Publication date: 2015

FAMILY PLANNING IN NEPAL: SAVING LIVES AND IMPROVING HEALTH In March 2015, as part of the FP2020 global partnership to increase access to family planning, the government of Nepal made the following commitments to improve its family planning (FP) program by 2020: ƒ Increase funding for family planning programs by at least 7 percent annually ƒ Identify barriers to accessing family planning services and formulate policies to address them ƒ Expand and strengthen family planning service delivery and support mobilizing resources from non-health sectors Family planning has many benefits for individuals and society. If Nepal achieves its FP2020 and Costed Implementation Plan (CIP) goals for family planning, it will save the lives of women and children and improve the health of families. These health improvements can have great impacts on the lives of the poorest and most disadvantaged women, as well as the national economy. Family Planning Saves the Lives of Women and Children Family planning prevents unintended pregnancies, reduces high-risk births, and protects the health of women and children. In Nepal, 1 in 200 women will die from pregnancy- or delivery-related causes in her lifetime (World Bank, 2015). The risks are higher for poor, rural, and disadvantaged women, who face more challenges accessing family planning and maternal healthcare. Use of family planning is lower among poor women compared to the national average, and their unmet need for family planning is higher. By helping women avoid high-risk pregnancies and births, meeting Nepal’s FP goals—while also increasing investments in education and gender equity—could save Photo by Jacob Kasell, Health Policy Project, RTI International 1,737 4,499 0 500 1,000 1,500 2,000 2,500 3,000 3,500 4,000 4,500 5,000 2015 2020 2025 2030 2035 Cu m ul at iv e M at er na l D ea th s A ve rt ed , Lo w es t W ea lth Q ui nt ile Cu m ul at ive M at er na l D ea th s A ve rte d, Lo w es t W ea lth Q ui nt ile Sarita lives in Nuwakot district, and her husband works in Kathmandu. “My husband is from Kavre district. He [works for] a trekking [company] in Kathmandu, and I see him about once every three months. We are planning on having another child soon.” Government of Nepal, Ministry of Health and Population HEALTH POL ICY P R O J E C T 64,237 144,310 0 20,000 40,000 60,000 80,000 100,000 120,000 140,000 160,000 2015 2020 2025 2030 2035 Lo w es t W ea lth Q ui nt ile Cu m ul at iv e Ch ild D ea th s A ve rt ed , Cu m ul at iv e Ch ild D ea th s Av er te d, L ow es t W ea lth Q ui nt ile Cumulative Child Deaths Averted, Lowest Wealth Quintile Cumulative Child Deaths Averted, Lowest Wealth Quintile the lives of a projected 4,500 mothers among the lowest wealth quintile by 2035 (RAPIDWomen, 2015). Currently, 38 in every 1,000 children in Nepal die before their fifth birthday (Central Bureau of Statistics, 2014). When women can decide the number and spacing of their births, they are better able to avoid high-risk pregnancies and care for their newborn children. Improving access to family planning among the poorest women could save the lives of an additional 144,000 children in the lowest-income group by 2035 (RAPIDWomen, 2015). Expanding Access to Family Planning Yields Many Benefits Investing in family planning now can see an impact within five years. Increasing the use of modern FP methods could avert an additional 100,000 unintended pregnancies annually by 2020. Reaching the CIP’s contraceptive prevalence rate (CPR) goal Incremental Cost Effectiveness Just an additional. . to avert one unintended pregnancy$2 on FP $91 on FP . to save one child’s life $906 on FP . to prevent one maternal death Source: ImpactNow model of 57.2 percent by 2020 could increase the number of intrauterine device users by 35,000 and implant users by 50,000 (ImpactNow, 2015). Expanding FP services, particularly for long-acting reversible contraception, can increase female life expectancy, decrease maternal and infant mortality rates, and reduce the number of high-risk pregnancies among disadvantaged women (RAPIDWomen, 2015). Family planning is a cost-effective investment. Each additional unintended pregnancy prevented through increased use of family planning costs only US$2 (ImpactNow, 2015). Call to Action To achieve its FP goals and reap the related health benefits, Nepal should prioritize investments in voluntary and high-quality FP information, services, and supplies. Additionally, FP investments can increase the effectiveness of investments in other sectors, such as education and the economy. To meet these goals, the government of Nepal should ƒ Increase and improve access to high-quality FP services—especially among disadvantaged and marginalized women—to achieve a CPR of 57.2 percent ƒ Provide a diverse range of contraceptive methods to increase use of long-acting reversible contraception ƒ Meet the commitment of increasing funding for FP programs by at least 7 percent annually References Central Bureau of Statistics. 2014. Nepal Multiple Indicator Cluster Survey 2014, Key Findings. Kathmandu, Nepal: Central Bureau of Statistics and UNICEF Nepal. Health Policy Project (HPP), United States Agency for International Development (USAID), and Marie Stopes International (MSI). 2014. ImpactNow Model. Washington, DC: Futures Group, Health Policy Project. Application for Nepal completed in 2015 by the Health Policy Project. USAID, Packard Foundation, and Futures Group. 2012. RAPIDWomen Model. Washington, DC: Futures Group. Application for Nepal completed in 2015 by the Health Policy Project. World Bank. 2015. “World Development Indicators: Reproductive Health.” Available at table/2.17# . Contact Us Health Policy Project 1331 Pennsylvania Ave NW, Suite 600 Washington, DC 20004 The Health Policy Project is a five-year cooperative agreement funded by the U.S. Agency for International Development under Agreement No. AID-OAA-A-10-00067, beginning September 30, 2010. HPP is implemented by Futures Group, in collaboration with Plan International USA, Futures Institute, Partners in Population and Development, Africa Regional Office (PPD ARO), Population Reference Bureau (PRB), RTI International, and the White Ribbon Alliance for Safe Motherhood (WRA). The information provided in this document is not official U.S. Government information and does not necessarily represent the views or positions of the U.S. Agency for International Development.

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