Asha Youth Health: Enhancing Access to Primary Health Care for Marginalised Young People in Nepal

Asha Youth Health: Enhancing Access to Primary Health Care for Marginalised Young People in Nepal

Pokhara, NepalNepal
Organization type: 
nonprofit/ngo/citizen sector
Project Stage:
$250,000 - $500,000
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

CWSN is a child centred grassroot NGO which aims to bring a sustainable change in the lives of the most disadvantaged children by ensuring their basic rights.

About Project

Problem: What problem is this project trying to address?

There are 2.1 million working children and over 5,000 street children in Nepal. Neglected by society and the state, they are deprived of the basic rights including access to primary health care services. Because of their living and working condition, they are particularly vulnerable to exposure to many infectious diseases including HIV/AIDS. Our recent studies have shown that only 13.8 percent children have ever used government health facility while having relevant health needs. Asha Youth Health tries to solve several barriers to access such as lack of knowledge about service providers, prejudice, their transient nature, unfriendly policies and lack of coordination among the service providers .

Solution: What is the proposed solution? Please be specific!

To remove the barriers to access, there is a need of multi sector partnership and multipronged approach. CWSN is building government, private sector and NGO partnership and combing service delivery and advocacy to address the problems. Since working children are hard to reach groups, we have partnered with private sector and other NGOs to reach out to them. We are also networking with other health service providers including government‘s health facilities. Through this network, we are trying to increase their awareness about the working and street children and change the prejudiced and unfriendly policies that are hindering the children’s access to health care services.
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

CWSN’s Ash Youth Health initiative has been providing comprehensive primary health care services to the working and street children. We have partnered with Pokhara Chamber of Commerce which has been working for child labour elimination programme in the area. The chamber has been operating 5 drop in centers to basic education and other supports to the working children and we have collaborated with them to provide primary health care services to the child labor. We have created a platform to foster coordination and dialogue among the health service providers with regard to increasing street and working children service providers in Pokhara and it has played important role in increasing the children's access to primary health care in the area. CWSN has been facilitating a saving and credit cooperative (Child Development Khajana) of working and street children. It provides these children a safe place to save their money and they can borrow their money also for emergency such as during illness. The initiative has become very effective in that it has significantly increased their access to health care services (in our recent survey, 94.6% children reported easy access to primary care services). The initiative includes Health care service delivery through network of 6 clinics and Outreach works Health Education Sessions Life School Education through peer education Child Development Khajana (a children's cooperative) Networking and advocacy actions

Marketplace: Who else is addressing the problem outlined here? How does the proposed project differ from these approaches?

There are several health care service providers in Pokhara but many are profit oriented and others nonprofits and government facilities lack understanding about the issues of ‘invisible’ working and street children. Asha Youth Health initiative is building a network of health service providers and creating awareness about the health care needs of the children. There is an increasing partnership with like-minded NGOs and government health facilities. The ultimate objective of the initiative is to remove all the barriers to access and mainstream youth health component to government’s framework. Therefore, government is key partner in this initiative. The main challenge is to create child friendly health policy and environment in the government facility.

Founding Story

This solution was the result of our long term works with street and working children. We were working with them for their education and protection while our social workers identified that these children are highly vulnerable to illness and disease due to their living and working condition. After this realization we conducted a systematic study and found that they are deprived of health basic health care services and also dangerously uninformed about protection of their health. We also found that there were no organisation providing health services to these children. Because of neglect and stigma (especially in the case of street children)associated with them, their access to health care was also very limited. We immediately decided to work toward improving their access to health care. We developed a dedicated programme for these children and named it Asha (in Nepali, Asha means Hope) Youth Health. This programme is now brings hope in the life of the marginalized children.
About You
Child Welfare Scheme Nepal
About You
First Name


Last Name


About Your Organization
Organization Name

Child Welfare Scheme Nepal

Organization Country

, GA, Pokhara

Country where this project is creating social impact
How long has your organization been operating?

More than 5 years

The information you provide here will be used to fill in any parts of your profile that have been left blank, such as interests, organization information, and website. No contact information will be made public. Please uncheck here if you do not want this to happen..

How long have you been in operation?

Operating for 1‐5 years

Which of the following best describes the barrier(s) your innovation addresses? Choose up to two

Access, Quality, Equity.

Social Impact
Please describe the goal of your initiative; outline what you are trying to achieve

By strengthening and scaling up the 'Asha Youth Health' programme, our organisation aims to achieve health equality in Nepal through increasing access to quality primary health care services to the deprived and marginalised groups of children. We also wish to contribute to Nepal's effort regarding achievement of health MDGs (4 and 6).
The specific objectives of the initiative are:

-To increase access of street and working children to primary health care services.
-To enhance health status of the target groups through raised awareness of protective health measures and adoption of preventative health behaviours.
-To create street and working children friendly health care delivery policies and environment in Nepal.

What has been the impact of your solution to date?

During the last five years, we have successfully reached out to over 3,600 street and working children in Pokhara area. We have created a network which is now active in this region and has 22 member organisations (private, government and civil society organisations). We conducted two workshops to identify the barriers and measures to remove the barriers respectively. Over 1,300 street and working children joined the children's cooperative, Child Development Khajana.Since these children are transient (often move one place to other), it is difficult to measure the actual outcome. But our recent survey has shown that most of the children has access to basic health care services. Their health seeking behaviour has improved significantly. Service providers are now aware of the needs of the children and are creating child-friendly environment. Government has increased collaboration with us to provide the services to the children.

What is your projected impact over the next five years?

Over the next five years, CWSN wants to completely remove the barriers regarding street and working children's access to primary health care services. We want to replicate our model in other regions of the country through our pre-existing national networks,'Civil Society Alliance for Child Rights.' We are a lead NGO in this network and we are also chair another alliance- National Alliance of Organisation Working for Street Children' Through these networks, we can influence policy change and create street and working children friendly health care facilities in Nepal. We also have a plan to midstream our service model into government framework by the next five years.

What barriers might hinder the success of your project? How do you plan to overcome them?

Current political instability and transition may pose challenge in realizing our plan of mainstreaming Asha Youth Health model into government framework.
We can exert pressure through our networks. There is also some positive progress in towards settlement of current political crisis.

Network/Alliance partners become passive- We have a long experience in working in consortium and alliance. Using this experience we will mobilise our partners and seek their active participation.

Winning entries present a strong plan for how they will achieve and track growth. Identify your six-month milestone for growing your impact
Identify three major tasks you will have to complete to reach your six-month milestone
Task 1

Conduct a follow up meeting of network partners in Pokhara and review the progress

Task 2

Publish children's newspaper which contains message pertinent to health care issues and needs of street and working chidlren

Task 3

Start service in one more contact centre targeting hotel and restaurant worker children

Now think bigger! Identify your 12-month impact milestone
Identify three major tasks you will have to complete to reach your 12-month milestone
Task 1

Organise a national level workshop on 'health care issues of the children'

Task 2

Publish a report on 'Situation of children in Nepal' which includes health care issues of the street and working children

Task 3

Develop and implement a module for health education for the children particularly focusing on their sexual health and HIV/AIDS

Tell us about your partnerships

As mentioned earlier, we are partnering with several private organisations (e.g. chamber of commerce and industry, like minded organisation (71 members across 5 regions of the countries)and relevant government agencies (e.g. district public health office and regional health directorate, Child Welfare Board). We also work with children's forums such as Western Regional Forum for Working Children). We are also one of the five members of South Asian Grassroot NGOs (Network of South Asian level NGOs working for and with children).

Are you currently targeting other specific populations, locations, or markets for your innovation? If so, where and why?

One of the main sources of street and working children is urban slums. As a result of conflict and limited economic opportunities in the rural areas, population and urban slum is increasing overwhelming. We are, therefore, targeting urban slum dwellings.Using our network, we are also trying to reach out to wider range of working children such as children working in entertainment sector (hotel/restaurant/bar). In long run, we are planning to expand our programme (mainly through our partners) in other cities of the country where child labour problem is more critical.

What type of operating environment and internal organizational factors make your innovation successful?

We have created a working environment in which we cultivate and encourage respect, mutual learning and trust. Our management system is horizontal and we need to promote this legacy further. We put great values on participation. in all stages of our initiative, children had significant participation and say. We have children's representative in our organisation' governing body ( a rare practice in Nepal).To enhance children's participation and morale, we have recruited staff such as peer educator who share the backgrounds of the children they are working for. We strongly believe partnership is one of key variables in our initiative. We will further enhance a conducive operating environment in future to achieve our innovation successful.

Please elaborate on any needs or offers you have mentioned above and/or suggest categories of support that aren't specified within the list