National Female Community Health Volunteers (FCHVs) Program

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Background
Recognizing the importance of women’s participation in promoting health of the people, GoN initiated the Female Community Health Volunteer (FCHV) Program in FY 2045/46 (1988/1989) in 27 districts and expanded to all 75 districts of the country in a phased manner. 

Kantipur (5th Dec 2015)

Initially, the approach was to select one FCHV per ward regardless of the population size. Later in 2050 (1993/94) population based approach was introduced in selected (28) districts. All together there are 51,470 FCHVs in the country (47,328 FCHVs at rural/VDC level and 4,142 at urban/municipality level). FCHVs are selected by members of Mothers’ Group for Health (MG‐H) with the help of local health facility staff.


They are provided 18 days basic training in two phases (9+9 days) on selected primary health care components. After completion of basic training, FCHVs are provided with a certificate and medicine kit box consisting of necessary drugs and supplies free of cost.
They are also provided with manuals, flip chart, ward register, IEC materials, FCHV bag, signboard and identity card. Family Planning devices (pills and condoms only to FCHVs) are supplied regularly through local health facility. 
The major role of the FCHV is to promote health and healthy behaviors of mothers and community people to promote safe motherhood, child health, family planning, and other community based health services. FCHVs distribute condoms and pills, ORS packets and vitamin A capsules, treat pneumonia cases and refer more complicated cases to health institution along with motivation and education to community people. Similarly, they also distribute iron tablets to pregnant women. 
Various policies, strategies and guidelines have been developed to strengthen the FCHV program. Numerous factors influence the program including national health sector reform, decentralization and handing over of health facilities to VDCs, experience gained from program implementation, and the recognition to FCHVs in reduction of maternal and child mortality and general fertility through continuous implementation of community‐based health programs in Nepal. 
The FCHV program strategy has been revised in 2067 (2010) which gave strategic directions and critical approaches to ensure a strengthened national program for consistency and continuous support to each FCHV. Government of Nepal is committed to increase the moral & participation of FCHV in community health development. In fiscal year 2064/65 MoHP established FCHVs fund by providing cash support of Rs. 50,000 to each VDC. The mobilization of this fund for income generation activities is expected to benefit the FCHVs and the community at large.

Goal   
The goal of FCHV program is to support national goal of health through involvement of community in public health activities. This includes imparting knowledge and skills for empowerment of women, increasing awareness on health related issues and involvement of local institutions in promoting health care.


Objective 
FCHV program has the following objectives:
  • To prepare a pool of self‐motivated volunteers as a focal person to bridge health programs with community
  • To prepare a pool of volunteers to provide community based health services
  • To activate women to tackle common health problems by imparting relevant knowledge and skills 
  • To increase the community participation in improving health 
  • To develop FCHV as a motivator for health
  • To increase utilization of health care services through demand creation

Summary

The major role of the Female Community Health Volunteers (FCHVs) is promotion of safe motherhood, child health, family planning, and other community based health services to promote health and healthy behavior of mothers and community people with support from health workers and health facilities. At present there are 51,470 FCHVs (47,328 FCHVs at rural/VDC level and 4,142 at urban/municipality level) actively working all over the country. FCHVs contributed significantly in the distribution of oral contraceptive Pills, Condoms and Oral Rehydration Solution (ORS) packets and counseling and referring to mothers in the health facilities for the service utilization.    FCHVs have contributed in distribution of 53 percent oral pills and 47 percent ORS packets at the national level. FCHVs distributed a total of 14,506,525 packets of condoms in the FY 2070/71. Service statistics shows that more than one half of the diarrhoea and ARI cases were treated by FCHVs.  
Read also:  Health Sector Progress Report 2018, Ministry of Health & Population
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