During the summer of 2008, I had the opportunity to travel to Nepal for my summer public health internship at the Nepal Family Health Program II (NFHP II). NFHP II aims to support the Nepal government and NGOs to build capacity and collaborations with stakeholders and to improve the delivery and use of the family planning, maternal, newborn, child health, and literacy life skills services. NFHP II is a community-based organization that serves 24 of the 75 districts in Nepal. NFHP II is a five-year JSI (John Snow, Inc) program, funded by USAID and is in its second phase (predecessor, NFHP I).

NFHP II has been a key component of the achievements that Family Planning Programs have made in Nepal; the contraceptive prevalence rate (CPR) is at an increasing trend, the total fertility rate is decreasing, and the availability of contraceptives is improving over the years. Challenges in FP programs appear when looking at the method mix; Voluntary Surgical Contraceptive (VSC) is the most preferred method while Intra-Uterine Contraceptive Device (IUCD) and Norplant is the least. Although there continues to be a high demand for limiting and spacing births, long acting methods like IUCD and Norplant account for less than three percent of the method mix.

My internship’s primary focus was to conduct a small-scale qualitative case study to explore the continued low use of long acting methods among contraceptive users in Nepal. The study’s objectives were to understand the use and non-use of IUCD/Norplant through service provider and contraceptive user in depth interviews as well as observations of facility equipment, family planning counseling, and IUCD/Norplant insertions and removals. Data was collected from the Terai districts of Parsa, Rautahat and Banke.

I worked mainly with the Reproductive Heath team at NFHP II, which has a major focus on family planning issues including a special focus on low use of IUCD and Norplant in Nepal. Dr. Kedar Baral, who is the reproductive health specialist for the Program, was my preceptor. Along with other smaller tasks, my main responsibilities were to create data collection tools for my site visits, conduct interviews and observations in at least two districts, write a report of my findings with future recommendations and present them to stakeholders.

Overall, I found my internship experience to be very valuable. Having the opportunity to work directly with health providers, female community health workers, and community members helped me appreciate the need for and the effectiveness of community based programs like NFHP II.

back to map

I am fortunate to have received the opportunity to perform my field studies experience at Family Health International’s Nepal Country Office. I brought to this internship a familiarity and interest in Nepali culture and language from previous trips here for studies and research. This added greatly to my experience but is by no means necessary to have a rewarding internship at FHI. My ten-week internship began in June 2008. My scope of work allowed me to work on a broad range of activities related to public health efforts on HIV and AIDS in Nepal, including contributing to various types of project documentation, planning and attending meetings and events, and performing a pilot capacity analysis and needs assessment.

With the team leader of Surveillance, Research, and Monitoring I attended a field visit to monitor several Integrated Bio-Behavioral Survey sites where data collection was taking place with female sex workers, one of the most at-risk populations in Nepal. From these observations I suggested edits and additions to the existing monitoring checklist. For the Third National AIDS Conference in July, I supported the Organizing Committee with tasks from spreadsheet management to registration tables. At the conference I attended a session on the integration of Reproductive Health with HIV/AIDS efforts in Nepal. My final activity at FHI was to complete a pilot capacity analysis and needs assessment with an implementing agency (IA). I interviewed different levels of staff from an IA working with drug users as a target population, and then utilized the qualitative data gathered to identify capacity building needs; I then documented these needs in report format.

My time at FHI Nepal has been an invaluable learning experience on many levels: I have gained an understanding of how an INGO in a developing country manages a large-scale public health project, as well as vastly increasing my knowledge about HIV and AIDS from testing to stigma to managing opportunistic infections. I returned to UCLA with a concrete idea of public health in the “real world,” and what I may contribute to this field in the future.

back to map