Community-based women’s health programme is based on women’s empowerment and a self-help approach as well as on plant-based medicine. It was initiated in April 1997 to address the need for the health program to embrace a holistic approach with appropriate human resources. WOREC adopted the concept of barefoot gynaecologists in its program which was the beginning of women’s health movement from the community level where women took control of their own health.

1. Looking back and beyond
health through women’s eyes
Community based women’s health
programme is based on women’s
empowermentandaself-helpapproach
as well as on plant based medicine. It
was initiated inApril 1997 to address the
need for the health program to embrace
a holistic approach with appropriate
human resources. WOREC adopted
the concept of barefoot gynecologists
in its program which was beginning of
women’s health movement from the
community level where women took
control of their own health.
This case which became foundation fo
WOREC’s women health program made
it clear that a number of health problems
that women faced were a result of social
inequalities. Not having control over
her body, sexuality and reproduction,
discriminatory cultural practices, values
and norms have further lowered women’s
status and contributed to women’s health
problems. The gender-based division of
labor, social norms, values and traditions
related to pregnancy, reproduction,
miscarriage, abortion, and use of
contraceptives without proper information
and lack of counseling were the factors that
contributed to degrading women’s health.
During a health camp in 1994, founder
of WOREC Dr. Renu Adhikari when
examined 56 years lady, the prolapsed
part of her uterus projected out, along
with a fountain of smelly dark yellowish
watery discharge.The lady had inserted
a rubber slipper inside her vagina for
ease of walking as it kept her uterus
inside.Married at age of 12,she had her
first child at 15 and her uterus prolapsed
after the birth of her third child at the
age of 20. Five years later, her husband
abandoned her and their five children.
She was not allowed by the women in
the village to take a bath at the public
tap because of her smelly discharge
and had to allow other to fill their water
pot first. She went to see several local
health institutions for treatment, but all
turned her away saying they did not
have medicines for women’s diseases.
WOREC started it health program with a
feminist perspective that encompassed
women’s right to bodily integrity as a
prerequisite for healthy womanhood.

2. Women’s Health Training
Training to community women as
barefoot gynecologists was conducted,
using the feminist model of ‘my body
is mine’. The program and training was
successful to produce human resources
capable of analyzing women’s health
from a women’s perspective who further
trained women at the community level.
Empowerment of community women
as barefoot gynecologists addressed
the women health needs and the
community women were able to break
the culture of silence and taboos
surrounding women’s health problems.
Training explored the anatomy and
physiology of the female body. Training
focused on identification of women’s
health concerns, looking at women
as persons rather than as mothers
alone. Thus, issues like discrimination,
violence against women and adolescent
girls, problems related to menarche,
menopause, mental health, prolapsed
uterus, fistula, osteoporosis and other
problems like nutrition, sanitation
environmental and occupational health
issues and concerns were discussed.
Women’s Health Resource and
Counseling Centers (WHRCC)
Women’s Health Resource and
Counselling Centres run entirely by the
women were the nodal points where local
women shared their health problems
and experiences and got relevant
information and counseling. These
provided the IEC and services following
self help approach. Under the umbrella
of these resource centers community
based women health networks were
established.
Women Health Training was completed
in different phases.
• First phase training developed
women’s understanding on gender,
social discrimination and its impact.
• In the second phase, women had
undergone capacity building then
sensitized different groups at the
communitylevelonissuesofwomen’s
health and the determinants of poor
women’s health.
• In the third phase, women centered
safe spaces for women, called
“Women’s Health Resource and
Counseling Centers” were set up,
to serve as counseling and health
service delivery centers for women.

3. The women health counselors gave
emphasis on the use of locally available
herbs to cure the women’s health
problems like gastritis, trichomoniasis,
candiadiasis, joint pain, white
discharge, menstrual disorders and
the first and second degree of uterine
prolapsed.Women with health problems
that cannot be well treated by herbal
remedies and require antibiotic or other
allopathic treatment are referred to
WOREC’s community health clinic or
district hospital.
Community initiation and theWHRCC
Community women, and Women’s
Health Networks have been very active
and their strong advocacy with the
multiple stakeholders in the community
have made the women’s health program
31 WHRCC centers are now run by either
local government or CBOs in coordination
and guiding support from WOREC. These
centres are attracting more local women,
exhibiting their effectiveness as well as a
feeling of ownership by local women.
sustainable. They began to demand
that the health budget allocated to
the Village Development Comittee
(VDC) be used to build the WHRCC.
Women’s groups and women’s health
networks became organized and vocal
about demanding the land, wood and
economic resources to build WHRCC.
Indeed, they became the watch dogs
in the VDC and scrutinized budget
allocations for various sectors like
women’s empowerment, health, children
etc. There was realization at community
that these counseling centers were keys
to provide support to women and youths
affected by conflict.
Women health camp
WOREC organized the Women’s Health
camp to disseminate information on
reproductive health of women and
to provide health services. WOREC
organized such fairs in Udyapur, Siraha,
Dang, Rukum and Salyan districts.There
were series of stalls addressing the
biological, mental and social changes
that occur during adolescence. Gender
Based discrimination, violence against
women, food and nutrition, reproductive
health and rights, ingrained patriarchal
societal structures and their impacts
on women’s health were the issues
highlighted in the fair. Orientation on
the conservation and utilization of local
plant diversity of medicinal values was
also given to the visitors. Moreover,
counseling services were provided to
the women after having recorded their
life stories.

4. The aim was to generate an
understanding about one’s own life,
the growing process, factors affecting
health and hea lth services available
to them, as well as understanding the
difficulties in getting health needs met
through available services. Pictorial
presentations of women’s growth and
well being with elaborated explanation
of those pictures by women themselves
played a very important role in breaking
the silence around issues of women’s
health. For most women in Nepal,
information about their health based on
women’s experience, knowledge and
perceptions was impossible to get.
The Fair imparted knowledge about
women’s bodies, factors affecting health
such as violence, gender discrimination,
common health problems of women,
special functioning of women and
menstruation, pregnancy, childbirth,
infertility etc. Self examination of their
body enabled participants to gain in-
depth understanding about women’s
health, strengthened their skills to do
self exam and find solutions collectively.
Kamala, 43, a woman who had never
gone to school managed a five days
training on women’s health conducted
by WOREC. She could relate the training
to her personal life as she herself was
suffering from white discharge, lower
abdominal pain and uterine prolapsed,
and also learned the treatment from
herbs for white discharge. With her health
problems cured, she began to trust the
program and she took the lead role in
taking forward the knowledge received
from the training. She had to struggle with
the family as they opposed her decision to
participate in the training,labeling WOREC
as an organization responsible for spoiling
women.She has equipped her knowledge
and confidence to serve hundreds of
women in the community to treat common
problems like white discharge, lower
abdominal pain and uterine prolapsed.
NEPAL 1991
Women’s Rehabilitation Centre (WOREC)
G.P.O. Box: 13233, Kathmandu, Nepal
Email: ics@worecnepal.org
Web: www.worecnepal.org
Conclusion
WOREC’s approach for women health
programme was successful in enabling
women to find solutions at the personal,
household and community level. This
created an environment for women to
get some degree of control over their
bodies, sexuality and over decision-
making, thus positively impacting
their health condition. Similarly, this
approach of health action has been
successful in identifying policy gaps
in realization of the goal of “health for
all” and also sought actions for policy
advocacy.