SUMADHUR
Women’s health, especially nutrition, in the preconception and early pregnancy period is important for both maternal and newborn health outcomes. However, this period is often neglected, which is especially troublesome in settings, like Nepal, where most women do not seek prenatal care until 4 or 5 months of pregnancy. The time before the first birth aligns with a time when women have very low status in their households in South Asia. This 5 year project in rural Nepal seeks to first understand more about the situation for newly married women in Nepal and, second, develop an intervention to improve access to nutrition, women’s status, and household relationships in the first few months of marriage by engaging newly married women, their husbands and mothers-in-law. We followed a cohort of 200 newly married women for 2 years, and conducted in-depth triadic interviews with newly married women, their husbands, and mothers-in-law. We found that newly married, young, women in rural Nepal have very low status in their household, resulting in eating less over all (especially of high quality food), eating last, not seeking health care as much, not being able to advocate for delaying the first baby and subsequently using desired family planning, and experience increasing levels of violence. We have developed and will be piloting a 4 month group intervention (called Sumadhur, meaning “harmonious”) for triads of newly married women, their husbands and mothers-in-law to come together with other household triads and gain information, engage in conversation, and activities, about nutrition, pregnancy, reproductive health, timing of births, violence, and gender norms.