Sharing reproductive health knowledge with a new generation

Jagtarain had an arranged marriage at the age of 18, became pregnant, and lost her first pregnancy without ever talking with her husband about their plans for parenthood. A year later, Jagatarain was pregnant again, and again it was a surprise to her and her husband. Traditionally, Nepali couples do not openly discuss babies, and why would they? After marriage, babies “just happen”.

“I was never taught to talk about babies and pregnancy with my husband. I never had any information about family planning when I was young. I learned about Depo only after I gave birth to my third child,” said Jagtarain. “Women in the community were the only source of information related to family planning methods.”

Jagatarain is now 32 years old, and is providing reproductive health information to her community in a new way. She facilitates games and conversations in her community about fertility awareness, side-effects and myths associated with family planning methods, and social norms which impede the use of family planning in the community. These games are part of a package called Pragati and were developed as part of the FACT project, which is supported by USAID and implemented by IRH and Save the Children.

Jagtarain and other “health champions” like her were trained to facilitate the games. Jagtarain schedules times when groups of women in the community are able to gather and participate. Sometimes the women request specific games to be played during these sessions. It was through these sessions that Jagtarain met Parvati.

Parvati is an 18 year-old girl who lives in Jagtarain’s village. She is still single and – unlike Jagtarain at this age – she is outspoken and confident. Even though Parvati is educated, she never learned about reproductive health in school. Many teachers skip the reproductive health lessons, expecting students to go through them on their own. “When we read those [reproductive health chapters] on our own, we don’t understand what it says,” Parvati said.

By playing the Pragati games, she learned about the menstrual cycle, fertile and infertile days, and methods of family planning. She also learned about family planning method side effects, and the games dispelled some myths that many women in the community believed.

Parvati feels that the knowledge she gained will help her start a conversation with her future husband about planning for children.

“I’ll also make sure that we take time to properly plan before giving birth to a child,” Parvati said. “As my husband might not know about family planning, I’ll share with him everything I have learned while playing games.”

Among all the games, Parvati says the menstrual cycle game was the most useful. When playing the game, Jagtarain asks participants to stand in a circle and gives them paper game cards representing the days in the menstrual cycle. Jagtarain explains the different events that occur in the menstrual cycle, and that there is a fertile window when pregnancy can occur. The participants are asked to identify if a particular day is a “safe” or “unsafe” day for sex.

Though Jagtarain never had an opportunity to learn about fertility awareness and family planning as an adolescent, she takes pride in how adolescents like Parvati now have access to this important information.

“This knowledge will change their lives. If I had the same information when I was young, my life would have been different,” Jagtarain said.

Jagtarain enjoys her work not only because she likes to interact with the women in her community and adolescents in the school, but also because her work gives her a sense of satisfaction.

“When the women of my community come to me and inquire about information related to fertility awareness and family planning methods, it makes me feel good,” she said.

“I feel proud when I see adolescent girls talk freely about family planning. In the community where women usually do not hold any opinion – even on the most general thing – seeing girls discussing about menstruation, family planning, and sexual health is great.”