Child marriage rates in South Asia are the second highest in the world. Despite stiff penalties for marrying under the age of 18, including up to 3 years in prison, this trend holds true for Nepal. A recent survey performed by Nepal’s Ministry of Health and Population showed that 41% of Nepalese women aged 20-24 were married before turning 18. The health impact of childhood marriage is significant. According the World Health Organization, pregnancy and childbirth complications are the second leading cause of death among 15-19 year olds globally.
Additionally, an estimated 26% – 38% of recent births in Nepal are from unintended pregnancies. In this region, women whose pregnancies are unintended are more likely to receive reduced pre and post natal care, resulting in negative health outcomes for both mother and child.
Taboos associated with sex and sexuality remain commonplace across Nepal. According to the Family Planning Association of Nepal, this results in a lack of subject specific teachers to teach sexual health in schools. If educational materials are present, they are often far out of date or in disrepair. Despite the lack of education, Nepalese adolescent pre-marital sex is increasing, creating a population vulnerable to HIV infection.
The Mobile Solution
The Nepali Health Ministry has taken a new approach to providing young people with sexual health and family planning education, launching an mHealth initiative called Mobile for Adolescent Sexual and Reproductive Health (m4ASRH).
The program, which got underway September 18, will reach out to at least 300,000 youth.
The m4ASRH initiative is performing four different types of outreach:
- On-Demand Information (Encyclopedia) – Adolescents will have access to an online encyclopedia, where they will be able to find the information and answers that they need, in a safe setting.
- Role Model Stories – Stories tailored specifically the adolescents’ age and gender which highlight the actions of role models will be sent. The recipient will have the capability to choose the path of the story and see different outcomes.
- Quizzes – To drive engagement and interaction, quizzes based on the content of the on-demand information and role model stories will be sent.
- Hotline – m4ASRH will provide adolescents with a hotline where they can talk directly to health care workers, allowing access to expert advice and guidance when needed.
There are several factors at play in Nepal that could help the m4ASRH initiative succeed. Despite being a mountainous country, Nepal boasts high mobile penetration. According to a September 2014 report from the Nepal Telecommunications Authority (available here), over 83% of Nepal’s population are mobile phone users.
Additionally, there is a rising tide of support from within Nepal for family planning awareness. The m4ASRH initiative was launched by Khaga Raj Adhikari, Minister for Health and Population, on Nepal’s first National Family Planning Day in Kathmandu.