A rollercoaster ride of film making for female community health volunteers

20 July 2023

Sulata Karki, a research officer at HERD International in Nepal, talks about the team’s experience working with female community health volunteers (FCHVs) on the production of a video about their working lives (watch the film here).

When we engaged in conversation with the FCHVs in Chandragiri municipality in Kathmandu, they shared their stories regarding their role within the community, maintaining a work-life balance, and the challenges they encountered.

“Throughout my years of voluntary service, I have encountered numerous challenges. Besides providing services on the ground, I have multiple roles. I must manage my household chores, take care of children and engage in farming. At the same time, we strive to ensure that no child suffers from malnutrition, every child gets immunized, and all pregnant women receive proper counselling,” Sunmaya Tamang (not her real name) shared her experiences.

Sunmaya also said that convincing community members and increasing acceptance of community-level healthcare initiatives is a challenging part of their work.

“Once, I took part in a national initiative to provide the public with medicines to treat lymphatic filariasis. Convincing people to accept the medicine was extremely difficult. I was in a challenging situation at the time,” she said. She recalled people saying similar things including:

“I’ll be dead after taking it.“

“These medications are expired.”

“Perhaps these medications are donations from abroad, it might be appropriate to administer to animals, they tried with humans here.”

As she spoke, other volunteers joined in and echoed similar reflections. Simultaneously, they also shared the importance of their work in contributing to the health and well-being of people despite the challenges they faced. This included their involvement in shock situations, such as natural disasters and pandemics.

Female Community Health Volunteers and ReBUILD staff at Jahadi Health Post, Lumbini Province, Nepal during our consortium workshop in September 2022

Who are female community health volunteers?

The common Nepali name, Mahila Swasthya Swayamsebika means Female Community Health Volunteer (FCHV). There are an inseparable part of the national health system. Around 51,000 volunteers are spread throughout the country [see the Ministry of Health website for more information – opens a new tab] as the first contact point for services at the grass-roots level. They are the pillars connecting families, communities, and health workers with primary healthcare facilities, regularly visiting households and raising awareness about important health issues such as maternal and child health, family planning, nutrition, hygiene, immunizations and prevention of common diseases. Their contribution to improvements in health indicators, particularly the decline in maternal, neonatal, and child mortality, has been recognized by the Government of Nepal.

How are we engaging with these volunteers?

To address gender norms and power dynamics among community health providers through participatory action research as part of REBUILD for Resilience, the HERD International team, in partnership with the Chandragiri municipality, selected 12 FCHVs from 6 different wards. A series of workshops was organized, initially a planning and coordination workshop followed by a session on problem identification and discussions on potential solutions. FCHVs prioritized the two main issues they faced – the lack of work recognition and their ad-hoc mobilization. Further workshops led FCHVs to emerge with the idea of community filming. The script was written and improved by FCHVs following an iterative participatory discussion approach. We developed a concrete plan for the community filming, formed three groups based on feasibility, and collectively chose the actors, camera persons, and sound recorders. All FCHVs were enthusiastic and hopeful that the video would be an excellent opportunity to showcase their contributions and change the perceptions of people towards them.

Although FCHVs agreed to produce the film as an effective means to portray their role, the filmmaking process required a certain level of dedication and work. The HERD International team provided technical support, but FCHVs led the entire filmmaking process. All FCHVs were heavily engaged in three consecutive days of community filming, receiving assistance from community participants who played a role in helping them complete this journey. It was their first-ever experience producing a film. They actively engaged in teamwork, though there were some difficulties. FCHVs experienced a range of emotions throughout the process – from laughter to frustration due to repeated shots, and occasional moments of fear. However, despite these varying feelings, their overall experience was enjoyable.

Techniques and technicalities – how did the volunteers feel?

Filmmaking involves techniques of scripting, storytelling and acting, and technicalities like handling the camera – participants said that holding the camera was ‘scary’ at the beginning but later turned into complete fun. “I had never had the opportunity to be a cameraperson before, I felt that if I keep doing it I can learn,” a volunteer who was involved in the shooting said. Some volunteers were very conscious of the camera, and nervous while speaking the dialogue, and some faced the challenge of selecting the community participants to act and encouraging them to play the role as per the script.

Acting in front of the camera and in the presence of many people was a unique experience for the FCHVs. A volunteer who played the actor role said, “Being involved in such a program for the first time made me nervous. Initially, I was a bit hesitant but after making multiple attempts at dialogue, I realized there is no difference whether we speak on usual occasions or in front of the camera.” Another volunteer taking on the role of sound recordist felt that a series of interactions, the group working on scripting, and technical support from the HERDi team (both researchers and audiovisual staff) helped make the entire process of filmmaking smooth which she enjoyed.

The FCHVs believed that the participatory film might change community perspectives, and they anticipated it would have a positive impact in the long-term run.

“Through the films, we have tried to show the role of female community health volunteers, our responsibilities at home, responsibilities outside, being always ready for service, even at night, at any time,” a volunteer who participated in the filmmaking said. “I hope it will make a certain impact in the community.”

Further information

The short film produced by the female community health volunteers is being disseminated in their community and further afield – watch it here.

This work is part of a wider ReBUILD study – Close-to-community providers addressing gender norms and power dynamics: participatory action research in fragile and shock-prone settings

Images: Ranjit Bishra and Biraj Bhattarai/ HERD International

NB This article was first published on the HERD International website. [opens new tab]