Training to Female Community Health Volunteers (FCHV) on CIDT tool, Stigma, Discrimination, and Human Rights – Project INDIGO

People having mental health illnesses are often found stigmatized and discriminated against in their local communities. This often results in a range of negative impacts in terms of social exclusion, and poor access to health care; affecting overall well-being. As FCHVs are the front-line workers in the community, who know their communities well, and are intimately familiar with community cultural perspective, project INDIGO (International study of discrimination and stigma outcome) run by Transcultural Psychosocial Organization (TPO) Nepal organized four days of training for FCHVs from Arjunchaupari Rural Municipality.

The four days training was held from 13th September to 16th September 2022 in the Arjunchaupari Rural Municipality training hall. There were 20 selected FCHVs from four health facilities: Darau, Rapakot, Arjunchaupari, and Aaruchaur. The overall objective of the training was to provide knowledge, skills, attitude, and practices on four major mental health disorders as well as to aware and reduce stigma and discrimination against mental health illnesses that exist among female community health volunteers (FCHVs) as well as in the family and community settings. Training also had pre and post-test to measure the learning outcomes of the participants.

The opening of the training was with a welcome speech from Ujjwal Bahadur Basnet, Chief Administrative officer from Arjunchaupari. Nirmala Puri, psychosocial counselor, Jananee Magar, assistant research coordinator and district coordinator, and Dristy Gurung, INDIGO AND RESHAPE project coordinator, were the facilitators of the event. On the third day of the training, with an objective to visit the field site, we also had Petra Gronholm, Research Fellow and the Scientific Coordinator of the INDIGO Partnership research program.

The first part of the training started with an introductory game, sharing and learning about society, heart-mind, psychosocial well-being, the concept of care and support, myth-busting exercise, and understanding of community informant detection (CIDT) tool to identify four major disorders (depression, anxiety, psychosis and alcohol use disorders (AUD). FCHVs also performed a role play to bring their major learning outcome through the practice session while feedback on role-play was also provided. The FCHVs who participated in the training shared that it was their first time learning about mental illness and were very enthusiastic.

Besides CIDT tools, training also had content on stigma and discrimination, types of stigma, human rights, and human right abuse of people with mental health illnesses. Participants initially brainstormed, discussed, and understood the concept of human rights, and different types of human rights as per Nepal’s constitution 2015. In addition, one of the facilitators of the event, Dristy Gurung also helped our participants understand the psychosocial disability and the rights of people having psychosocial disability.  Participants were also provided different case stories to discuss on violation of rights in those respective case stories and the role of FCHV as a community informant people.

In the last section of the training, FCHVs also discussed on different mass media campaigns that they could use in the community to aware their community on mental health illnesses and reduce the stigma and discrimination against them. FCHVs agreed to use hoarding boards, flex print, and pamphlets as three main resources to share the messages on mental health illness and raise awareness on stigma and discrimination.

As a next part of the training outcomes, FCHV will start identifying the mental health illness and refer the identified person to a health post to visit the health workers. These health workers are already trained in WHO Module 2 training for 7 long days, they will then diagnose the patients. Alongside, trained FCHVs will also work on developing the content as a message to share with the community to provide the right knowledge on mental health illnesses and to reduce stigma and discrimination against such mental health illnesses.

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