From October, 2015 through June, 2016, I was working as a Lombard Fellow with Helen Keller International (HKI) in Nepal. HKI and Save the Children International (SCI) were co-implementing partners for a large, country-wide nutrition program called Suaahara. Funded by USAID, Suaahara aimed to improve the health and nutrition behaviors of young mothers and their babies. This was achieved primarily through working with Female Community Health Volunteers, rural clinics, local agriculture specialists, and field staff to educate and motivate young mothers to practice a set of key behaviors. These health and nutrition behaviors included practices such as increasing dietary diversity, exclusive breastfeeding of infants, visiting clinics for pre-natal and post-natal care, and using family planning methods among many other important health behaviors.
By the time I arrived in Nepal, the first phase of Suaahara was in its fifth and final year, so HKI and SCI were busy with a number of studies to evaluate the impact of the program and to prepare for the next 5-year phase of Suaahara. My assignment was to design and conduct a qualitative study to examine the impact of gender equality and social inclusion (GESI) factors on the young mothers’ ability to implement the health behaviors. Nepal’s patriarchal social structure and caste system have left many women in a vulnerable and powerless state, and we wanted to better understand how these social pressures were impacting women’s health.
I developed a research plan and designed a set of interview and focus group discussion guides to gain more information about (1) women’s access to nutrition information, (2) women’s access to health/nutrition resources and services, (3) women’s control over those resources and decision-making power in the household, and (4) family support, gender roles, and social and cultural norms around health. I then helped train 5 Nepali interns to conduct the interviews and spent about 2.5 months doing fieldwork with them in several rural communities around Nepal.
The fieldwork was the most rewarding part of the whole experience for me, as I was able to visit and have meaningful interactions in some very remote communities that most foreigners would never go to. We conducted interviews and focus group discussions with young mothers and their family members and with the female community health volunteers. Through this work, I learned about rural lifestyles and cultures and saw both the struggles and joys of life in rural Nepal. The Nepali people are incredibly welcoming and hospitable, and I was struck by the kindness and generosity they showed to complete strangers. Despite having very limited personal resources, they were always willing to share what they had with guests and friends. It was a very comforting feeling to know that I could go just about anywhere in rural Nepal and would always be able to find a roof to sleep under and a meal to share.
Following the fieldwork, I spent the remainder of my internship compiling, analyzing, and interpreting all of the information that we had gathered during the interviews and focus group discussions. I presented all of our findings in a report that we submitted to HKI, SCI, and USAID. The findings from our study are intended to help guide and inform the programming that is currently being developed for the second phase of Suaahara, and I am hopeful that our work will help strengthen the programs and make it easier for young mothers to implement better health and nutrition behaviors.
My Lombard experience was challenging at times, but incredibly rewarding. I had to face the difficult realities of working in the developing world, with limited resources and many logistical nightmares. However, those challenges were always outweighed by the support of my co-workers and the generosity of the Nepali people as a whole. Through this fellowship, I gained significant experience with qualitative research methods, and, more importantly, I experienced first-hand the beautiful cultures and people of Nepal and now have a vast network of close friends in Kathmandu and beyond. I am eternally grateful to the Lombard Fellowship and the Dickey Center for making this fantastic experience possible.