The document discusses uterine prolapse (UP) in Nepal and proposes a sustainable program to address it. Some key points:
- UP affects millions of women worldwide and 50% of women who give birth or reach menopause. In Nepal, 600,000 women have UP, with 44% of women aged 20-29 affected.
- Current approaches in Nepal rely on health camps with no follow-up care. The proposed program would create a multi-purpose facility in Bhalayatar, Nepal to provide long-term UP awareness, treatment, follow-up, and generate community development and income.
- The goal is to create a sustainable program that empowers women and communities while measuring health and socioeconomic
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Himalayan Policy Research Conference 2013
1. The Value of Sustainable
Protocol to Address
Uterine Prolapse in Nepal
Health
Camp, Education, and
Employment Strategy
2. 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
3. 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
4. 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
5. 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
6. 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
7. 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
8. 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
9. 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
10. 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
11. Women Won’t Admit UP
Physical
Social
& Emotional Impact
Impact
Intimate
Impact
STIGMA
12. Women Won’t Admit UP
Physical
Social
& Emotional Impact
Impact
Intimate
Impact
STIGMA
13. Women Won’t Admit UP
Physical
Social
& Emotional Impact
Impact
Intimate
Impact
STIGMA
14. Women Won’t Admit UP
Physical
Social
& Emotional Impact
Impact
Intimate
Impact
STIGMA
28. 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.
Notes de l'éditeur
Excited to be here. 3rd yr @ HPRC-lunch-today share vision of project moving forward for UP in Nepal.
POP basics-Global Prevalence significant -50/50 85+ million women had given birth in US as of 2009 US Census-childbirth leading cause.
Define POP-Variety of reasons weak/damage to pelvic floor muscle, organs drop
UTERUS, bladder, rectum, intestines, vagina
POP prevalence grossly underestimated in all countries
currently no routine screening protocol, no accurate stat capture
Nepal only country in world w/gov’t POP Awareness initiative
200,000 in need of immediate surgery
Guestimate-women don’t disclose because of stigma
Damage sustained by young women giving birth is significant
Stigma keeps POP shrouded in secrecy in all countries
Vaginal/rectal pain & pressure, vaginal tissue bulge, urinary/fecal incontinence
Mother-in-law dynamic, family disgrace
Intimacy can be painful, infection odorous, husband takes new wife
Multiple causal factors, both global norms and cultural to area
Nepalese women predominantly farm labor
Marriage at young age leads to pregnancy at young age pelvic structure not optimal for childbirth
Impression when first saw pic-young girl
Foot massage, pushing on abdomen to expedite delivery, pulling baby out cause damage
Body needs time to heal, early return to farm labor, heavy lifting causes damage 75%
Healthcamp norm-screen, pessary/surgery-promo pics 4 sponsor org-no follow up
Found HCN-reputable NGO in Nepal to partner w- via HPRC 2012 + GIRHL-US women’s reproductive nonprofit build SUSTAINABLE program
Phase 1 WOMEN’S HEALTH AND EMPOWERMENT NETWORK
UP SCREEN-pessary/surgery- Lumbini-MICRO FINANCE INCOME GENERATION for women-HEALTH EDU, reduce stigma, gender sensitization, shift causal factors
Water & sanitation-storage and purification+toileting facilities
Manufacture/marketing of product, sanitary pads from hemp plants, income generation for women & facility upkeep
Multiple outcome measures tracked for UP and Village impact leave w/w/w/how/why to experts
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