Improving Lives for Children and Women in Nepal ...

United Nations Children's FundNepal Country OfficeP. O. Box 1187UN House, PulchowkKathmandu, Nepal

Improving Lives forChildren and Women in Nepal

Decentralized Action for Children and Women (DACAW)

Government of Nepal

Telephone: 977-1-5513200Facsmile: 977-1-5527280www.unicef.org/nepal

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Local Body Support SectionGovernance Coordination DivisionMinistry of Local DevelopmentShree Mahal, PulchowkKathmandu, NepalTelephone: 977-1-5522015Facsmile: 977-1-5522045www.mld.gov.np

Some 46 per cent of Nepal’s population of 26 million arechildren aged less than 18 years. The mortality rate ofunder-ones has decreased substantially over the last twodecades, and currently stands at 48 deaths per 1000 livebirths. However, this still amounts to over 40,000 childrenaged less than one year dying each year. Child malnutritionrates are also high, with half of all under-fives beingstunted, or too short for their age. Every year, ther areapproximately 960,000 pregnancies in Nepal. Thematernal mortality rate was estimated to be 281 per100,000 live births in 2005. About 82 per cent of birthstake place at home without any trained assistance,increasing the risks for both the mother and the newborn.

Since the restoration of multiparty democracy in 1990,successive governments have struggled to implementadministrative and institutional reforms to improvegovernance. However, the passage of the Local Self-Governance Act in 1999 provided an opportunity to

increase decentralization through greater localparticipation in decision-making.

Nepal’s decade-long conflict has contributed to multipledeprivations by hampering the delivery of basic services,restricting development assistance, and causing abreakdown of family and community networks. Womenand children, who rely most heavily on these essentials,have particularly felt the negative impacts of thedeprivation and violence. In April 2006, after weeks ofpro-democracy protests, the king ended his direct rule.Parliament was reinstated and an all-party governmentwas formed. During the last year, the coalit iongovernment has negotiated the Comprehensive PeaceAgreement with the Maoists, which includes thecantonment of combatants and weapons under UNsupervision, and has made preparations for creating aConstituent Assembly. Elections for this are expectedsometime in 2008.

Situation of children and women in Nepal

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DACAW Districts (23)

Map of Nepal

INTERNATIONAL CONVENTIONS

Nepal has ratified the following international conventions that are relevant to UNICEF’s work.UN* Convention on the Rights of the Child (CRC)UN Optional Protocol to the CRC on the sale of children, child prostitution, and child pornographyUN Optional Protocol to the CRC on the involvement of children in armed conflictsUN Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW)ILO* Convention on the Worst Forms of Child LabourSAARC* Convention on Regional Arrangements for the Promotion of Child Welfare in South AsiaSAARC Convention on Preventing and Combating Trafficking in Women and Children for Prostitution

* UN = United Nations, ILO = International Labour Organization, SAARC = South Asian Association for Regional Cooperation.

UNICEF responds in emergencies to protect the rights ofchildren. In coordination with United Nations partnersand humanitarian agencies, UNICEF makes its uniquefacilities for rapid response available to its partners torelieve the suffering of children and those who providetheir care.

UNICEF is non-partisan and its cooperation is free ofdiscrimination. In everything it does, the mostdisadvantaged children and the countries in greatest needhave priority.

UNICEF aims, through its country programmes, to promotethe equal rights of women and girls and to support theirfull participation in the political, social and economicdevelopment of their communities.

UNICEF works with all its partners towards the attainmentof the sustainable human development goals adopted bythe world community and the realization of the vision ofpeace and social progress enshrined in the Charter of theUnited Nations.

The mission of UNICEFUNICEF is mandated by the United Nations GeneralAssembly to advocate for the protection of children’s rights,to help meet their basic needs and to expand theiropportunities to reach their full potential.

UNICEF is guided by the Convention on the Rights of theChild and strives to establish children’s rights as enduringethical principles and international standards of behaviourtowards children.

UNICEF insists that the survival, protection anddevelopment of children are universal developmentimperatives that are integral to human progress.

UNICEF mobilizes political will and material resources tohelp countries, particularly developing countries, buildtheir capacity to form appropriate policies and deliverservices for children and their families.

UNICEF is committed to ensuring special protection forthe most disadvantaged children—victims of war, disasters,extreme poverty, all forms of violence and exploitation,and those with disabilities.

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I M P R O V I N G L I V E S F O R C H I L D R E N A N D W O M E N I N N E P A L

What is DACAW ?

Decentralized Action for Children and Women(DACAW) is UNICEF Nepal’s primary programmefor channelling a range of interventions to ruralcommunities in 23 districts across Nepal.

It is based on the understanding that the decisionstaken by people themselves about their own lives areoften the most effective and sustainable. Byfacilitating mothers in self-help groups to discusstheir concerns in depth and examine the reasons

Contents

Map of Nepal showing DACAW districts ................ 2

Situation of children and women in Nepal ........... 2

What is DACAW? ........................................................ 3

“DACAW has changed my life.” ............................... 4

Decentralized Action for Children andWomen (DACAW) ........................................................ 6

Major partnerships with other UN agencies ........ 7

DACAW strategies ...................................................... 8

Community Action Process (CAP) ............................ 8

Responsive service delivery ................................... 8

Decentralized governance ...................................... 9

Channels of implementation ................................... 9

Partnership modalities ...........................................10

Proportional costs of DACAW 2002–2006 ..........10

DACAW’s approachto developing sustainability ..................................11

DACAW’s support for the peace process ............ 11

DACAW’s focus on the disadvantaged ................. 13

DACAW strategic results ......................................... 15

Quality basic education .......................................... 15

Protection of children and women ....................... 16

Maternal health and care .....................................19

Child health .............................................................. 20

Child and maternal nutrition ................................. 22

Early childhood development ...............................23

Water supply and sanitation ................................. 24

HIV/AIDS awareness ............................................... 25

The mission of UNICEF ...........................................27

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behind them, the programme strengthens the abilityof individuals and communities to find their ownsolutions to their particular problems. Sometimes achange in behaviour within the family might makethe difference, and sometimes mobilizingcommunity-level resources can improve the situation.However, sometimes it is necessary to demand newor better services from sources outside thecommunity. This approach is known as theCommunity Action Process (CAP). DACAW doesnot initiate group formation, instead it integrateswith community organizations already established byother programmes that are mainly aimed atmobilizing savings and loans. The key implementingpartners are currently the Ministry of LocalDevelopment, the Department of Women’sDevelopment, the Small Farmers DevelopmentProgramme, and various NGOs. Each communityorganization has a mobilizer, who has been trainedunder DACAW to facilitate monthly group meetings,

and each Village Development Committee (VDC)has a facilitator, who supervises communitymobilizers and links the community organizations tothe broader world.

If you were to visit a settlement during a CAPmeeting, you might see a group of young mothersweighing their babies and discussing how to ensurethat their children maintain a healthy rate ofgrowth. Or they might be learning about the majordanger signs to look out for during pregnancy andchildbirth, and what should be done when awoman experiences a pregnancy complication. Thismight lead on to a discussion about resourceswithin the family and the need for setting up a fundthat can be accessed by group members when amedical emergency arises. Or women might becollecting their contributions for their savings andloan fund, and discussing ways that they cangenerate a cash income. Sometimes they might be

“DACAW has changed my life.”

Kalpana* lives in Navadurga VDC, Dadeldhura District.She is married and has five children aged between 15years and four years. Although her household owns asmall piece of land, the family is food deficient for aboutthree months a year. During this time, her husband worksas a daily-wage labourer in a nearby town. She tells usabout the changes in her life since she became a memberof her local community organization in 2002. “When myeldest children were growing up, they always seemed tobe getting sick with diarrhoea or coughs and colds. I didn’tknow what to do. If their fever got really bad, I wouldsometimes take them to the shaman (faithhealer) butusually I just kept them at home. I didn’t have enoughmoney for medicine and, anyway, there wasn’t a healthpost in our village. Now, if my youngest gets diarrhoea, Itreat her at home with ORS or take her to see Rita, ourfemale community health volunteer (FCHV). Rita has been

trained and knows what to do; she often comes to ourmonthly meetings and explains how to keep our childrenhealthy. But somehow my kids don’t get as sick thesedays; they seem much stronger than in the old days. Maybethat’s just because when they were little, I took them to beweighed each month and learned how to make sarbottampitho (super flour) to feed them. Also, two years ago, webuilt a latrine and joined the community water users’group, so now it is easier to keep the household and thechildren clean. We paid for the latrine with a loan fromthe community organization. I paid back the money byselling achar (chutney) that I learnt how to make aftergoing to a training organized by our communityorganization. My youngest children have also beenvaccinated and given vitamin A. I heard about theseservices at our monthly meetings, and our communitymobilizer, Bhagwati, explained that these injections stop

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diseases from attacking the children in the first place. Iwas scared about them at first but then the neighbour’sdaughter had her vaccinations and she was fine. So myfriend and I took our children to the immunization centre.Now nearly everyone in the village takes their babies forvaccination. My eldest daughter didn’t really go to school.She started in Grade 1 when she was five but she didn’tlike it, as there was no toilet and the teachers were roughwith the kids. Anyway, she preferred to help me with myyounger ones and that was fine with me. But after I startedgoing to the group meetings, I realized that it is importantfor kids to go to school and learn how to read and write, sothat they can get a good job and not get cheated. Someparents talked with the local School ManagementCommittee and eventually the school building was repairedand toilets were installed, and the teachers got some newtraining and new materials. Now, my eldest son, who is

thirteen, has just finished primary school. He would liketo go to secondary school but it is far from here, so we’llhave to see about that. My other two sons are in Grade 2and Grade 4. They like school and try their best, but it isexpensive for us to buy books and uniforms. In our village,we have a child development centre, where my youngestdaughter goes three mornings a week. My eldest daughterhelps at a tailors and is learning how to sew. People areasking to marry her but I want to wait until she is olderand has finished her training as that is better for her. Inthe future, when my children are older, I would like tobecome a mobilizer for our community organization. Myhusband thinks that is a good idea and he says it wouldmake him proud to see me helping other women in ourvillage. I’m really pleased that I joined the communityorganization. My life has changed in many ways and it makesme happy to see my children growing up healthy and clever.”

* Kalpana’s story is an amalgamation of the voices of several women who have spoken about DACAW over the last seven years.

learning about where and when the next vitamin Adistribution or immunization day is taking place, orhow to protect themselves from HIV/AIDS. Wheninputs are required from outside the settlement,such as for an improved drinking water supply orrenovation of school buildings, the villagefacilitator links the request from community groupswith the appropriate external supply agent, andhelps to ensure that the task agreed upon isaccomplished. Each month the communitymobilizer will update a Community InformationBoard with a variety of details such as the numberof children aged 3–5 years attending a local childdevelopment centre or the number of childrenreceiving treatment from a trained health worker foracute respiratory infection or the number ofhouseholds with a latrine. This informationpublicly monitors progress within the settlement

and also serves as a prompt for new groupdiscussion at the monthly meetings.

As well as taking part in the regular monthly groupmeetings, some women also become involved incommunity-wide groups such as paralegal committees,watch groups, or federations that operate across awider arena than the community organizations. Thesegroups have evolved from DACAW and offer aneffective community-based mechanism for tacklingparticular aspects of the programme such asprotection, healthcare, or establishing sustainablecommunity organizations in ways that benefit andstrengthen the whole community. They are proving tobe effective at empowering women and areencouraging the expansion of DACAW into newVDCs as well as being replicated as successfulmechanisms in other development programmes.

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Decentralized Actionfor Children and Women(DACAW)

DACAW has been the centerpiece of UNICEF Nepal’scountry programmes since 1998 (initially it was knownas the Decentralized Planning for the ChildProgramme). During this time, it has demonstratedthe synergistic effect of combining support forcapacity-building of local communities andgovernment functionaries with promotion ofdecentralized service delivery. The goal of theprogramme is to ensure the progressive realization ofthe rights of children and women in programme areasthrough rights-based and bottom-up approaches thatfocus on the most severely disadvantaged.

The programme is structured to address criticalproblems underlying children’s wellbeing.It is based on the assumption that people’s limitedcapacity and lack of opportunity to analyse theirsituation, as well as their overall lack of participationin and control over resources, services and decision-

making, are underlying barriers to the realization oftheir rights. It uses three strategies to bring aboutchange.

Strengthening the capacity of individuals andcommunities to demand change by using theCommunity Action Process (CAP).Strengthening the capacity of local serviceproviders/delivery agencies to respond todemands for change from the community.Strengthening decentralized local governance infavour of children and women.

DACAW is a coordinated and sustained effort aimedat alleviating poverty and addressing the MillenniumDevelopment Goals. It focuses on promotion ofquality basic education; protection of children andwomen against violence, exploitation and abuse;improvement of maternal and neonatal health;improved management of common childhoodillnesses; improved psychosocial and cognitivedevelopment of children; greater access to safedrinking water and sanitation; and increasedawareness of HIV/AIDS.

Halve the proportion of people living in extremepoverty by 2015.Ensure universal primary education by 2015.Promote gender equality and empower womenby eliminating gender disparity at all levels ofeducation by 2015.Reduce the under-five mortality rate by two-thirds by 2015.Reduce the maternal mortality rate by three-quarters by 2015.Combat HIV/AIDS, malaria and other infectiousdiseases.Halve the proportion of people without access tosafe drinking water and basic sanitation by 2015.Develop a global partnership for development.

MILLENNIUM DEVELOPMENT GOALS

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One of the main strengths of DACAW is itsintegrated approach. This enables the programme toaccommodate donor support both formultidimensional problems that require inputs fromseveral sectors and for more focused issues, withoutunnecessary duplication of effort. This attribute will beparticularly valuable during the coming years, in thereconstruction of community assets and institutionsand the rehabilitation of returnees (internally displacedpersons and combatants), following the peaceagreement and associated political changes.

Another strength is the effectiveness of theprogramme’s partnership modalities that combinethe mobilization of pre-existing communityorganizations with the development of newinnovative group formations such as federations,child clubs, paralegal committees and watch groups.This has enabled the programme to avoidunnecessary duplication. It has also strengthenedlocal organizations, and enhanced their institutionaland management capacities.

DACAW is a tried and tested method that is provingto be extremely effective at improving the lives ofchildren and women in rural Nepal. It is hoped thatgovernment agencies and other developmentpartners will be able to take up this approach andreplicate it in other districts.

Major partnershipswith other UN agencies

As part of the UN’s Development AssistanceFramework (UNDAF), UNICEF is committed tostrengthening its cooperation with other UNagencies. Joint programmes will be developed withthe United Nations Population Fund (UNFPA) andthe World Health Organization (WHO) for maternaland neonatal health; with the World FoodProgramme (WFP) for nutrition and qualityeducation; and with the United NationsDevelopment Programme (UNDP) for districtgovernance and community mobilization. Inaddition, an enhanced UN collaboration initiative(UNDP, UNICEF, UNFPA and WFP) in fourdistricts will be developed. In the health andeducation sectors, UNICEF will strengthen itspartnerships through the External DevelopmentPartners and Education for All forums, in whichbilateral donors have an important presence.UNAIDS is the coordinating body and secretariat forUN agencies working on HIV/AIDS. UNICEF isthe lead agency for prevention of mother-to-childtransmission (PMTCT) of HIV, paediatric AIDStreatment, and the care of orphans and vulnerablechildren (OVCs). The United Nations Mission inNepal (UNMIN) will coordinate interventions withspecific relevance to the peace process, and UNICEFis actively involved in various mechanisms for thispurpose. UNICEF will take advantage of thestrengthening of democratic institutions to furtherdevelop its long-standing partnerships with localNGOs, media and civil society.

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Community Action Process(CAP)

The Community Action Process (CAP) is the keystrategy for implementing DACAW activities. CAPenhances the capacities of individuals, families andcommunities to assess their situation, analyse itsvarious causes, and plan appropriate actions bymobilizing internal and external resources needed tobring about change in the community—the Triple Aprocess (assessment–analysis–action). CAP alsoprovides a forum and process for examining andlessening gender disparities at household andcommunity levels. The increased analytical abilitygained through these processes helps women tobecome empowered decision-makers at bothhousehold and community levels.

Community organizations use various participatorytools and techniques, gender-sensitive tools, aCommunity Information Board (CIB), growth-monitoring charts, and meetings to facilitatediscussions on issues that affect the wellbeing oftheir children.

Responsive service delivery

The delivery of services in Nepal has long been overlycentralized and, as a result, often inefficient and

unmatched to local needs. DACAW seeks to makelocal service-delivery institutions more responsive bybuilding their capacity to work on child rights andwomen rights issues. Community organizationscreate demand for better services by informing peopleabout their rights and mobilizing them to utilizelocal services. Village Facilitators serve as the linkbetween the community and service-deliveryinstitutions.

An important aspect of improving service deliveryis the training provided to functionaries of localinstitutions. These include VDC Secretaries,teachers, members of School ManagementCommittees (SMCs) and Parent–TeacherAssociations (PTAs), village-level health workersand volunteers, traditional birth attendants, andsanitation workers.

DACAW strategiesStrengthening the capacity of individuals and communities to demand change by using the CommunityAction Process (CAP).Strengthening the capacity of local service providers/delivery agencies to respond to demands forchange from the community.Strengthening decentralized local governance in favour of children and women.

CAP COVERAGE

As of August 2007, CAP was being implemented inover 6,900 community organizations in 283 VDCsand 10 municipalities of 15 districts. Over 60 percent of community organizations have an all-femalemembership. CAP is supported by over 265 trainedVillage Facilitators, and over 7,500 trainedCommunity Mobilizers. CAP covers 33 per cent ofVDCs in the 15 DACAW-supported districts.

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Decentralized governance

The passage of the Local Self-Governance Act in 1999has provided an opportunity to bring about goodgovernance based on greater popular participation indevelopment. The act promises a role for civil societyorganizations in contributing to both service deliveryand good governance, and is seen as a significant steptowards fulfilling civil and political rights. The act hasalso created a legal basis for the transfer of decentralizedplanning to locally elected authorities. DistrictDevelopment Committees (DDCs), municipalities,VDCs have begun to undertake resource allocation andprogramme planning and implementation.

DACAW works with these local bodies to build theircapacity to prepare medium-term plans, and annualplans and actions aimed at improving the wellbeingof children and women. Despite the absence ofelected local bodies since 2002, five-year DistrictDevelopment Plans have been prepared in 15DACAW districts.

DACAW has demonstrated the positive effects ofconvergence between responsive service delivery anddecentralized governance with more focused localplanning in favour of children and women. It hasbeen able to expand cooperation between DACAW,district-level government agencies and local NGOs indeveloping programmes for local communities. Ithas also increased flexibility in fulfilling the demandsof local communities for community-manageddevelopment initiatives.

An important element of UNICEF’s support forstrengthening decentralized government is itspartnership with UNDP through the DecentralizedLocal Governance Support Programme (DLGSP). Inthe new phase of the DLGSP that starts in 2008,UNICEF will continue to work with DDCs to

ensure that DACAW is expanded to the mostdisadvantaged VDCs in each DACAW district andthat district-level officials are capacitated to managethe programme.

Channels of implementation

The Ministry of Local Development is the maingovernment implementing partner for DACAW and,with support from the National PlanningCommission, is responsible for overall coordinationof the programme. DACAW activities areimplemented in collaboration with the Ministry ofHealth and Population, Ministry of Education andSports, Ministry of Finance, Department ofWomen’s Development, and Department ofDrinking Water Supply and Sewerage. A NationalSteering Committee comprised of key sectoralministries, associations of local bodies anddevelopment partners provides policy guidance andinter-sectoral coordination. At district and localgovernment levels, DACAW collaborates withDDCs, VDCs, and other local governmentdepartments and offices.

At the settlement level, DACAW works throughexisting groups that are formed by otherorganizations. This is an important aspect of ensuringownership and sustainability, and also avoidsduplication. Community organizations are facilitatedand supported by paid village facilitators (VFs) at theVDC level and volunteer community mobilizers(CMs) at the community organization level.

Since 2004, DACAW funds have been channelledthrough District Development Funds (DDF) insupport of the government’s financialdecentralization policy, and are thus reflected in theaccounts of the central treasury.

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Partnership modalities

DACAW has four main partnership modalities forimplementing the programme.

In the Village Development Programme (VDP)modality, community organizations are formedby the Decentralized Local Governance SupportProgramme (DLGSP), which is funded by theUNDP and implemented by the Ministry ofLocal Development (MLD).The Integrated Women and Child DevelopmentApproach (IWCDA) modality representsfederations or cooperatives that were supportedearlier by UNICEF through the Women’sDevelopment Section of the Department ofWomen’s Development.In the Small Farmers Cooperative Limited (SFCL)modality, federations and cooperatives are formedby the Small Farmers Development Programme,which was initiated by the AgricultureDevelopment Bank.In the Integrated Child DevelopmentProgramme (ICDP) modality, communityorganizations are formed by NGOs with supportfrom various donors (including UNICEF).

The two largest partners are the VDP and theIWCDA.

QIP MODALITY

The QIP modality arose from the Quick ImpactProgramme (QIP) that was jointly initiated by UNICEFand the World Food Programme (WFP) in 57 conflict-affected VDCs of nine Mid- and Far Western districts in2003. The aim of the programme was to improve basicservices, particularly in health and education, forvulnerable populations by implementing the elementsof DACAW in conjunction with the WFP’s Food-for-Workand Food-for-Training schemes. Local developmentprojects such as rehabilitation of schools and healthposts, and installation of drinking water and sanitationfacilities were implemented by two national partnerNGOs. This modality proved to be extremely effectiveat bringing much-needed benefits to rural communitiesin remote areas in conflict situations. Nonetheless, itwas important that capable, professionally managedand neutral NGOs were involved as implementingpartners, and that they maintained neutrality in theirbehaviour and full transparency in their financial andprogramme activities. This modality has now beenincorporated into DACAW.

PROPORTIONAL COSTS OF DACAW 2002–2006

DACAW 2002–2006 for 15 districts = US$ 17,380,975

34%Education

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DACAW’s approach todeveloping sustainability

A recent evaluation of DACAW by the RoyalNorwegian Embassy recommends that federationoffers the most effective approach to long-termsustainability.

DACAW works with federations formed andfacilitated mainly by the Department of Women’sDevelopment (the IWCDA modality). The entrypoints for federation are small groups that areformed at the settlement level. These groups meet tomobilize internal savings and are trained in groupdynamics to build trust and harmony. Afteroperating for at least one year, these groups establishthemselves as ward-level committees. After beingactive for an additional year and successfullydemonstrating the ability to handle funds andorganize various activities, these groups are given theoption to either register as an NGO or as acooperative. It is during this two-year process thatgroup cohesiveness and the solidarity to work onsocial issues related to women and children areestablished and demonstrated. The ultimate purposeof these groups is to achieve both social andeconomic empowerment.

These federations, mostly cooperatives, are self-sustaining and seek to empower women by teachingthem about their own rights and that of theirchildren. Women are able to voice their opinions andmake decisions. Federations teach members tobecome financially independent by providing themwith vocational skills and access to loans. The strategyof implementing CAP through these federationsusing the IWCDA modality has proved to beeffective and sustainable for achieving DACAWresults. In some districts, federations havedemonstrated financial sustainability by bearing the

entire cost of the village facilitator’s salary frominterest earned through their seed grant. In somedistricts, federations have increased salaries for villagefacilitators from their own sources, while in othersthey have convinced the VDC to top-up the villagefacilitator’s salary.

Federations that have demonstrated success throughthe IWCDA modality have emphasized anempowerment approach that is aimed atparticipation, ensuring realization of the rights ofchildren and women, and focusing on inclusion ofthe most disadvantaged. They show strongaccountability, as they have institutional structures atsettlement (women’s groups), ward (ward-levelcommittees) and VDC (VDC-level committees)levels. These committees provide support to villagefacilitators and community mobilizers in socialmobilization, programme implementation, andmonitoring. Additionally, the district-level Women’sDevelopment Section office has assigned staff at theVDC level that backstop and assist the work offederations and village facilitators/communitymobilizers. Federations are proving to be effective atdeveloping and putting systems on the ground thatenable women to represent and articulate issuesrelated to children and women, and also successfullyexpand inclusion of the disadvantaged.

DACAW’s supportfor the peace process

After 10 years of Maoist insurgency that severelydisrupted the provision of government servicesthroughout the country, particularly in rural areas, theComprehensive Peace Agreement signed inNovember 2006 has paved the way for new initiativesthat are aimed at building a strong and peacefuldemocratic society in Nepal, where government

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agencies can function effectively. The UN, throughUNMIN, is playing a central role in supporting thispeace process.

Over the coming years, DACAW will implementboth short-term and long-term projects that arespecifically designed for strengthening peace. Theseprojects will integrate with existing DACAWstrategies and will continue to focus on improvingthe lives of children and women. Already identifiedprojects will include the release and reintegration ofchildren associated with armed forces and armedgroups (CAAFAG); mine-risk education and victimassistance; juvenile justice; protecting children indemonstrations and political activities; and facilitatingand strengthening the voices of young people ininfluencing the Constituent Assembly and draftingthe new Constitution, through ‘Engaging YoungVoices’ listener clubs. This last activity will build onlistener clubs already established by UNICEFthrough the radio programme ‘Chatting with myBest Friend’. In a similar vein, UNICEF iscollaborating with the UNDP on a Peace andConstitution-Building Project where the BBC WorldService Trust will develop drama and discussionprogrammes to both change behaviour and raiseawareness on conflict resolution, peace andconstitution building. UNICEF-supported VillageFacilitators will be trained to facilitate listening anddiscussion groups, and will be provided withmaterials, radios and support so that they can deliverthe programmes to DACAW’s network ofcommunity groups.

Other DACAW activities that will be particularlyuseful in supporting the peace process include thoseon rights and reconciliation (paralegal committees;reconciliation through recreation; monitoring the

implementation of Security Council Resolution1612); and those that support basic services andimproved living conditions (support for the FemaleCommunity Health Volunteer (FCHV) programme;supply of essential drugs and clean delivery kits;community-based therapeutic care (CTC) for acutelymalnourished children; HIV prevention amongwomen of reproductive age and adolescents;improvement of education infrastructure; safedrinking water and sanitation for neglectedcommunities; safe water, sanitation and hygieneeducation for schools in neglected communities;improving health in neglected communities thoughhand-washing with soap and household drinkingwater treatment; and school feeding).

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DACAW’s focuson the disadvantagedUNICEF aims to focus its interventions onmarginalized, disadvantaged, discriminated andexcluded groups that are hard to reach throughnormal channels. These groups are often referred toas socially excluded groups; this term is intended tocover all people who are put at a disadvantage insome aspect of everyday life for economic orsociocultural reasons.

DACAW has actively experimented with innovativestrategies and actions to increase inclusion of thedisadvantaged. Some demonstrated successes includeusing disaggregated data for planning; hiring villagefacilitators and community mobilizers fromdisadvantaged communities; focusing facilitation onactively enabling participation by excluded groups;including dimensions of exclusion in all participatoryprocesses and tools; mainstreaming issues related toexclusion in regular training; ensuring constantadvocacy when engaging with governmentcounterparts; providing regular backstopping forimplementing partners; and providing seed grant/equity funds for disadvantaged communities.

A particularly important improvement in DACAW’sability to reach disadvantaged households is the

CORE INDICATORS FORMAPPING OF THE DISADVANTAGED

Survival based on daily-wage labourHomeless, shelterless and mostly residing onencroached land or land without titleAnnual food sufficiency of >3 months or 3–6monthsIndebtedInability to afford cost of children’s education,clothing and medicineSocially and culturally oppressed groups(e.g. Dalits, janajati, etc.)Female-headed households with no additionalsource of incomeLack of confidence to voice legitimate demandsin public and private forums

recently completed mapping study. Up till now,identification of exluded communities andhouseholds has been based on localizedinterpretations of their ‘disadvantaged-ness’, mainlyrelating to ethnicity or food sufficiency. However, it iscommonly acknowledged that, in Nepal, acombination of both social and economic factorsacting together can result in a family becomingchronically disadvantaged. The conventional definitionof disadvantaged-ness has unintentionally resulted insome inequity in the categorization of excludedhouseholds. The newly-devised definition nowenables the systematic identification and targeting ofdisadvantaged households in UNICEF’s area-basedprogramme though the application of eight coreindicators and participatory methodology/tools.

As well as being able to map households within acommunity, the study also developed a related set ofsix indicators to rank VDCs or municipal wards bydisadvantaged-ness (in terms of access to services,gender discrimination, protection, marginalization,

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vulnerability to conflict, and representation in thedistrict). The Ministry of Local Development, DDCs,district partners, and political parties have all beeninvolved in ranking VDCs and municipal wards inthe 15 DACAW-supported districts, generatingstrong stakeholder ownership. Both the Ministry ofLocal Development and UNICEF are now usingthese rankings to ensure that DACAW and otherdevelopment programmes are expanded into themost disadvantaged VDCs and municipal wards.

Some 320,000 households in 236 VDCs and eightmunicipalities of 15 districts were mapped in early2006. In total 28 per cent were classified as severelydisadvantaged, 28 per cent were classified asdisadvantaged, and the remaining 44 per cent wereclassified as non-disadvantaged. The study alsoindicated that DACAW covers over 63 per cent of themost disadvantaged households in CAP VDCs.

MAPPING OF THEDISADVANTAGED IN DACAW VDCS

Food sufficiency of less than three months(concentration of daily-wage earners, forced out-migration in search of labour, economicenslavement and bonded labour—kamaiya, hali,haruwa/charuwa)Concentration of marginalized groups (such asDalit, janajati, etc., resulting in socio-culturaldiscrimination, untouchability, verbal abuse,social exclusion in public gatherings, and non-acceptability of ethnic cultures)Lack of access (functional and responsive) to basicservices: primary-level school and sub health post(deprivation and low affordability of basic services)Low level of representation/participation of women,Dalit and janajati in formal decision-making bodiessuch as VDC, School Management Committees,Health Management Committees, local NGOs, etc.(lack of recognition of existence, lack of awarenessof the rights of women and marginalized groups,illiteracy and low acceptability)Prevalence of gender discrimination (such as earlymarriage, girls not going to school, superstitionof witches, violence against women, polygamy,polyandry, dowry, chaupadi, parda, etc.)High prevalence of vulnerable groups such asthose suffering as a result of the conflict (orphans,widows, single female-headed households, out-migration, etc.), human trafficking, disabled,natural calamities, HIV/AIDS, hepatitis B, etc.

INDICATORS USEDTO RANK ALL VDCS IN A DISTRICT

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Quality basic education

Quality basic education for girls andchildren from disadvantaged groupsThe education programme aims to increase access toquality basic education for girls and children fromdisadvantaged groups and to provide appropriatelearning opportunities, including life skills, for at-riskchildren and adolescents. The programme is focusedon action at two levels: advocacy and technicalsupport at the national policy level to promotequality child-friendly education for all, and district-level actions to field innovative initiatives. Theprogramme tries to ensure that children have access toa variety of education services. DACAW takes anintegrated approach to non-formal, informal andformal education, with a view to contributing in anintegrated manner to the government’s Education forAll (EFA) and Girls’ Education Programmes.

With girls’ education at the forefront, the programmehelped the Ministry of Education and Sports toadopt the Welcome to School (WTS) model,successfully piloted by UNICEF in 15 DACAWdistricts in 2004, as a national model for enrolment in2005. Increase in girls’ participation in the DACAWdistricts is consistently above the national average. In

DACAW strategic resultsIncrease access to quality basic education, especially for girls and disadvantaged groups.Protect children and women against violence, exploitation and abuse.Improve maternal health.Reduce childhood morbidity and improved management of illness due to acute respiratory infection (ARI),diarrhoea and vaccine-preventable diseases.Improve care for reduction in child and maternal malnutrition.Improve psychosocial and cognitive development of children.Reduce incidence of diseases from poor and inadequate sanitation and water supply.Increase awareness of HIV/AIDS.

As a result of the Welcome to School (WTS)campaign, the number of children enrolled inprimary school increased from 4,030,045 in 2004to 4,506,970 in 2005—an increase of 12 per cent.Enrolment of girls increased from 1,865,012 in 2004to 2,134,646 in 2005—an increase of 14 per cent—and enrolment of Dalit children increased from421,605 in 2004 to 969,059—an increase of 130per cent. In 2005, the WTS campaign increased theenrolment of girls in the 15 DACAW by 49 per centover 2004. Although these numbers are impressive,the challenge now is to ensure that these newlyenrolled students do not drop out of school but stayon to complete a full cycle of primary education.

addition, now that disaggregated, school-level data isavailable for Dalit and non-Dalit attendance, it showsthat the increase in Dalit participation isproportionally greater in DACAW districts than inother districts.

In 2005, a comprehensive package to support schoolimprovement processes, strengthen communitymanagement, improve education management andchild-friendly methods was introduced. This hasbenefited approximately 7000 schools in DACAW’s23 districts.

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Alternative learning opportunitiesfor out-of-school childrenOf the 13 per cent of Nepal’s 6–10-year-olds who donot participate in primary education, most are girls orchildren from poor, disadvantaged households. Over85 per cent of these out-of-school children currentlywork an average of 22.4 hours a week. This makes itdifficult for working children to attend school on aregular basis. For these children, UNICEF has beensupporting rural and urban out-of-school educationprogrammes (OSP) through NGOs. These classesdeliver basic education to children who have missedthe opportunity to enrol or have dropped out ofschool after only a year or two. After completion ofthe OSP course, graduates are encouraged to enrol informal school. In 2005, more than 5,800 childrenwho completed the OSP were transferred to formalschools to continue their education. About 37 percent of these completers—more than 50 per cent ofthem girls—transited to primary schools, which is anincrease of six percentage points over 2004.

As well as the OSP, there are two other alternativelearning packages: (1) the School OutreachProgramme, which provides classes based on theformal education curriculum for Grades 1 to 3 in aconvenient venue for children aged 6–8 years; and(2) the Flexible Schooling Programme, which is athree-year condensed course equivalent to five yearsof primary basic education for children aged 8–10years. These programmes are more suitable for

As of June 2006, 45,000 out-of-school children aged10–14 have completed Out-of-School Programmes(OSP I and OSP II), of which about 65 per cent aregirls. In DACAW districts, 15,700 out-of-schoolchildren completed a cycle of non-formal educationcourses (10 months) and 65 per cent of thecompleters were girls.

children who eventually want to join the formalschool system, as these modalities are based on theschool curriculum. In 2008, DACAW will besupporting 150 School Outreach Programmes innine districts.

Protection ofchildren and women

Paralegal programmeDACAW has initiated the formation of paralegalcommittees, a community-based mechanism thatworks to protect children and women fromviolence, abuse, exploitation and discrimination.Paralegal committees typically consist of 13–15volunteer women (self-selected or elected) at theVDC level. They are also expanding to the wardlevel.

Child protection abuses such as child marriage,domestic violence, and child labour exploitation canemerge from attitudes and traditions incommunities and society. Paralegal committeessuccessfully create ‘pressure’ from inside thecommunity to challenge such non-protective socialnorms Paralegal committees use social and legal

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arguments to address protection abuses. In ruralNepali communities, people usually do not relate towhat the law says about the age of marriage or childlabour (“What’s wrong?” they say, “It’s been like thatfor years!”). Thus, it is particularly important toengage community in discussions on ‘why certainthings should be stopped’.

Paralegal committees challenge prevailing impunityover violence against women and children. Theyfocus their work on prevention/awareness-raising;early detection and intervention; case follow-up; andmonitoring/reporting. In each district, paralegalcommittees are supported by the District ResourceGroup (DRG), consisting of five lawyers and fivesocial activists. The DRG’s main responsibilities are:(1) training of VDC Paralegal Committees; (2)regular monthly outreach consultations with VDCParalegal Committees; and (3) technical backstoppingfor difficult cases brought up by VDC ParalegalCommittees.

At present, 404 VDC Paralegal Committees (4500+members) are supported in 23 DACAW districts.

THE ROYAL NORWEGIAN EMBASSYEVALUATION OF PARALEGAL COMMITTEES

Paralegal committees provide protection to women andchildren whose cases have not been openly discussedwithin the community or brought before the formaljustice system. Cases include wife-beating, abuse ofwomen and children, rape, mental and physicalharassment, early marriage, alimony, and propertyinheritance. As a result, family and community membershave become more aware of these abuses and crimes.Most cases are dealt with by paralegal committees,while a few complicated ones are referred to the formaljustice system. It is clear that the conflict mitigation andresolution through mutual cooperation offered byparalegal committees has enhanced harmony withincommunities. In addition, paralegal committeesremained functional and effective during the conflictand the absence of local elected bodies.

ACHIEVEMENTS IN 2006

59 orientations on protections issues wereconducted for 2,950VDC-level stakeholders.885 paralegal committee members from 59VDCs received 1st phase training.22,475 paralegal committee members from 165VDCs received 2nd phase training.1,905 paralegal committee members from 127VDCs received 3rd phase training.350 stakeholders from seven districts receivedorientation on protection and paralegalcommittees.

In today’s context of peace-making, there is muchdiscussion on the role of the community inreconciliation and reintegration of children andwomen affected by conflict. Community-basedmediation programmes in other countries haveproved effective at facilitating access to justice,reconciliation of community members involved indisputes, and healing of survivors.

Although systematic data has yet to be collected onthe specific role of paralegal committees inreconciliation, anecdotal evidence suggests thatthey are actively involved in facilitating healing andreconciliation of a wide range of disputes incommunities, including the reintegration of femaleMaoist cadres into the community. For this reason,DACAW in coordination with UNICEF’s ChildProtection Section is conducting an assessment ofparalegal committees in order to determine theirpotential role in community-based reconciliationand facilitation of integration of various affectedpopulations, in particular, children associated witharmed forces and armed groups (CAAFAG).

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Birth registrationAt the national level, policy advocacy on birthregistration by various partners including UNICEF hasresulted in positive decisions made by the SupremeCourt to remove and change gender discriminatoryprovisions in the Birth Registration Act. The act statedthat only the ‘eldest male member’ of the householdcould act as the key informant. The Supreme Court hasnow ordered words ‘eldest male’ to be deleted and bereplaced by ‘eldest member in the family’.

Child clubsAt the global level, UNICEF has affirmed the right ofchildren to participation through its human-rights-based approaches. One of its guiding principles is theimportance of promoting ‘the meaningful andappropriate participation of children and youngpeople in decision-making processes that affect them’.

In Nepal, UNICEF has been actively promoting childparticipation through the development of childclubs. UNICEF Nepal has supported thedevelopment of many thousands of child clubsthroughout the country and has tried to includechildren from disadvantaged communities in theseclubs.

Child clubs in Nepal have a diverse set-up.Community-based child clubs involve children

aged about 8–18 years. School-based child clubsengage children aged about 9–16 years. Inaddition, some Out-of-School Programme classesare also converted into child clubs. These involvechildren aged about 10–14 years. In some places,adolescents have also organized themselves intolisteners groups around a radio programmesupported by UNICEF, ‘Chatting with my BestFriend’. These groups engage youths aged about16–22 years. UNICEF encourages child clubmembership to be at least 50 per cent female; atpresent, girls make up nearly 47 per cent ofmembers.

Many child cubs began by providing a space forchildren and young people to play, and engage insports and cultural activities. However, over theyears some have evolved into groups aimed atcommunity development and rights advocacy—forexample, water and sanitation programmes,

The 2003 update survey of seven DACAW districtsshowed that 15 per cent of all children aged lessthan one year were birth registered, and 65 per centof all children aged less than 18 years. Significantlymore children aged less than 18 years were birthregistered in CAP settlements than non-CAPsettlements, and disadvantaged children in CAPsettlements were significantly more likely to be birthregistered than disadvantaged children in non-CAPsettlements.

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challenging discriminatory practices and earlymarriage, promoting the right of access toeducation, improving the school environment, andchallenging violence against young people. Childclubs have also helped to develop facilitation,negotiation and leadership skills. They haveempowered children and increased their self-esteem and confidence. This has made it possiblefor children individually and collectively tonegotiate their concerns, often focused onprotection issues. Many have been able tonegotiate with both state and Maoist bodiesduring the conflict. Some have negotiated a placein School Management Committees, withemployees, and in Village DevelopmentCommittees. They have been able to engage inlocal policy development and influence theallocation of resources. Some begin with a veryspecific focus, for instance, school sanitation, butlater expand to other areas with broader objectivessuch as child rights advocacy. Some work onspecific issues such as child domestic workers.

Child clubs have also brought about a change in themindset of adults; they are now willing to listen tochildren. Overall, child clubs have been successful inovercoming social rules and have brought aboutgender parity and social inclusion.

Maternal health and care

Support to the National SafeMotherhood ProgrammeNepal’s National Safe Motherhood Programme aimsto increase access, availability and utilization of qualitymaternal health services in health facilities, linking withoutreach service delivery at the community level.

Eight DACAW districts (Achham, Dang, Humla,Kavre, Jumla, Panchthar, Saptari, Udayapur ) havebeen selected by the government forimplementation of the National Safe MotherhoodProgramme in collaboration with UNICEF. Thegovernment provides inputs required forstrengthening maternal and newborn healthservices, including the construction of facilities,provision of equipment, and technical training.UNICEF provides support for coordinating theseactivities as well as for directly-funded micro-planning workshops and social mobilizationactivities through training community volunteers.Community mobilization has resulted in theestablishment of emergency funds in many VDCs.These funds are used to save lives of pregnantwomen who might die from complications becausethey lack the money to pay for transportation tohealth facilities or for emergency care.

In four of DACAW’s Women’s Rights to Life and Health(WRHL) districts, utilization of emergency obstetric carehas increased from 2.5 per cent in 2000 (half thenational average of five per cent) to 24 per cent in2005. The number of complications managed hasincreased from 225 in eight project facilities in 2000 to2,120 in 2005—an eight-fold increase over five years.The met need for emergency obstetric care increasedfrom 2.6 per cent in 2000 to 24 per cent in 2005.

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Community participation in outreachclinics and linkages with emergencyobstetric care (EOC) servicesWatch groups (in Dang) and Safe MotherhoodAction Groups (in Sunsari and Udayapur),comprising Female Community Health Volunteers(FCHVs), traditional birth attendants (TBAs) andcommunity mobilizers, have been established inrecent years. These groups are linked to outreachservices and refer pregnant women for antenatal andpostnatal care services, tetanus toxoid (TT)immunization, and pregnancy weight monitoring.Vitamin A and iron tablets are also distributed; thishas helped to increase their uptake. Women are alsoinformed about birth preparedness duringpregnancy.

Watch groups are also involved in establishingemergency obstetric care (EOC) funds in wards withseed money from UNICEF and matching fundsfrom the community. They have also strengthenedthe linkages between the government health systemand the community.

Child health

The child health programme aims to strengthennational capacities and commitment to ensure goodhealth and adequate healthcare for children throughadvocacy, technical support, policy and humanresource development.

Extended Programmeon ImmunizationThe Extended Programme on Immunization(EPI) aims to extend full immunization to allchildren in Nepal. DACAW supports the EPI in allDACAW districts. About 83 per cent of childrenaged less than two years are fully immunized inNepal.

In terms of child survival, progress has been made,with a substantial reduction in measles cases anddeaths, as a result of measles campaigns.

Integrated Managementof Childhood IllnessIntegrated Management of Childhood Illness(IMCI) is an approach developed jointly by WHOand UNICEF to address the major childhoodillnesses: diarrhoea, acute respiratory infection(ARI), measles, malnutrition and malaria, whichtogether account for about 70 per cent ofchildhood mortality in the developing countries.In Nepal, IMCI was first implemented inMahottari in 1997. Since then, it has graduallyexpanded to 33 districts, covering more than 60per cent of the total population. In IMCI, a childis looked at in an holistic manner, savingunnecessary visits to the health facility andreducing unnecessary medication. At thecommunity level, as Female Community HealthVolunteers (FCHVs) started treating cases ofpneumonia, access to treatment of pneumonia,the leading cause of child mortality in the country,has increased immensely. During the Joint AnnualReview of the health sector at the end of 2005,External Development Partners (EDPs) urged thegovernment to develop a three-year plan for scalingup CB-IMCI to all districts using pooled funding.

WATCH GROUPS

There are about 162 Watch Groups in Dang in thewest of Nepal, and 228 Safe Motherhood Action Groupsin Udaypur and Sunsari in the east of the country.

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Female CommunityHealth Volunteers ProgrammeThe national Female Community Health Volunteers(FCHVs) Programme was initiated by the Ministryof Health and Population in 1988 in an effort toenhance Nepal’s primary health care network throughcommunity participation and expanded outreach bylocal women working voluntarily. At present, thereare more than 48,500 FCHVs in 75 districts.

FCHVs serve as motivators and educators, provideinformation on family planning, immunization,nutrition, maternal and child healthcare, andtreatment of minor injuries. They are provided witha first aid kit with minor first aid medicines, iron/folate tablets, vitamin A capsules, oral rehydrationsolution (ORS) packets, oral contraceptives andcondoms for free distribution.

Data from 2005 show that in districts whereCommunity-based IMCI (CB-IMCI) is implementedand pneumonia cases are treated by FCHVs, theproportion of expected cases treated is about 65 percent as compared to 25 per cent in districts notimplementing CB-IMCI, and the proportion ofsevere pneumonia cases is 3.6 per cent compared to9.5 per cent in non-CB-IMCI districts. An estimated8,500 child deaths are averted annually because ofcommunity-based treatment by FCHVs.

Besides routine activities, FCHVs continue to becornerstones of national health campaigns such as theVitamin A Programme, National Immunization Daysfor polio eradication, and treatment of pneumonia inchildren. During the conflict, as health facilities wereincreasingly non-functional, it was FCHVs who playeda key role as service providers and became even morecritical for the health of children and women.

Community Drug Programme (CDP)The Community Drug Programme (CDP) aims toensure year-round availability of essential drugs atsub health post, health post, and primary healthcarecentre levels. The CDP is based on community cost-sharing schemes through community involvementin financing and management. The Local HealthFacility Operation and Management Committee(LHFOMC) at the VDC level is encouraged tointroduce user fees for drugs and utilize thefunds for replenishing drugs.

UNICEF was involved in implementation ofthe CDP in 12 districts in the past and, incollaboration with other partners, now supportsdevelopment and revision of training and IECmaterials, district-level review meetings andfield monitoring costs. In 2005, the Ministry ofHealth and Population decided to mainstreamthe CDP throughout the health system.

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Child and maternal nutrition

Community-based growth monitoringDACAW has been successful in reducing childmalnutrition, and in some communities,malnutrition rates (underweight), as reported by thecommunity growth-monitoring system, has droppedfrom 40–50 per cent to 16 per cent.

In DACAW settlements, community mobilizersweigh all children below three years of age on amonthly basis. Weights are plotted on children’sindividual growth charts, and also on a largecommunity chart, dotting the weight of all childrenon one chart. This big chart makes the situationextremely visible, as everybody can see how manychildren are falling below the ‘underweight’ line. Bycomparing with older charts, the community can alsosee how the situation changes over time. Afterweighing, the community mobilizer holds a meetingwith the community to discuss the situation, andfind out why children are malnourished and what canbe done about it. The community mobilizer—as wellas the village facilitator, her supervisor—has beentrained on nutrition and causes of malnutrition aspart of basic DACAW training. She has also beentrained on facilitation. Her task is to see how thecommunity can take scientific findings and put theminto the local context, thus finding locally acceptablesolutions. Generally, however, what is needed isimproved young child feeding, with more calorie-richfood and more frequent meals. Another importantunderlying cause of child malnutrition is the highdisease burden suffered by Nepali children, especiallydiarrhoea.

At present, DACAW monitors some 70,000 childrenbelow the age of three years as part of the growth-monitoring initiative.

A major challenge is to reduce malnutrition inchildren from the most disadvantaged households.In-depth studies have shown that the currentapproach can bring down the prevalence ofunderweight children from 50–60 per cent to around20 per cent even amongst the most disadvantaged.However, non-disadvantaged groups have been ableto reduce malnutrition to as low as six per cent. Inorder to bring about similar reductions indisadvantaged groups, efforts are ongoing to explorenew approaches. One such attempt made in Saptari isthe establishment of feeding centres in the mostdisadvantaged communities. In feeding centres,underweight children receive porridge made of flour,sugar and oil twice a day and, according to villagefacilitators, there have been improvements inchildren’s nutritional status.

MicronutrientsIn CAP VDCs and municipalities, communitymobilizers were mobilized to support FemaleCommunity Health Volunteers (FCHVs) todistribute vitamin A capsules and deworming drugstwice a year. The total target population of childrenaged 6–59 months in the 15 DACAW districts is

Nearly 60,000 children are weighed on a monthly basisin CAP settlements. Sixteen per cent of these childrenare underweight, compared to 43 per cent in 1999.

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about 900,000. Overall percentage of children coveredin the October 2005 round was above 95 per cent.

Therapeutic feedingTherapeutic foods (F-75 and F-100) are provided tovarious nutrition rehabilitation centres across thecountry, especially in the Mid- and Far WesternDevelopment Regions where many severelymalnourished children live.

So far around 200 children received therapeutic foods.Provision of this specialized food has played a crucialrole in speeding up rehabilitation of severelymalnourished children.

Early childhooddevelopment

There is generally low awareness in Nepal of theconcept of early childhood development (ECD) andthe need for early childhood care and stimulation. Tohelp improve this situation, UNICEF is supportingECD activities both at national level and throughDACAW. At national level, UNICEF is supporting theMinistry of Education and Sports with policyformulation, and development and dissemination ofinformation and communication. Support is alsoprovided to research and documentation by an ECDResource Centre at the national university. In DACAW,child development issues are addressed through CAP.In addition, parenting orientation and community-based child development centres are supported.

Parenting orientationThis is a non-formal orientation programme forcaretakers of young children, which helps to developbasic understanding of the rights and needs ofchildren. Classes use participatory discussion andpractical sessions, covering topics such as child

development, nutrition, immunization, birthregistration, and child rights. Classes are conducted bytrained facilitators, for three months, two hours a day,six days a week with about 25 participants in each class.

During the reporting period, UNICEF supported atotal of 1,066 classes in 23 DACAW districts.

Community-basedchild development centresThese centres provide opportunities to children aged3–5 years to engage in activities that promote theirholistic development, including psychosocial, cognitiveand linguistic development in a clean, safe andstimulating environment. The centres also providemothers with greater freedom to pursue activitiesbesides childcare, and relieve older sisters of the

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burden of looking after younger siblings, therebygiving them the opportunity to attend school. Forlong-term sustainability, community managementcommittees are formed, and UNICEF providesmatching funds to complement funds raised by thecommunity. By the end of the third year, centres arefinancially self-sustaining. At present, there are 512Community-based Child Development Centres inCAP settlements, with about 12,000 children enrolled.

Water supply and sanitation

DACAW aims to reduce morbidity and mortalitylinked to inadequate hygiene, water andenvironmental sanitation, and to contribute to policydevelopment, capacity building and advocacy forresource allocation for improved water supply,hygiene and environmental sanitation.

The main thrust of the sector programme has been to(i) support activities that provide sustainable access towater supply and sanitation facilities to disadvantagedgroups in CAP communities, (ii) provide forinstallation of toilets and drinking water facilities inschools in DACAW districts, (iii) promote improvedsanitation and hygiene practices among school childrenthrough activities organized by child clubs, (iv)implement a public–private partnership initiative forpromotion of hand washing with soap and point-of-use water treatment, and (v) investigate the extent andaddress problems of arsenic contamination in groundwater on the southern plains (terai).

At the national level, the programme has supporteddeveloping national strategy and operationalguidelines to supplement the sanitation policyapproved last year.

Jointly with seven other agencies, over 700,000 wellswere tested for arsenic contamination. In total, 2%of the wells tested over the limit of 0.05mg per litreconcentration of arsenic. In collaboration with theDepartment of Water Supply and Sewerage (DWSS),Filters for Families and Filters Nepal are distributingover 1,300 bio-sand filters in three districts and anextension from the municipal supply in one districtheadquarters has been completed ensuring safe waterto 75 households.

In three districts (Panchthar, Udayapur, andAchham), 19 small drinking water schemes wereinstalled/ rehabilitated among disadvantagedcommunities covering 6,350 people.

The School Sanitation and Hygiene (SSHE) Projectprovides not only a safe water supply and toilets, butalso introduces activities that facilitate changes inattitudes and behaviour towards sanitation andhygiene among school children. SSHE projectactivities continued in 594 schools, benefiting anestimated of 148,000 children. In 2005, theprogramme supported installation of water supplyand toilets/urinals facilities, separate for boys andgirls in 99 schools. Over 11,000 household latrineswere constructed in 15 DACAW districts covering anestimated 66,000 people.

The SSHE initiative has been implemented byUNICEF in 15 districts, and by Nepal Red CrossSociety and Eco-Himal in another eight districts. Thisyear UNICEF has been supporting installation oftoilet and water supply facilities in some 200 schoolsalong with building the capacity of child clubs and

The National Sanitation Week was observed for thesixth year, in partnership with 25 other key agencies in30 focus districts, reaching around 215,000 peopleand resulting in about 35,000 latrines beingconstructed or initiated during the one-week campaign.

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school-based community institutions, namely SchoolManagement Committees (SMCs) and Parent–Teacher Associations (PTAs). Some schools throughchild clubs have initiated fund-raising activities forimplementation of the SSHE programme, especiallyfor latrine construction, operation and maintenance.In 15 districts, SSHE activities were conducted in 594schools, water and sanitation facilities installed in 99schools, and participatory assessment completed.Changing people’s hygiene and sanitation behaviourand practices takes several years. Recent learning,working jointly with schools (child clubs, teachers,SMCs, PTAs) and community people, has broughtabout significant positive changes in hygiene andsanitation both in schools and surroundingcommunities.

HIV/AIDS awareness

DACAW’s life-skills-based peer educationprogramme aims at providing necessary informationand skills for young people to protect themselvesfrom risky behaviour, solve problems and managedifficult situations. Specifically, UNICEF Nepal hasfacilitated the integration of a life-skills-basedcurriculum, which has now been approved by theMinistry of Education and Sports, into the healthcurriculum for Grades 1 through 10. UNICEF is nowsupporting the Curriculum Development Centre andLife-Skills Working Group to finalize the curriculumand develop modules to be integrated into schools.

Life-skills-based education throughnon-formal education programmeAn out-of-school life-skills-based peer educationprogramme on HIV/AIDS prevention and care wasinitiated in 2005 for out-of-school adolescents aged9–15 years. The programme has been piloted in sixDACAW districts (Kavre, Sunsari, Parsa, Nawalparasi,

Kaski and Banke (Nepalgunj area only)). Theprogramme is closely linked with the UNICEF-supported Out-of-School Programme (OSP)designed to improve basic literacy, numeracy and lifeskills among disadvantaged children aged 10–19years who do not attend formal school. There is aspecial focus on working/domestic/street childrenwith a separate package for urban OSP and a smallfocus on HIV/AIDS prevention education.

In 2005, 22,800 children received life-skills-basededucation in four pilot districts and 150 out-of-schoolpeer educators were trained in six districts.

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This programme is currently implementedthrough groups of peer educators (out-of-schooladolescents aged 10–19 years) mainly fromlisteners clubs of the popular radio programmeSathi Sangha Manka Kura (SSMK) [Chatting withmy Best Friend]. Trained peer educators raiseawareness, provide accurate information,provide basic reproductive health and HIVservices, facilitate peer learning, and helptheir peers develop skills to change behaviour.The programme is coordinated and supervisedjointly by DDCs/municipalities and NGOsalready present under DACAW.

The Youth Friendly Multipurpose Service Centre(YFMPSC) project that was initiated in two districts(Kavre and Kapilvastu) has now been expanded toan additional three districts (Sunsari, Kaski andNawalparasi). These centres ensure multiple serviceswith focus on HIV/AIDS prevention, care, andsupport services. They also assist young people’scapacity to translate knowledge, attitudes and skillslearnt through life-skills-based peer education intopractice. The centres continue to provide a safe andsupportive environment for young people throughyouth participation in all stages of projectimplementation and strong community support.

Some 46 per cent of Nepal’s population of 26 million arechildren aged less than 18 years. The mortality rate ofunder-ones has decreased substantially over the last twodecades, and currently stands at 48 deaths per 1000 livebirths. However, this still amounts to over 40,000 childrenaged less than one year dying each year. Child malnutritionrates are also high, with half of all under-fives beingstunted, or too short for their age. Every year, ther areapproximately 960,000 pregnancies in Nepal. Thematernal mortality rate was estimated to be 281 per100,000 live births in 2005. About 82 per cent of birthstake place at home without any trained assistance,increasing the risks for both the mother and the newborn.

Since the restoration of multiparty democracy in 1990,successive governments have struggled to implementadministrative and institutional reforms to improvegovernance. However, the passage of the Local Self-Governance Act in 1999 provided an opportunity to

increase decentralization through greater localparticipation in decision-making.

Nepal’s decade-long conflict has contributed to multipledeprivations by hampering the delivery of basic services,restricting development assistance, and causing abreakdown of family and community networks. Womenand children, who rely most heavily on these essentials,have particularly felt the negative impacts of thedeprivation and violence. In April 2006, after weeks ofpro-democracy protests, the king ended his direct rule.Parliament was reinstated and an all-party governmentwas formed. During the last year, the coalit iongovernment has negotiated the Comprehensive PeaceAgreement with the Maoists, which includes thecantonment of combatants and weapons under UNsupervision, and has made preparations for creating aConstituent Assembly. Elections for this are expectedsometime in 2008.

Situation of children and women in Nepal

RASUWA

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DACAW Districts (23)

Map of Nepal

INTERNATIONAL CONVENTIONS

Nepal has ratified the following international conventions that are relevant to UNICEF’s work.UN* Convention on the Rights of the Child (CRC)UN Optional Protocol to the CRC on the sale of children, child prostitution, and child pornographyUN Optional Protocol to the CRC on the involvement of children in armed conflictsUN Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW)ILO* Convention on the Worst Forms of Child LabourSAARC* Convention on Regional Arrangements for the Promotion of Child Welfare in South AsiaSAARC Convention on Preventing and Combating Trafficking in Women and Children for Prostitution

* UN = United Nations, ILO = International Labour Organization, SAARC = South Asian Association for Regional Cooperation.

UNICEF responds in emergencies to protect the rights ofchildren. In coordination with United Nations partnersand humanitarian agencies, UNICEF makes its uniquefacilities for rapid response available to its partners torelieve the suffering of children and those who providetheir care.

UNICEF is non-partisan and its cooperation is free ofdiscrimination. In everything it does, the mostdisadvantaged children and the countries in greatest needhave priority.

UNICEF aims, through its country programmes, to promotethe equal rights of women and girls and to support theirfull participation in the political, social and economicdevelopment of their communities.

UNICEF works with all its partners towards the attainmentof the sustainable human development goals adopted bythe world community and the realization of the vision ofpeace and social progress enshrined in the Charter of theUnited Nations.

The mission of UNICEFUNICEF is mandated by the United Nations GeneralAssembly to advocate for the protection of children’s rights,to help meet their basic needs and to expand theiropportunities to reach their full potential.

UNICEF is guided by the Convention on the Rights of theChild and strives to establish children’s rights as enduringethical principles and international standards of behaviourtowards children.

UNICEF insists that the survival, protection anddevelopment of children are universal developmentimperatives that are integral to human progress.

UNICEF mobilizes political will and material resources tohelp countries, particularly developing countries, buildtheir capacity to form appropriate policies and deliverservices for children and their families.

UNICEF is committed to ensuring special protection forthe most disadvantaged children—victims of war, disasters,extreme poverty, all forms of violence and exploitation,and those with disabilities.

United Nations Children's FundNepal Country OfficeP. O. Box 1187UN House, PulchowkKathmandu, Nepal

Improving Lives forChildren and Women in Nepal

Decentralized Action for Children and Women (DACAW)

Government of Nepal

Telephone: 977-1-5513200Facsmile: 977-1-5527280www.unicef.org/nepal

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Local Body Support SectionGovernance Coordination DivisionMinistry of Local DevelopmentShree Mahal, PulchowkKathmandu, NepalTelephone: 977-1-5522015Facsmile: 977-1-5522045www.mld.gov.np

Improving Lives for Children and Women in Nepal ...

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