Culture in general refers to sheared beliefs, values, and norms on different matter of life and socialisation. Similarly political culture in my understanding, is  a set of widely shared beliefs, values, and norms concerning the ways that political and economic life ought to be carried out. The concept of  political culture in short captures the  relationship of citizens to government, to one another, and to the economy.It can be understood as a set of  attitudes, beliefs, and values which underpin the operation of a particular political system. It can be seen as including knowledge and skills about the operation of the political system as well as positive and negative emotional feelings towards it. It provides a broader political framework which constrains political action and discourses. Political culture in any community is determined by awareness, expectation and political participation. As similar to other culture political culture are transmitted from one generation to another.

In its broadest sense, I would prefer to define  political culture is the political atmosphere or climate of a nation’s government as it is perceived by its people that  is based upon a shared identity or belief system in the government and its functions.

Democratization process going on in Nepal has now been not only the interest of Nepalese but the whole world. Many countries in globe have undergone similar phase of political transition .

Democratisationprocess is a slow process that might take years to decades. Nepal is undergoing the process of fundamental and transformative change thst is definitely more challenging. In Nepalese context, Maoist that faught 12 years believing in the puissance of violence,  is  now  in peace process and party itself has become the largest elected party of Nepal. Repeated political committeement of the political leaders of different political parties towards democracy has helped in the democratisation process significantly.However violence and other non democratic practices going on in different parts of country present a gloomy scenario. What we need to consider here is that, Nepal is in the phase of transition and at this phase different social strata  based on religion, cast,  ethnicity etc  want to secure their stake in New Nepal.And is such circumstances some disagreement, conflict and debate is common as considering to example of other countries that have passed through the process of transition.

However, there always the risk of failure of peace process and also failure of democracy till new constitution is drafted. To prevent this, citizens specially youth need to be vigilant and sensitize political leaders for drafting 0f constitution and institutionalisation of democracy.

Institutionalization of democracyrefers to systemically establishing democratic norms and values in every social strata of political system. It needs a great degree of committeement youth and every citizens of the country. Young people are the catalyst of fundamental and transformative change across the world. So youth have significant role in the institutionalization of democracy inn Nepal. Nepaleseyouth have always been in the forefront of change , whether it is janaandolan 1 or 2. As the change begins from oneself, Youth as a social , community or political leader, need to transform their own behavior and practices to make them compatible to democratic norms and values. By doing so, youth can act as a role model of democratic leadership. Institutionalization of democracy doesn’t only refer to political structure or system, for democracy to be engrained people should have faith in democratic norms and values. Youth can aware, advocate and lobby for democratic culture  in family, in friends circle, in institution they work, and political systemat various level. Theycan play role in sensitizing political leaders and policy makers for adoption of democratic process. Also,Conciously selecting and voting political leaders can help in the process.

 

Extent of problem Each year more than half a million women die from preventable complications of pregnancy and childbirth. while a woman in devel¬oped countries stands a 1 in 2,800 lifetime risk that she will die of pregnancy-related causes, this increases to 1 in 61 in developing countries. Lifetime risk of maternal mortality reflects both the number of pregnancies and the safety of each delivery. That women die of preventable causes during childbirth is a tragedy. This tragedy is compounded when the pregnancy was not even intended.

Pregnant women with poor nutritional status are also at particularly high risk of suffering pregnancy-related and childbirth complications that may result in death. Malnutrition in women during pregnancy and childbirth as well as throughout their lifecycle has been associated with obstructed labor, obstetric fistula, anemia and higher susceptibility to infections, which increase the risk of maternal mortality and morbidity. Even in the best of circumstances, about 15 percent of pregnant women experience complications that require emer¬gency obstetric care.

One in every three women in rural area live 5 km away from health centre. In this context the only way that can improve maternal health substantially is to aware, ainvolve and mobilize community in promoting maternal health. Community participation and mobilization in improving maternal health.

“Community participation is defined a the process by which individuals and family assume the responsibility for their own health and welfare and for those of the community, and develop the capacity to contribute to their and their community’s development.” WHO

The rationale and effectiveness of community-participation and mobilization on maternal and child health are not new and have been widely reported. Community participation, community empowerment or social mobilization all aim to increase the use of maternal health services , and to reduce maternal and perinatal mortality . Most community-based interventions involve the use of lay people referred to as community motivators, community health agents, community health workers among others . Although the requirement for both supply and demand side interventions are implicit and acknowledged in maternal mortality reduction frameworks, in practice, most maternal and perinatal reduction strategies have mainly focused on the supply side and more tangible interventions (such as buildings, equipments, vehicles, staffing, training and supervision among others).

community mobilisation , defined as a process, a movement of the population leading to behavioural changes towards a specific problem, mostly health related but also applicable to other development sectors such as education or agriculture . The social mobilisation and thus, community mobilisation when restricted to a community is summarised into four interrelated and complementary pillars:

• Avocacy and awareness,

• Social marketing,

• Behavioural change communication (BCC) and

• Capacity strengthening

  Awareness aims at engaging local traditional leaders, administrative and religious leaders, local associations with the use of skilled care through problem-solving techniques, negotiation, and persuasion and lobbying. It focuses on danger signs during pregnancy and delivery, birth preparedness , emergency preparedness and quality delivery care. In a context of low literacy, and where there is a value for community self identification and where communities are responsive to recommendations of religious and traditional leaders, it is critical that any intervention in a community meets the needs of local stakeholders and wins their support. Communities are not ‘empty vessels’ and understanding and building upon cultural beliefs of care and means of communication ismore likely to be effective.

Social marketing postulates quality services at affordable price. In this framework, community-based interventions through social marketing aim at reducing financial barriers and out of pocket for the use of skilled care. There is no one-size-fits-all approach and communities are encouraged to use acceptable and effective strategies.

BCC It is expected that each community use the most relevant, acceptable and effective one to induce change towards safer delivery.

capacity strengthening pillar refers to facilitating community problem-solving skills towards skilled delivery care. This process improves ownership of activities and includes analysis and prioritisation of community problems and sustainability of agreed upon consensual decisions. An important part in the capacity building pillar is also prompting household to raise funds for possible emergencies and to promote revenue generating activities.

Why is community participation and mobilization needed?

• To increase resources for health.

• To extend coverage beyond formal health system.

• To build health programme on existing cultural structure.

• To break vicious cycle of dependency.

• It improves the acceptability of health services as community people are directely involved in identifying the need, planning of intervention, implementation , monitoring evaluation and control.

• It develops the sense of ownership and builds greater committement towards success of the programme directed towards improving maternal health.

• It encourages the males involvement in promotion of women’s health which has a long term impact on maternal health.

• Community participation and mobilization helps to develop locally sensitive, problem responding, and acceptable intervention to improve maternal health through participation of local people.

• Ensures the sustainability of the intervention or programme.

• It is also a process of community empowerment that makes the community capable to assess need , plan intervention , and execute intervention on their own.

• Improved communication and mutual understanding between community members and health personnel on maternal health service utilization in rural part of county;

• Increased community voice and participation in health services through organized joint meetings between community members and clinic personnel to discuss measures needed to enhance use of maternal and child health (MCH) services

• Established joint action on identified barriers by communities and health workers, and

• Improved the understanding and uptake of MCH services in the community.

How to promote community participation and mobilization in improving maternal health in rural areas? To facilitate the community to identify and analyse barriers to maternal health service utilization in activities were held to:

• Assess the problems of community through their full participation.

• Sensitize the local community especially male and every member of community the need to promote maternal heakth and their role in doing so.

• Mobilize traditional healers in awareness on maternal health related issues as they are socially accepted as religious healers.

• Design culturally sensitive message through full participation of local people.

• Empower mothers group and other community based organization providing technical and other support.

• Mobilize grass root women and men, expectant mothers and partners, local leaders, community based organisations, local government leaders, media and health workers; and explain the activity.

• Obtain views on and experiences of maternal health services, and of the relationships between health workers and mothers, and health workers and the community.

• Draw out people’s experiences of maternal health issues including access to and use of services using pra/pla tools and

• Identify problems and barriers to maternal health services in the health services, through full community participation. Its not the marginal or substantive participation that could improve the situation its structural participation of community in managing every health programme in community including maternal health.

BIBLIOGRAPHY

•Park, K. (2007) Text Book of Preventive and Social Medicine.19th ed. Jawalpur.New Delhi

•Rao, S. (2007). Principle of community medicine. New Delhi: AITBS.

• Gupta, MC and Mahajan, BK(2003). Text book of preventive and Social Medicine.3rd ed. New Delhi: Jaypee Publications.