Bishnu Nepal, KATHMANDU: A study conducted in six selected hospitals across the country receiving the highest expecting mothers has unveiled that many of the expecting mothers and new mothers received nominal counseling on family planning services.
The study conducted by CREHPA on impact of institutionalizing immediate-post-partum IUD services as a routine part of antenatal counselling and delivery services in selected hospitals showed that only 25 per cent of the pregnant women coming to the hospitals for routine check-up had received counselling on contraceptives and the prevalence of contraceptives among the new mothers was very dismal.
The Ministry of Health and Population has accorded priority to the programme aimed at offering counselling to the expecting mothers and new mothers on nutrition and pros and cons of contraceptives as condoms, pills, Depot, interplant and IUD and providing them contraceptive services post their delivery.
Under the antenatal care programme, pregnant women are advised to receive four or more times antenatal services and counselling throughout their pregnancies.
Among those receiving antenatal counselling, only 4.5 per cent were found to have used IUCD, a type of long-acting reversible contraception that is inserted in the uterus of women to prevent pregnancies.
In the last two decades, the number of this contraceptive users has not gone up. According to the survey jointly conducted by CREHPA and Harvard School of Public Health in 2016, the prevalence of IUCD among the new mothers was at 1.4 per cent.
Research coordinator Dr Mahesh Puri told RSS that the survey was conducted among 75,000 pregnant women who received antenatal and post-partum services in Bheri Regional Hospital in Nepalgunj, Lumbini Regional Hospital in Butwal, Pokhara Regional Hospital in Pokhara, Chitwan Hospital in Bharatpur, Koshi Regional Hospital in Biratnagar and BP Koirala Institution of Health and Science in Dharan.
A continuous observation was made whether 22,000 new mothers had received contraceptives for 9 months and 18 months after their delivery.
The study, conducted over the three years, is considered to be the longest studies on the availabilities on family planning services in Nepal new mothers in Nepal.
Absence of adequate counselling
Though contraceptives are the reliable means of family planning, their use is relatively low in Nepal. Almost all means of family planning are women target and lack of adequate knowledge about the benefits and side effects among the target group, service providers failing to reach among them and absence of skilled and dedicated health workers in such service delivery system human have led to the low use of contraceptives.
According to the Family Health Division, only 3.3 percent, among the married women, use Implant and 1.4 percent opt for IUCD. Only trained human resources render these services. Only 15 percent health institutions in the mountain and 22 percent in hill avail these services.
According to the study, in case of Nepal, less than 50 percent health institutions are in the position of providing these family planning services. Health Ministry’s former secretary Prof Dr Kiran Regmi said the sharing of knowledge about the family planning services during pregnancy would contribute to improve women’s health. Regmi indicated the weakness in government counselling services, adding that women faced additional barriers to independently decide about the use of contraceptives.
It has been already three decades since the family planning programmes commenced in the country, but its major indicators are stagnant for years. Despite many efforts, the prevalence of modern contraceptives among married women is stagnant at 43 percent between 2006-2016 in Nepal and the one in four married women ( 24 5) have an unmet need for family planning. Moreover, studies show that there is high unmet need for family planning during the postpartum period (52 percent). Knowledge that means of family planning should be used is above 90 percent. The annual expenditure of the Nepal Government in this sector is above 480 million while the international donor agencies spend over five billion. RSS
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