A decade of Nepal's family planning program: achievements and prospects
Thapa, S.
Studies in Family Planning 20(1): 38-52
1989
ISSN/ISBN: 0039-3665 PMID: 2785301 DOI: 10.2307/1966659Document Number: 359385
The paper reviews the infrastructure for family planning service delivery and organizational support in Nepal, examines emerging patterns in awareness about and practice of family planning, and discusses factors influencing, these patterns and the prospects for reaching the national fertility target through increasing contraceptive use. Data come from three surveys carried out in rural and urban regions. Knowledge and practice of family planning in Nepal increased considerably in 1976-86, with significant improvements in the availability of and accessibility to contraceptives. However, a proportionately larger share of the achievements were made during 1976-81 than in 1981-86. The impact on fertility of contraceptive use during the decade was minimal. Knowledge and use of reversible contraceptive methods remained very low, primarily because of the continued strong emphasis on sterilization in Nepal's family planning programme. Consequently, the welfare of many couples who may be in need of contraception for spacing births, but not necessarily for terminating childbearing, does not appear to be adequately addressed by the programme. A more balanced emphasis on reversible methods of contraception does not necessarily imply that a substantially higher level of contraceptive prevalence would be required to reach the fertility target. Several steps to improve programme performance and contraceptive method mix are suggested. Knowledge and practice of family planning in Nepal increased considerably from mid-1976 through mid-1986, with significant improvements in the availability of and accessibility to contraceptives. However, a proportionately larger share of the achievements were made during 1976-81 than in 1981-86. The impact on fertility of contraceptive use during the decade was minimal. Knowledge and use of reversible contraceptive methods remained very low, primarily because of the continued strong emphasis on sterilization in Nepal's family planning program. Consequently, the welfare of many couples who may be in need of contraception for spacing births, but not necessarily for terminating childbearing, does not appear to be adequately addressed by the program. A more balanced emphasis on reversible methods of contraception does not necessarily imply that a substantially higher level of contraceptive prevalence would be required to reach the fertility target. Several steps to improve program performance and contraceptive method mix are suggested.AS.