Our Initiatives
Women's Health Program
Pelvic organ prolapse: The prevalence of pelvic organ prolapse is found to be 10 to 42% among the women of Nepal in various districts. According to UNFPA (2005), 600,000 women are suffering from uterine prolapse, about 69% are suffering from 1st degree uterine prolapse and 30% are suffering from second and third degree uterine prolapse. Many women suffering from pelvic organ prolapse are not been able to seek medical help due to various reasons including gender discrimination, cultural stigmas, taboos, poverty and illiteracy. Various factors lead to Pelvic organ prolapse like early marriage, multiparity, unassisted delivery, early resumption of work after delivery and poor nutrition. Since pelvic organ prolapse is not a life threatening condition, women and also the family do not seek help until they have complications but suffer silently. The complications may vary from difficulty in walking and carrying out the daily chores to being bedridden. Therefore, there is a need to address this neglected problem with preventive programs as well as curative programs which can bring a huge difference in the lives of the ladies who are suffering from it.
Cervical cancer: According to WHO, cervical cancer is the fourth most common cancer among women, representing 6.6% of all female cancers, 88% occurring in developing countries. Almost 90% of the deaths from cervical cancer occur among low and middle- income countries which can be reduced by prevention, early diagnosis, and effective screening and treatment programs. Cervical cancer ranks among the first most frequent cancer among women in Nepal and 1st most frequent cancer among women between the ages of 15 to 44 years of age. There is no national data on the prevalence of cervical cancer among the Nepali women. Cervical cancer is an important public health problem among the developing countries and an early detection and intervention can prevent the progression of the disease as well as unnecessary expenditure of the family along with reduced economic burden of the country. In Nepal, females do not visit hospitals on a regular basis for routine checkup because of various factors like, gender discrimination, poverty, inaccessibility to health care center and illiteracy. There is a need to visit these ladies who are at high risk of cervical cancer in their own localities for early detection because by the time they present to the hospital, the cancer is in a stage where it is beyond treatment.
Project
COSAN carries out activities like awareness and educational programs on women's reproductive health especially focusing on pelvic organ prolapse, its causes, prevention, screening programs and finally treatment with conservative as well as operative measures.
Along with this all the female in the reproductive years (i.e. 30-60 years) undergo screening for cervical cancer with VIA method and primary treatment with cryotherapy or thermocoagulation is done at the site with proper counseling as to when and where to follow up.
The site of project implementation depends on the high prevalence of POP and cervical cancer in that particular area, the demand from the local government as well as community, the economic status of the population in that area and the accessibility to health care facilities. The communities who are deprived of basis health care that effects these vulnerable women are given high priority.
The local government is approached with one to several years of proposal and the details of the activities. Stakeholder meeting with the local leaders and local health care workers is done before implementation of the project. The local health care workers including the Auxiliary Nurse Midwife (ANM), Female Community Health Volunteer (FCHV), Village health Worker (VHW) are given basis training of Women's Reproductive Health focusing on POP and Cervical cancer, their signs and symptoms, how to diagnose and the possible treatments options. Care is taken not to duplicate the government's program but strengthen it and work alongside the government bodies in health sector.
COSAN forms a team of 2 to 3 specialist doctors, 4 to 5 nurse trained in pelvic organ prolapse and cervical cancer screening and treatment, program manager, COSAN's field workers, local field workers, 3 to 4 assistants, drivers along with the local health workers who go to a particular area to conduct prevention programs as well as health camps focusing on the above mentioned topics conducting 8- 12 such events for a period of 1 year.
The ladies who are recognized to have conditions requiring surgical attention are assisted in surgery while those requiring follow up are counseled accordingly.