COMMUNITY ASSESSMENT REPORT

 For

(Jhapa, Morang & Sunsari Districts)

Jan-Apr, 2000

  Submitted to:

Family Health International Nepal

Gairidhara, Kathmandu, Nepal

 Submitted by:

AMDA/FHI, AIDS Prevention Project

Damak, Jhapa, Nepal

 ACKNOWLEDGEMENT:

First of all we would like to express our heartily thank to USAID/Nepal and FHI Nepal for their support, guidance and effective direction for the project. We would like to express our gratitude and special thanks to Ms. Barbara Franklin-Communication Officer, FHI Asia Regional Office Bangkok for her valuable suggestion and comment during her visit in our Project Office and field sites. We are also grateful with Ms. Asha Basnyat, Program Manager and Mr. Bharat Bilas Panta, Program Officer FHI-Nepal for their periodic visit and feedback during our community assessment.

Ms. Franklin, Ms. Basnyat and Mr. Pant have visited and observed our outreach activities in actual field sites and provided feedback and suggestions during the initial phase of our outreach activities. They have also highlighted the present rules and policies of USAID and FHI. Those information, comment and suggestions have been very useful and significant for us to implement the BCI program in the community.

We are grateful to the AMDA/FHI project management committee for their initial consideration and continuous support through out the community assessment.

We would like to thank to all those INGOs, NGOs, GOs and private sectors for their cooperation and valuable suggestion during the period of Community Assessment. We wish to express our gratitude to those entire key-informants including FSWs and their clients for their patience, keen interest and kind cooperation while providing the needed information for the Assessment. 

We wish to express our thanks to Life Saving And Life Giving Society for their technical support to provide related training to all program staffs.

Finally, we would like to thanks all writers, publishers, journalists for their HIV/AIDS/STIs related materials, which we have reviewed during Community Assessment.

Dr. Shankar Prasad Huzdar

Project Manager

Community Assessment Team:

1)                     Dr. Anil Kumar Das                             Project Coordinator

2)                     Dr. Shankar Psd. Huzdar                   Project Manager         

3)                     Ms Jaga Maya Shrestha                     Program Officer                     

4)                     Mr. Yuba Raj Chaudhary                     Finance/Admin Officer           

5)                     Mr. Bishweshwar Psd. Mishra            Finance Assistant      

6)                     Mr. Ajij Psd. Poudyal                           Program Assistant     

7)                     Mr. Bishow R. Neupane                      Field Supervisor

8)                     Mr. Bhagawat Psd. Paudel                 Field Supervisor                     

9)                     Mr. Venas Shrestha                            Outreach Educator    

10)                   Mr. Sailesh Rana Magar                     Outreach Educator                

11)                   Mr. Saday Kumar Das                        Outreach Educator    

12)                   Ms. Khem K. Timsina                         Outreach Educator    

13)                   Ms. Laxmi Lata Paudel                       Outreach Educator    

14)                   Mr. Dhundi Raj Bhandari                     Outreach Educator    

15)                   Mr. Lal Bdr. Chaudhary                       Outreach Educator                

16)                   Mr. Ananda K. Shrestha                      Outreach Educator    

17)                   Mr. Niran Sangroula                            Outreach Educator                

18)                   Mr. Mahesh Acharya                           Outreach Educator    

19)                   Ms. Bishnu Maya Sapkota                  Outreach Educator

20)                   Ms. Ranjana Pokhrel                           Outreach Educator

21)                   Ms. Lakhi Gurung                                Community Counselor                                   

22)                   Ms. Lata Khadka                                 Community Counselor

List of Acronyms:

AHAPP            AMDA Hospital AIDS Prevention Project

AIDS                Acquired Immune Deficiency Syndrome

AMDA              Association of Medical Doctors of Asia

BCI                  Behavior Change Intervention

CSM                Condom Social Marketing

CRS                Nepal Contraceptive Retail Sales Company (Pvt.) Ltd.

DACC              District AIDS Coordination Committee

DHO                District Health Office

FHI                   Family Health International

FPAN              Family Planing Association of Nepal

FSW                Female Sex Worker

GOs                Governmental Organizations

NGOs              Non-Governmental Organizations

HIV                   Human Immune deficiency Virus

IDU                  Injection Drug User

IEC                  Information, education and Communication

STD                 Sexually Transmitted Disease

STI                   Sexually Transmitted Infections

USAID             United States Agency for International Development

ABSTRACTS:

The Community Assessment was conducted from 23 January to 22 April 2000 in three districts Jhapa, Morang and Sunsari. The main objective of the Community Assessment is to estimate the magnitude of commercial sex work, i.e. to identify the locations and types of commercial sex work, estimate the number of FSWs and their clients and identify their occupational categories and demographic characteristics.

For the Community Assessment we've followed the following steps:

1) Contact with organizations and literature review

2) Structured Observation

3) Key Informants interview

4) Report writing

We have identified 30 most risky places for high-risk sexual activities and contacted 16 FSWs during community assessment.

Community Assessment is the first step of program, and during the period we've conducted introduction and coordination visit with various organizations/agencies and private sectors in the project areas. We've tried to study and observe the all aspects of community including high-risk sexual behavior. We've studied different literatures related with HIV/AIDS/STDs, conducted structured observation, selected Key Informants and interviewed them. The Community Assessment was carried out through personal contact, group discussion and using questionnaire for interview.

From the study we've found that there are a large number of people involved in risky sexual behavior in the project areas. Community people don't have detail knowledge about HIV/AIDS/STDs. Many of them are STD clients but they are not getting proper treatment. There is easy accessibility of condom but they are not using condom that much because the majorities don't know that the condom is an effective means of protection from HIV/AIDS/STDs.

During the Community Assessment the community people showed positive response towards our program. They are very interested and enthusiastic. We are hopeful that if we can implement our program effectively, the community people will definitely help us to work towards our project goal. If we work together we will succeed.

TABLE OF CONTENTS:

                          Contents                                                                       Page No.

CHAPTER 1 INTRODUCTION

            1.1 Back ground                                                                                  1

            1.2 Justification of the community Assessment                                 2

            1.3 Map of Project Districts                                                                3         

            1.4 Objective of the Community Assessment                                    4              

CHAPTER 2 METHODOLOGY & FINDINGS

            2.1 Map of High - Risk Places of Project Area                                   5         

            2.2 Assessment Techniques/Approach                                             6         

            2.3 Steps of Community assessment                                                6         

                 2.3.1 Contact with organizations/Literature Review                      7

                       2.3.1.1 Review of Related Literature Document/Literature     8             

                     2.3.2 Structured Observation                                                    9         

       2.3.3 Key Informants Interview                                                                9              

             2.3.3.1 Identification of Risk behavior of FSWs & their Clients         10

                           2.3.3.2 Location & Nature of Risk Behavior                         11

                           2.3.3.3 Trend & Nature of Risk Behavior

                      2.3.3.3.1 FSW                                                                           16

                      2.3.3.3.2 Clients                                                                        17

                      2.3.3.3.3 Cross Border                                                             17

                      2.3.3.3.4 Intravenous Drug Users                                             18

2.4 Geographical Structure                                                                             18

2.5 Political & Demographic Structure of Project Area                                  19

2.6 Educational Institution                                                                               19

2.7 Health Care Facilities                                                                                19

CHAPTER 3

            3.1 Positive Aspect of Community Assessment                                                   20

            3.2 Lesson Learned From Community Assessment                                            20

            3.3 Conclusion                                                                                                       21

ANNEXES:

I. Name List of Different Organizations Contacted in the Project Area.

II. Name List of Key Informants.

III. Population of Different V.D.Cs and Municipalities of Jhapa, Morang and Sunsari.

IV. Educational Institutes in Different V.D.Cs and Municipalities of Jhapa, Morang and Sunsari.

V. List of Health Institutes Distributing Condom Free.

VI. Some Photos of Community Assessment.

VII. Reviewed Literature regarding HIV/AIDS/STIs.

VIII. Estimated Number of Primary Target Groups in our Project Area.