Clients’ Perspectives on Quality of Abortion Services in Specific Rural Areas in Nepal

Session: Improving Access and Quality of Safe Abortion Services: Global Lessons and Questions

Presenter: Swadesh Gurung, Ipas
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Nepal is one of the countries on track for achieving the Millennium Development Goal 5 for reducing maternal mortality by 80 percent by 2015. As acknowledged by the White Ribbon Alliance this goal is being achieved in Nepal, in part, by making safe abortion services, treatment of incomplete abortion and postabortion contraception available, accessible and high quality for women who otherwise would resort to unsafe abortion.  Following liberalization of the abortion law in 2002, under the umbrella of Safe Motherhood, comprehensive abortion care has been integrated into national health and development plans, emergency obstetric care and safe abortion care training for auxiliary nurse midwives, and decentralization of services to all 75 districts in the country. To further meet the needs of rural and marginalized women, services are being further scaled up to reach women at health posts in their communities through provision of medical abortion.  Results of assessments of women’s perceptions and experiences with abortion care underscore the importance of proximity of services, affordability, and privacy and confidentiality for rural women, young women and marginalized women, such as commercial sex workers. Even with liberalizing the abortion law, women fear being stigmatized for using abortion and contraceptive services.  To address one of the key barriers to women’s access, the government of Nepal recently passed a policy making safe abortion care services free of charge. Going forward, Nepal will continue to work to ensure women’s equitable access to care and to improve the quality of abortion care to meet women’s needs. Nepal’s successes in addressing this key cause of maternal mortality serve as a model for how other countries can address this entirely preventable cause of maternal mortality as part of Sustainable Development Goals, the Global Strategy for Women’s, Children’s and Adolescents’ Health, and the post-2015 development agenda.