Remote Area Initiative (RAI)

Remote Area Initiative (RAI)

In 2014, as part of the GGMS project, CRS through its promising community-based initiative, RAI has been promoting and creating demand for FP, Maternal and Child Health (MCH) services amidst the rural communities, in hard to reach districts of Jumla, Bardiya and Bajhang. During the inception year, RAI covered 41 selected VDCs in these three districts. In year two, RAI was scaled up to 28 new VDCs to cover 68 VDCs and one municipality through 47 CCAs.
At the core of this promising community initiative are the community based change agents (CCAs), who are local woman that are trained to conduct health promotion in their VDCs, disseminate important maternal and child health messages to community women, and also encourage them to adopt their preferred choice of FP method. The main messages disseminated by the CCAs are on: FP, importance of antenatal check-up/ institutional delivery, health and hygiene, prevention and treatment of uterine prolapse.

RAI’s focus on the hard to reach areas stems from the need to breach existing gaps with regard to the quality, demand, access and delivery of FP and maternal health services in rural Nepal.
Reasons for the gaps in these services includes: limited knowledge about FP/MCH issues, limited availability and access to contraceptives, concerns regarding the quality of FP services are all contributing factors for these existing gaps. Underlying complications such as the poor involvement of men in FP, poor participation by socially excluded population, particularly Dalits and Muslims, prevailing myths and misconceptions and lack of awareness about FP and safe sexual behaviour, further exacerbate these gaps.  

The main objectives of RAI are to: create demand for FP/MCH products and services and modern methods of contraception among marginalized and vulnerable groups through targeted BCC interventions; improve FP knowledge, attitude and practice among married women of reproductive age group (15-49) in hard to reach geographical areas; help increase ANC attendance and institutional deliveries; and increase awareness about uterine prolapse and service seeking behavior.
With guidance and oversight of the field team which includes the District Coordinators and the Social Mobilizers, the CCAs play a key role in health promotion by engaging the community women in interactive and participatory ‘women group meetings’ in the VDCs, reaching them with key BCC messages and empowering  them to make informed FP decisions. CCAs are selected on certain specific criteria such as their literacy levels and their influence and reputation in the communities. The selected CCA usually represent the predominant group in the community (for instance if the members are primarily Dalit, then the CCA should be from that community).
CRS staff trains the CCAs periodically, and provides them on-the job training and support to enable them to reach rural women with targeted messages. Generally, one CCA per VDC is selected to conduct women group meetings on the four components mentioned above. In the first year 41 VDCs were covered through 35 CCAs.  In the second year, RAI was scaled up to additional 28 VDCs through 24 CCAs.  In the first year, CCAs conducted separate women group meetings on each of the four components to hone in these key messages and raise awareness among the participants.

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