By Hari Bastola
About forty-five percent of women in Nepal experience unintended pregnancies due to a lack of access to modern contraceptives, a study shows.
A report of the study conducted by the Guttmacher Institute and Center for Research on Environment, Health and Population Activities (CREHPA) highlights that a larger number of women in Nepal are compelled to have unintended pregnancies: it may be mistimed, unplanned or unwanted at the time of conception; due to an unmet need for the modern means of family planning.
The study conducted in 2017 brought out the fact that 12 million women become pregnant each year in Nepal and of them, 539,000 pregnancies are unintended. It shows that many women are not receiving the services they need.
Of the unintended ones, around one third get an end into unplanned birth and two-thirds are aborted and remaining end with miscarriages, shared CREPHA joint director Dr. Mahesh Puri.
As he said, among Nepali women of reproductive age (15 to 45 age group) who want to avoid pregnancy, 44% are considered to have an unmet need for modern contraception because they either use no contraceptive method or use a traditional method of family planning.
All the seven states in the country have no access to the supply of contraceptives as per the demand.
The Gandaki State has the highest 52 percent demand and the State two has the lowest demand. Most of the women are deprived of health services to cope with pregnancy and birth-related problems, he said.
According to available data, it has been found that 64 percent of pregnant women have got at least four times pregnancy test and 61 percent of births are assisted by skilled birth attendants. Such types of care is important in preventing and managing health complications that could arise during pregnancy and delivery, and delivery, and which are crucial for importing maternal and newborn health.
Only 27 percent pregnant women have gotten health services required for pregnant women, postnatal mothers and their newborns, said Puri.
Infant mortality rate out of each 100,000 live births is 239, which is equal to 1,600 annually more than average than the South Asia Region.
Approximately USD 30 million is estimated yearly to spend on purchasing modern contraceptives demanded by Nepali women, an increment from around USD 17 million.
If all unmet need for modern contraception were met, there would be 469,000 fewer unintended pregnancies annually, 306,000 fewer induced abortions and 300 fewer maternal deaths, the report states.
If all unmet need for modern contraception is fulfilled, only 70,000 unintended pregnancies would occur each year (those caused by method failure).
This would result in 469,000 fewer unintended pregnancies than currently occur, a reduction of 87%.
The study shows that monthly 300 maternal deaths could be reduced if the entire requirement of contraceptives was met.
It is stated in the report that maternal and child deaths could be minimized with the fulfillment of the maternal and child health services.
Family Planning Association of Nepal (FPAN) Kaski branch president Niranjan Shrestha said they have been providing all five types of contraceptive devices in Kaski district.
Stating that education about and access to family planning education and devices have not reached the remote areas even at present, he stressed that the forthcoming programs should be targeted to rural areas along with awareness-raising campaigns.
NGO Federation general secretary Ram Prasad Subedi called on the government to increase investment in family planning and reaching out to the people in remote settlements.
He stressed that the local governments and the NGOs have an important role to play in this.
Subedi also stressed on the need for discouraging abortions based on sex identification, saying this practice increased the risk to women’s health and spending on health.
It is stated that collective efforts of the federal, provincial and local levels, the private sector as well as the international development partners are necessary for fulfilling the demand for modern contraceptive devices.