-law dynamic, family disgrace
  14. Intimacy can be painful, infection odorous, husband takes new wife
  15. Multiple causal factors, both global norms and cultural to area
  16. Nepalese women predominantly farm labor
  17. Marriage at young age leads to pregnancy at young age pelvic structure not optimal for childbirth
  18. Impression when first saw pic-young girl
  19. Foot massage, pushing on abdomen to expedite delivery, pulling baby out cause damage
  20. Body needs time to heal, early return to farm labor, heavy lifting causes damage 75%
  21. Healthcamp norm-screen, pessary/surgery-promo pics 4 sponsor org-no follow up
  22. Found HCN-reputable NGO in Nepal to partner w- via HPRC 2012 + GIRHL-US women’s reproductive nonprofit build SUSTAINABLE program
  23. Phase 1 WOMEN’S HEALTH AND EMPOWERMENT NETWORK
  24. UP SCREEN-pessary/surgery- Lumbini-MICRO FINANCE INCOME GENERATION for women-HEALTH EDU, reduce stigma, gender sensitization, shift causal factors
  25. Water & sanitation-storage and purification+toileting facilities
  26. Manufacture/marketing of product, sanitary pads from hemp plants, income generation for women & facility upkeep
  27. Multiple outcome measures tracked for UP and Village impact leave w/w/w/how/why to experts
  28. feedback -village committee, we don’t know what we don’t know-POP on medical record 4000 years, still shrouded in silence-address 1 step at time