Can socio-cultural information improve health planning? A case study of Nepal's assistant nurse-midwife.

Nepal's Assistant Nurse-Midwife program demonstrates some of the consequences of ignoring social and cultural information in health planning. Partly in response to national and international pressures to develop careers for women, the program was designed to train young women to provide maternal and child health care in rural areas. But traditional expectations about women, which are widely known, have impaired the program's effectiveness. Thus, even when cultural information is relevant and available--in fact, common knowledge--it still may not influence health planning. This case study pinpoints crucial planning issues in primary health care and recommends changes that could make the Assistant Nurse-Midwife's role more appropriate to its social and cultural setting.