Project Description

Project ID

06PN001

Project Type

Funded Project - Normal Project

Project Title

Utero-Vaginal Prolapse: An Unseen Grief of Women (A Documentary)

Project Summary

The overall objective of the proposed project is to develop a 20 – 25 minute long visual documentary, that can be used as an effective IEC material for creating awareness about uterovaginal prolapse; its development and risk factors, ways of prevention and treatment, and role of individuals, family and society in reducing this condition.

So this project is aimed to reduce uterovaginal prolapse problem among rural as well as urban women through an effective awareness program.

Location

None

Time Frame

The final documentary will be submitted to ANMF within three and half months from the date of signing.

Institution

Public Health Concern Trust (phect-NEPAL)
Pradarshani Marg, Kathmandu
GPO Box: 6064 Fax: 4256917

Telephone: 4232328, 4222450
Email: phectnpmos.com.np

Contact

None

ANMF/Nepal Project Manager

None

ANMF/America Project Manager

Dr. Binod Shah
BinodShahanmf.net

Project Description

Background:

The population of Nepal is approximately 22.8 million and women share more than half (50.1%) of the total. Forty-two percent of the population falls under below the poverty line. Eighty-six percent of Nepalese live in rural areas with more than half the population deprived of basic and primary health care services. The health resources are not equally distributed, and the available facilities are not accessible to them. The worse thing is whatever available is less accessible for women in compare to men. The reproductive health (RH) and women’s health in general has been looked at in a more holistic way since International Conference on Population and Development (ICPD) in Cairo 1994. The concept of reproductive health as a central component of women’s development was further endorsed during the Fourth World Congress on women held in Beijing in 1995.

According to WHO estimates, reproductive ill health accounts for 33 percent of the total disease burden in women as compared to 12.3 percent for males. The report further states that osteoporosis, genital prolapse and other gynecological complications contribute significantly to reproductive morbidity

The high maternal mortality rate in Nepal is caused during pregnancy, during childbirth, in post partum period and during unsafe abortion. Sexually transmitted infections, UTI and HIV/AIDS are other diseases which are responsible to deteriorate women’s health. On top of that, high prevalence of genital prolapse in rural Nepalese women is one of the biggest physical and psychological problems.

Utero-vaginal prolapse (UV Prolapse):

Women’s health is comparatively less prioritized issues in our society. Among many health problems of women, utero-vaginal prolapse is very much common problem of elder women but is most neglected health problem though it gives very much physical as well as psychological problem to women. This problem is also seen among young women.

A genital prolapse or uterovaginal prolapse is a downward or forward displacement of one of the pelvic organs from its normal location in females. It is caused most commonly due to multiple pregnancies and child births prolong labor, and short birth spacing. It is also related to diseases that cause increased pressure in the abdomen, such as obesity, long-lasting (chronic) cough, chronic constipation, doing heavy work immediately after child birth and big pelvic masses. Lack of health education, low socioeconomic status and gender discrimination play indirect but great role in developing this problem in women. Economic circumstances force women in rural parts of Nepal to resume heavy workloads soon after delivery without rest or pelvic floor exercises.

This condition creates great physical as well as social problems to the women. It can result in reduced quality of life as many women no longer engage in sexual behaviour and/or many husbands desert them. But, fortunately, this problem is preventable as well as curable. By taking a few precaution at certain conditions of women’s life would help a lot in prevention of this condition. And depending on the degrees of the organ displacement, conservative such as pelvic floor exercises and a vaginal pessary as well as surgical treatments are available for this problem.

The global problem prevalence of genital prolapse is estimated to be 2-20 percent in women under age 45. While no national level data is yet available it is estimated that there is a significant problem of prolapse uterus faced by many women in Nepal. Exact numbers are difficult to obtain because women with prolapse often remain silent about their problem and do not report to health care providers. However, it is estimated that a half of parous women lose pelvic floor support, resulting in some degree of prolapse and that of these women 10-20% seek medical care. It is estimated that 25-35% of rural Nepalese women have some degrees of genital prolapse. In Kathmandu valley alone, surgery for prolapse is the second on the operation list of the major hospitals.

One of the hospital– based studies from the Maternity Hospital in Kathmandu investigates the risk factors, beliefs and treatment and care practices of Nepalese women regarding uterus prolapse. Of the 1147 gynecological patients attending the hospital during the study period, 110 (9.6%) were found to have prolapsed. The most significant risk factors associated with the onset of prolapse were heavy work (94.5%) and lifting heavy weight (85.5%) during the post-partum period. and nearly one fifth with a prolapse were 15-24 years of age.

Since last few years, some organizations, such as UNFPA, Public Health Concern Trust (phect-NEPAL), and America Nepal Medical Foundation (ANMF) have been working for the rural women with prolapse uterus.

The proposed program will develop a visual documentary that provides information and creates awareness about development of uterovaginal prolapse, ways of its prevention and availability of treatment for existing problem.

Rationale

Utero vaginal prolapse is one of the major health problems of women in our country. Though it creates a lot of physical disability in women, because of lack of easy access to health services addressing this problem in our health system and existing social stigma about this problem, women do not reveal their problem to others. In our community, many women have been facing family clash due to this problem, though this is preventable as well as manageable health condition. Our male dominated society, workloads to women, poor socioeconomic condition and lack of education have put forth women in this vulnerable situation. It is one of the major public health problems of women in Nepal.

So far some organizations such as ANMF, phect-NEPAL, UNFPA that working for UV prolapse are basically centered in treatment of uterovaignal prolapse through surgical interventions and conservative treatment applying ring pessaries. Preventive sectors including community awareness are still less prioritized. In fact unless and until effective awareness program are incorporated addressing prevention of this condition among individual women, family and society, it would be almost impossible to reduce the prevalence of this condition as expected. Still there is lack of such IEC material that could help most effectively. So it is very important to develop effective IEC materials in light of creating awareness to all members of the society besides treatment of existing problems.

Objective:

The overall objective of the proposed project is to develop a 20 – 25 minute long visual documentary, that can be used as an effective IEC material for creating awareness about uterovaginal prolapse; its development and risk factors, ways of prevention and treatment, and role of individuals, family and society in reducing this condition.

So this project is aimed to reduce utrovaginal prolapse problem among rural as well as urban women through an effective awareness program.

Project implementation methodology/activities:

Preliminary planning:

Recruitment of team coordinator and researcher
Review of existing available IEC materials, literature
Meeting with the organizations working in UV prolapse program
Meeting with some women having UV prolapse problem, some of their spouses, field observation
Meeting with documentary making team
Script writing

Video documentary production:

Video shooting
Editing
Dubbing
Mass production

Publicity and dissemination:

Launching the video documentary (premiere)
Distribution of the copies to concerned organizations to use as IEC material in their program
Telecast on television channels
Public show on various occasions

Detail action plan: (Tentative time frame: October 16, 2006 – January 30, 2007)

Program Activities

Targ. / Week

Oct

November

December

January

3

4

1

2

3

4

1

2

3

4

1

2

3

4

Preliminary planning

*

Recruit team coordinator

*

Recruit researcher

*

*

Review of existing available IEC materials, literature

*

Meeting with the organizations working in UV prolapse program

1 time

*

Meeting with some women having UV prolapse problem and some of their spouses / immediate care takers (individual), field observation

*

*

*

*

Meeting with documentary making team

4 time

*

*

Script writing

Documentary production

Video shooting   Editing   Dubbing   Mass production

*

*

*

*

*

Dissemination

Launching the video documentary   Distribution of the copies to concerned organizations to use as IEC material in their program

1 time

*

Telecast on television channels

4 time

*

*

Public show on various occasions

(As need/demand on different occasions)

Reporting:

Phect-NEPAL will report to the ANMF authority on a regular basis abouth the development of the project once in two weeks till the completion of the task. Prior, phect-NEPAL will discuss with ANMF authority on the documentary script before going to the production phase. Phect_NEPAL will submit one copy of each format of the final version to ANMF.

Material Requested

None

Training Requested

None

Advisors/Instructors Requested

None

Travel/Expenses Requested

None

Grants/Stipends Requested

None

Other Items Requested

None

Total Funds Requested

NRS 1,347,750 = $20,200

Budget

Particulars	No	Rate	Days	Total (NRS.)
Pre production
Human resource
Researcher (field observation, literature review)	1	5,000	10	50,000
Script writer	1	20,000	-	20,000
Transportation (by air in 2 spots and by road travel in several places within Nepal)				30,000
Accommodation (out of valley)	1	1,500	6 night	9,000
Meeting (1 times with other concerned institutions)
Stationers				1,500
Refreshment	10	250	1	2,500
Sub Total				113,000
Production
Human resource
Director	1	5,000	10	50,000
Camera person	1	4,000	10	40,000
Camera assistant	1	2,500	10	25,000
Sound person	1	2,500	10	25,000
Light person	1	2,500	10	25,000
Shooting goods
SONY PD 390 camera	1	7,000	10	70,000
Recording tape	30	500		15,000
Transportation
Road vehicle hire for the valley	1	5,000	4	20,000
Road vehicle hire for out of the valley	1	8,000	6	48,000
Accommodation	7	1,500	5	52,500
Sub total				370,500
Post production
Human resource
Director	1	2,500	30 hrs	75,000
Editor		2,000	30 hrs	60,000
Narrator (English / Nepali)				60,000
Processing
Editing set	1	3,000	60 hrs	180,000
Logging		500	30 hrs	15,000
Graphic titling				15,000
Background music				100,000
Cassettes and CD for master copy
Master CD	2	1,000		2,000
Master VHS	2	1,500		3,000
Master Beta SP Pal	2	2,000		4,000
Master DV	2	2,000		4,000
Master DVD	2	5,000		10,000
Pre final presentation
Hall hiring	1	10,000	1	10,000
Refreshment	25	250		6,250
Sub total				544,250
Publicity and dissemination
Documentary Launching Program (Premiere)	1			50,000
Telecast in four TV channels	4	40,000		160,000
Produce bulk video copies (CD/DVD)	50	300		15,000
Sub total				225,000
General management
Human resource
Team coordinator (hire for 3 and half months)	1	20,000	3.5 month	70,000
Others (communication, stationers)				25,000
Sub total				95,000
Grand total				1,347,750

(In words: NRS. One million three lac forty seven thousand seven hundred fifty only) = $20,200

Additional Information

None

Project Status

8/31/06	Request received by ANMF/Nepal
9/12/07	ANMF/Nepal approved funding last $5,000
9/19/07	Projects Committee approved funding last $5,000
9/23/07	Board approved funding last $5,000, Dr. Binod Shah appointed project manager
5/28/08	phect-Nepal notified ANMF/Nepal that project has been terminated
6/22/08	Project closed by Board