The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #62146

Gopal Nakarmi, MBA, International Program, World Neighbors Nepal, PO Box 916, Kathmandu, Nepal, 977-1-5546688, 977-1-5522970, gopal@wnsa.org.np and Catharine McKaig, DrPH, International Program, World Neighbors, 4127 NW 122nd Street, Oklahoma City, OK 73120.

Since 1992, the integrated development program in Nepal has pioneered a new model of reproductive health service delivery for isolated rural areas. Working with 18 local non-governmental organizations, modest clinics have been established that provide services by a female provider. The goal of each rural clinic is to attain self-reliance in three to four years. In the last three years the program has been extended to Bihar, India. In two years, four clinics in Nepal and two in India have provided over 29,000 client visits for reproductive health services. Four out of the seven clinics established in 2001 are very close to complete cost recovery through income earned by the sale of medicine and service charges. In addition to the clinics, the local organizations initiate self-help groups which undertake micro-enterprise activities in the catchment area of the clinic. Manthalil Savings and Credit in Ramechapp, Nepal, is an example of one group which has demonstrated remarkable succes and contributes to the functioning of the clinic, not only through its members use of services, but by additional financial support it provides. Initiated in 1995 with a capital of $140 and 11 members, its capital now is $400,000 and it has 700 members. Since 2001 the group has provided funds for clinic services from the profit it makes from banking activities. In Ramechapp District, with a population of 230,000, this clinic provides the only qualified medical care.

Learning Objectives:

At the conclusion of this session, the participant in this session will be able to:
• Recognize a model of service delivery linked to economic activities which is implemented by local non-governmental organizations.
• List five lessons learned in sustaining non-governmental organization clinics in Nepal.
• Identify four key indicators for sustainability of non-governmental organization clinics.

Keywords: Access and Services, Sustainability

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.