The Britain-Nepal Medical Trust

Disadvantaged communities enabled to participate in health improvement.

The impact of the decade long conflict in Nepal has weakened the social & health structure in the country side. As in most post conflict situations, women and children suffer the most. In Nepal, this is exacerbated due to the patriarchal society, caste system, diverse ethnicity and religion. Health is one of the basic fundamental human rights. BNMT has been working on the Rights Based Approach (RBA) in implementing a Health Improvement Program for the past seven years. The programme focuses on disadvantaged groups (DAGs), emphasizing community empowerment of right-holders and strengthening the capacity of duty-bearers including health service providers. Replication of this successful Rights Based Approach in 4 new Districts of Western Nepal, which have been affected the most by the recent internal conflict, is the Big Idea.

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Registered Charity in England and Wales (255249)




  • Health/WellbeingHealth/Wellbeing


  • Children (3-18)Children (3-18)
  • Older PeopleOlder People
  • Women & GirlsWomen & Girls
  • Young People (18-30)Young People (18-30)
  • OtherOther



500,000 Sterling spread over 3 years Evaluations conducted by BNMT while implementing the RBA in Eastern Nepal have shown that women, children, widows, dalits, untouchables and others from the marginalized and vulnerable groups have been denied access to health the most. These rural community members have little or no information to take health related decisions. Healthcare in these rural communities is not about medicines, doctors and hospital beds but about awareness and knowledge, training and information. How do we make these rights realities? An external evaluation of the Rights Based Approach project supported by the BIG Lottery Fund found that the project outcome incorporating the RBA in health systems has to a large extent been achieved. Linkages, networking and coordination were established in these communities and promoted among staff of the government health program and local partner NGOs.s. The project promoted district level coordination and local fund mobilization. It enhanced the capacity of Health Facility Management Committees (HFMCs) and health workers, increased community health financing through Health Financing Scheme, strengthened Primary Health outreach clinics, increased availability of essential drugs and improved regularity of service providers in the facility. The evaluation also showed that the RBA project contributed towards greater empowerment in these communities. The project developed institutional capacity of partner NGOs, increased DAG members in Health Improvement (HI) groups and health awareness programs, increased DAG service users in health facilities, and made the program inclusive by increasing the participation of DAG women. These findings were further reiterated by evaluation of similar projects funded by a Dutch donor. However, both evaluations noted that health services were not strengthened in response. . There was inadequate training to district supervisors on health rights using Participatory Learning and Action (PLA). Drawing upon the lessons learned from this RBA project, BNMT will work with the most disadvantaged clusters in 4 Western Districts that have been far removed from this pattern of development.. Social mobilization and behavior change interventions will be initiated through a participatory method involving women in health management committees, training both spouses, mobilization of youth and children to demand their health rights and seek easy accessibility and cure of diseases, with awareness on prevention of common diseases that afflict rural communities. The project will enable the health service providers to deliver quality health service through participatory learning and action with rights holders.. The followings are the specific objectives: • Marginalized and Disadvantaged groups are mainstreamed in local governance units, Health/School Management Committees, Self-help groups, NGOs and civil society. • Disadvantaged groups more able to take control and manage their health, influencing prevention, care and support for key health conditions. • Women are empowered to claim reproductive health rights and services. • Disadvantaged groups more able to assess quality interventions, including prevention, care and support for key health conditions.