This section will begin with findings on mothers’ group meetings in the villages. Then, it describes the ways health information is shared and the issues the FCHVs faced
within the group. Most of the mothers’ groups operated savings and credit activities and challenges related to these activities are presented.
In both regions, each FCHV facilitated the mothers’ group meetings made up of the women of reproductive age in the village. The FCHVs shared MCH issues with the
group members, who were then expected to share what they had learnt with other
118 In the hill villages, each mothers’ group was also supported by an NGO. They provided
some financial (NRs 3000 or £20) and technical support that included training and
supervision of the volunteers to help them to run the mothers’ group. A service user reported the role of FCHVs in the mothers’ group meeting:
“We have a mothers’ group in our village. In that group, we are often given training. There is a FCHV who shares information on the importance of going to the health centre for childbirth. All the sisters currently do not stay at home, but they go to health centres for check-ups, and give birth at hospital.”
WomanD11.
Although mothers’ group meetings were organised each month, the FCHVs were able to be flexible:
“I have to run the mothers’ group meeting once a month, but instead sometimes I run once in two months or twice in the same month. If I cannot arrange a meeting this month, then I will have two meetings next month.” FCHVS16.
In both study regions, it was often difficult for FCHVs to find a venue for group
meetings and this was a particular challenge in the rainy season. One of them
complained:
“The mothers’ group meeting is held in open ground of school. There is no sitting place.” FCHVD3.
I attended a mothers’ group meeting in a hill village. The construction of the outreach clinic was not complete. So, the meeting was held in a damp room because we had to clean up the mud and water left by the heavy rain. [Field notes - 17th June 2014].
In the Terai, the women had to run for cover because of a heavy shower in the middle of the meeting held in an open yard. There was nowhere else to hold a meeting in that village. [Field notes - 19th July 2014].
119 Some FCHVs frequently highlighted the expenses incurred while volunteering to run
the groups, as one of them admitted:
“The main thing is that there is no money for us. I went to a village for the whole day and came back. There is nothing for us, not even a snack. I now have a zero balance on my mobile due to the arrangement of mothers' group meetings [shows her mobile].” FCHVD8.
Some FCHVs expressed reduced enthusiasm to run the meeting, as both the volunteer
and women felt bored talking repeatedly about the same health topics. Therefore,
women were no longer interested in attending meetings:
“Mothers often do not attend the meeting. They say, ‘Why to attend it? The topic of a talk is the same every time.’ The women are bored.” FGD3-Participant2.
To reduce the boredom and to maintain a regular participation of women in the mothers’ group, the majority of them also operated a microcredit scheme. This involved group
members saving a fixed amount of money every month. One FCHV commented:
“We have started to save money, as money is an important thing. If we collect money in the meeting then everybody will attend it. Otherwise, nobody comes to listen to me, do they?” FCHVD5.
Savings also supported the group members in case of financial emergencies, as the
group member could take out a loan at a low interest rate.
“We do have saving as well, we save NRs50 (£0.33) every month. It is saved for emergency situations. If someone needs money immediately, then she could have it. This way we don’t need to stretch our hands in front of others (to beg for money).” FCHVS15.
The saving activity enhanced the confidence of some FCHVs:
“We save money, share knowledge and learn from each other in the mothers’ group. We save NRs100 (£0.66) each month. Until now, we have collected NRs
120
66,000 (£440). This money can be loaned for anything, for example treatment of illnesses.” FCHVD3.
However, saving money was not without challenges. One FCHV commented that some
women were more concerned about the money than the health matters:
“We talk about Sahakari [savings credit group]. We talk about money. The group members say that they lost such and such amount of money.’ Disease issues are rarely discussed.” FCHVD1.
In a mothers’ group meeting in the hill village, I saw that women spent considerable amount of time discussing around budgeting and finance. The group members collected the deposits and maintained its records, but paid less attention to the topic of nutrition presented by the FCHV. [Field Note -17th June 2014].
The reduced interest on health related discussion could be associated with the boredom
from the talk around the same health topics as discussed above, or this could also be
because the group members prioritized saving credit activity over the health talks.
Another challenge with the saving credit activity was the security of money collected
from the group members. In one isolated but important case, one volunteer complained
that she was betrayed by a member of her own mothers’ group, while running the savings credit:
“I was operating the mothers’ group as well. Then, I don’t want to name her, but one woman from the group took all the money. I was offended for it, because I was the group facilitator and was also the group secretary. I felt so ashamed. Everyone in the area knows it.” FGD3 Participant2.
The FCHV was illiterate. Had she been educated, she could have produced a written
record of who had borrowed the money thus possibly preventing the shame. Issues
121 Apart from the regular facilitation of mothers’ group meetings, a few FCHVs reported that they attended outreach clinics to assist pregnant women or mothers to access
healthcare services in their own villages. Some examples are discussed in 5.3.1.
A health worker also commented on the limited attendance of FCHVs in the outreach
clinics.
“In the outreach clinics, we don’t get the opportunity to ask FCHVs for help. Some FCHVs attend the clinic and some don’t. Sometimes they leave the place within 10 minutes. They are crafty.” HW9.
In this section, I presented the regularly organised mothers’ group meetings led by FCHVs and its challenges. The major challenge was that sometimes the saving activities
overshadowed the discussion of health topics. The illiteracy of FCHVs was also an
issue. Some volunteers were also involved in outreach clinics, but they hardly spoke
about it. However, many spoke about their role in additional healthcare activities, which
are shown below.