FCHVs are trusted members of the community who have promoted positive behaviors related to safe motherhood, child health, family planning and other various health related areas. This slide covers a comprehensive ideas regarding the FCHVs, their functions, roles and status in Nepal.

1. Female Community
Health Volunteer(FCHV)
Prepared by:
Milan Thapa
“The unknown health worker” who climbs up and down steep hillsides in the Himalayas to reach
children and provide safe vaccines to protect them from measles, rubella and polio.

2. Introduction
◎FCHVs are local women who function as a bridge between the
government and the community as they support the health
programmes initiated by health institutions and government.
◎Female Community Health Volunteers (FCHVs) are contributing in the
health of mother & children through prevention, promotive and
curative services as guided by programs at ward level.
◎At the community level, FCHVs are the main vehicle of service
delivery and also play key role to increase community participation.
◎This programme has been the backbone of the health system in
Nepal for the past three decades.
2

3. ◎Pure volunteerism
◎Aimed at achieving basic health
care facility at the doorsteps of
general population
◎Concept was actually developed
from Aaganwadi Programme
(आँगनवाडी कार्यक्रम) of India
3
Fig: Aaganwadi workers in India

4. FCHV programme
◎Initiated in FY 2045/46 in 27 districts
◎Later expanded to all districts in a phased manner
◎Initial approach: One FCHV per ward
◎Later in 2050(1993) population based approach was introduced in
selected (28) districts.
4

5. GOAL OF FCHV PROGRAMME
Improve the health of local community people by promoting public health
measures of health promotion and disease prevention. This includes
imparting knowledge and skills for empowering women, increasing
awareness on health related issues and involving local institutions in
promoting health care
5

6. Objectives OF FCHV PROGRAMME
◎Mobilize a pool of motivated volunteers to connect health
programmes with communities and to provide community-based
health services
◎Activate women to tackle common health problems by imparting
relevant knowledge and skills
◎Increase community participation in improving health
◎Develop FCHVs as health motivators
◎Increase the demand of health care services among community
people.
6

7. ◎Selected by members of Mothers' Group for Health (Health mother
groups)
◎Provided training for 18 days
7
FCHV
training
18 days
Basic
training
9 days
Refresher
training
9 days

8. 8

9. 9
Oral Rehydration Solution
Vitamin A capsule Zinc tablets
Pills Condoms

10. ◎FCHV television drama that reflects volunteerism spirits of FCHVs
has also been launched with support from NFHP II/USAID.
◎Urban FCHVs are mobilized through municipalities, while rural
FCHVs are mobilized by local health posts or PHCCs.
◎The standard number of FCHV has been fixed as per:
➢ Terai Region: 1 FCHV per 1000 population
➢ Hilly Region: 1 FCHV per 600 population
➢ Himalayan region: 1 FCHV per 150 population
◎Besides, the geographical area, need and capacity of the local level
determines the number of FCHV.
10

11. 48549 48489
48680
48897
50007
51470 51470 51416
49101
51420 51420
49481
65/66 66/67 67/68 68/69 69/70 70/71 71/72 72/73 73/74 74/75 75/76 76/77
Number
of
FCHVs
Fiscal Year
ACTIVE FCHVs THROUGHOUT THE NATION
11

12. 86% 85%
90% 91%
88% 89% 87%
82%
72% 72%
95%
90%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
65/66 66/67 67/68 68/69 69/70 70/71 71/72 72/73 73/74 74/75 75/76 76/77
Percentage
Fiscal Year
REPORTING TO HMIS
12

13. FCHV Strategy
◎Historically, FCHV strategy has been revised five times in the past:
➢ First time- 2047 B.S (1990)
➢ Second time- 2048 B.S (1992)
➢ Third time- 2056 B.S (2003)
➢ Fourth time- 2064 B.S (2008)
➢ Fifth time- 2067 B.S (2010)
◎Following the federalization of health system, the FCHV strategy
developed in 2067 was also amended for the first time in 2076, to
promote a strengthened national programme naming it FCHV
programme strategy, 2067(first amendment 2076).
◎It was bought into action after the green signal from Ministry of Health
and Population(MoHP). 13

14. SELECTION OF FCHV
◎A meeting of MGH will select FCHV on the following basis.
Basis of selection of FCHV
a. Permanent resident of the related ward
b. Interested to work as FCHV for at least 5 years
c. Age between 25-45 years
d. Priority is given to married women
e. Having commitment to serve the community
f. Priority will be given to those with at least education up to 10th standard
g. Priority will be given to women from marginalized groups
h. Those who are interested to be FCHV will have to submit an application
i. Women who are involved in a paid job, will not be allowed to be FCHV.
14

15. 15
Fig: Application to be submitted to health mother group while applying for FCHV

16. ROLES of FCHV
◎Assist the health mothers group to conduct the regular meetings
◎Raise awareness and health promotional activities
◎Promote utilization of available health services and raise awareness
on health
◎Disseminate health education on various existing problems
◎Help in various national health programs
16

17. ◎Submit monthly and annual report to local health institution and HMG
◎Conduct referral to HFs in order to increase the utilization of services
◎Identify risk factors in local context and act to minimize the negative
consequences
◎Entitled to abide by the code of ethics
17

18. 18

19. MAJOR ACTIVITIES PERFORMED BY FCHV
◎FCHVs were considered as frontline health service providers in both
the programs of CB-IMCI and CB-NCP.
◎Biannual distribution of vitamin A capsules to 6 to 59-month olds
◎FCHVs have been involved in community level maternal and newborn
health interventions
◎FCHVs provide information and education to women and couple at
community and distribute male condoms and resupply OCPs.
◎FCHVs are utilized to raise awareness on HIV and PMTCT
19

20. Highlights of FCHV in National Health Policy(2075)
20

21. Chair of the FCHV committee
◎Central level FCHV committee: Director, Nursing and
Social Security Division, DOHS
◎Province level FCHV committee: Director, Provincial
Health Directorate
◎Local level FCHV committee: Deputy mayor(Metropolitan
city, Sub Metropolitan city and Municipality)/ Vice
chairperson (Rural Municipality)
21

22. Review meeting of FCHV
◎Respective health institutions held a review meeting of FCHV two
times a year (with a gap of six months, preferably in Mangsir and
Jestha) with a duration of 2 days.
◎The in-charge of local health institution will conduct the review
meetings of the FCHVs in the local level.
◎During the review meeting, review of the work of FCHVs and relevant
health programs are carried out.
◎During the review meeting the activities related to FCHV fund
mobilization and utilization is done. 22

23. महिला स्वास्थ्य स्वयंसेहिकािरुको हियहमत बैठक
चन्द्रलालपुर स्वास्थ्य चौकी, हसरिा
२0७८/३/२९
23

24. FCHV fund
◎Since fiscal year 2064/65 MoHP established FCHVs fund in each VDCs by
providing Rs.50,000 to each VDC (now, each local level)
◎FCHV fund operational guidelines, 2064 also passed consecutively
◎Additional budget of Rs.10,000 was added in fund during 2071/72
◎Annual budget of funds was again increased by NPR 10,000 during 2072/73
◎Underutilization of FCHV fund have been a topic of concern since the initial days of
the programme
24

25. FCHV Day
◎Globally 5th December is commemorated as the International
Volunteer Day and National Female Community Health Volunteers
(FCHVs) Day.
Theme for 15th FCHV day- महिला स्वास्थ्य स्वर्ंसेहवकाको हनस्वार्य सेवााः स्वस्र्,
समृद्ध राष्ट्र हनमायणमा टेवा
Theme for 16th FCHV day- गाउँनगरमा महिला स्वास्थ्य स्वर्ंसेहवका, स्वास्थ्य
प्रवद्धयनमा अिम् भुहमका
Theme for 17th FCHV day- कोहभड-१९को रोकर्ाम र समृद्धद्धका लाहग संर्ुक्त
कार्य: महिला सामुदाहर्क स्वास्थ्य स्वर्ंसेहवकाको भूहमका अपररिार्य
25

26. 26

27. LOGO
◎An identifying “logo” has been designed to depict the
identity of FCHV. This logo will be used in papers
related with FCHV.
◎Innermost circle represents the action in community
or ward level.
◎Second circle shows the action is spread in the
entire local level (Metropolitan, Sub-Metropolitan,
Municipality, Rural-Municipality)
◎Third circle depicts whole province will be/is covered.
◎The outermost circle shows that the FCHV
programme will cover/is covering the whole nation.
27
Fig: National logo of FCHV

28. 28
“When a small pebble is thrown into a pond, it creates a wave, which gradually
spreads all over the surface of pond.” Similarly, the activities of FCHV starts at
ward level and gradually will cover the whole nation.

29. DRESS CODE OF FCHV
◎FCHV Programme Strategy 2067 standardized uniform (dress) for
FCHVs.
◎The border of the FCHV’s saree will have sky blue border with 4 circle
in it as per the logo of FCHV.
29
Fig: Design of FCHV saree

30. DRESS ALLOWANCE
◎Introduction of dress allowances to FCHV was one of the major
activities done in FY 2069/70
◎Dress allowance for FCHVs increased from NPR 5,000 to NPR 6,000
in FY 2072/73
◎Dress allowance for FCHVs increased from NPR 6,000 to NPR 7,500
in FY 2073/74
◎Dress allowance for FCHVs increased from NPR 7,500 to NPR
10,000 in FY 2075/76
30

31. OTHER MOTIVATIONAL ACTIVITIES
◎A board is designed for the identification of house of FCHV
31
Fig: Identification boards of FCHV
Old format New format

32. ◎Identity card is provided to FCHV for their personal identification.
32
Fig: Format of identity card for FCHV
Front Back

33. Facilities for FCHVs
◎A travel allowance of Rs. 3000/- is provided to each FCHV
as transportation cost every year.
◎Government of Nepal bears the 50 % of premium of health
insurance for individual FCHVs and also they are one of the
target groups to receive service through Social Service Unit
of health facilities.
◎Free health care services as mentioned in Free Health Care
guidelines
◎Uniform
◎FCHV fund
33

34. RETIREMENT
◎FCHV can work up to the age of 60 years.
◎Since 2071/72 the government has allocated budget of NPR 20,000
for farewells to FCHVs over 60 years of age as recommended by
healthy mothers’ groups.
◎Women working as FCHV for at least 10 years are honored with
appreciation and economic beneficiaries.
◎Issuance of amount in the name of FCHV who have served for at
least 5 years in case of their untimely demise.
◎Resignation can be given after submitting application to the president
of HMG with a valid reason to do so.
◎Local level may continue to give free services available at local level
to the FCHVs retiring after completing the service of 10 years. 34

35. महिला स्वास्थ्य स्वयंसेहिकािरुलाइ िगद सहित प्रमाण पत्र र खादाले सम्माि र हबदाइ
भरतपुर मिािगरपाहलका, हचतिि
२०७८/३/२७
35

36. महिला स्वास्थ्य स्वयंसेहिकािरुको हबदाई र ियााँ महिला स्वास्थ्य स्वयंसेहिकािरुको स्वागत
ताक
ुु कोट स्वास्थ्य चौकी, लमजुङ
२0७८/३/२९
36

37. Issues and constraints
◎ Low utilization of FCHV fund
◎ FCHV are not interested in farewell programmes
◎ Decreasing work performance of FCHV
37

38. REFERENCES
◎ Annual Report 2076/77. Department of Health Services, MoHP
◎ National FCHV programme strategy, 2067; USAID
◎ National FCHV programme strategy, 2067 (First amendment 2076)
◎ https://www.mohp.gov.np/eng/program/reproductive-maternal-
health/female-community-health-programme
◎ https://swasthyakhabar.com/story/26281
◎ An article to read:
https://ceezana10.wordpress.com/2016/03/22/crossing-the-lines/
38

39. Thank you
FCHVs are the eyes and ears of the health programs, because they are working as
the main media of the community problem and bring all the health problems to health
facility which helps to organize the community health program.