Family Planning in Asia and the Pacific - International Council on ...

eproductivehealth; designs <strong>and</strong> conducts research activities on reproductive health; <strong>in</strong>itiates <strong>and</strong> upgradesservice delivery <strong>and</strong> tra<strong>in</strong><strong>in</strong>g facilities at various levels; develops adolescent reproductive health programmes;<strong>and</strong> promotes coord<strong>in</strong>ation <strong>and</strong> collaboration.1998, Safe Mo<strong>the</strong>rhood Policy: family plann<strong>in</strong>g services needed as a key component of maternal care.2000, National Adolescent Health <strong>and</strong> Development Strategy: emphasizes <strong>in</strong>creased access to <strong>and</strong> utilizationof adolescent-friendly services to reduce unwanted pregnancies, sexually transmitted <strong>in</strong>fections<strong>and</strong> HIV/AIDS.Second Long-term Plan: family plann<strong>in</strong>g is considered an essential health-care service.Kreditanstalt fur Weideraufbau (KfW)Department for <strong>International</strong> Development (DFID)Nepal <strong>Family</strong> Health Programme (NFHP)UNFPAWorld BankStatus of contraceptive use, non-use<strong>and</strong> preferred method <strong>in</strong> <strong>the</strong> futureLevels <strong>and</strong> trends <strong>in</strong> contraceptiveprevalence ratesContraceptive use has <strong>in</strong>creased dramatically <strong>in</strong> <strong>the</strong> past30 years (see Table 3). CPR us<strong>in</strong>g any method <strong>in</strong>creasedfrom 3 per cent <strong>in</strong> 1976 to 48 per cent <strong>in</strong> 2006 – a sixteenfold<strong>in</strong>crease dur<strong>in</strong>g <strong>the</strong> last 30 years. Similarly, <strong>the</strong> use ofmodern methods has also <strong>in</strong>creased considerably, from 2.9per cent <strong>in</strong> 1976 to 44.2 per cent <strong>in</strong> 2006.TableLevels <strong>and</strong> trends <strong>in</strong> method mixThe contraceptive method mix has changed over <strong>the</strong> years<strong>in</strong> Nepal (see Figure 1 <strong>and</strong> Table 4). However, femalesterilization has dom<strong>in</strong>ated <strong>the</strong> method mix s<strong>in</strong>ce <strong>the</strong>early 1980s. Its share <strong>in</strong> CPR <strong>in</strong>creased from 34 per cent<strong>in</strong> 1981 to 50 per cent <strong>in</strong> 1991 <strong>and</strong> decl<strong>in</strong>ed to 41 percent <strong>in</strong> 2006. Thus, major efforts of <strong>the</strong> family plann<strong>in</strong>gprogramme appeared to have been spent on target<strong>in</strong>gwomen for sterilization. The total share of female methods<strong>in</strong> <strong>the</strong> method mix was only one fourth of CPR <strong>in</strong> 1976but reached 81.7 per cent <strong>in</strong> 2006. Interest<strong>in</strong>gly, <strong>the</strong>percentage us<strong>in</strong>g male sterilization <strong>in</strong>creased steadilyfrom 1.9 per cent <strong>in</strong> 1976 to 7.5 per cent <strong>in</strong> 1991, <strong>the</strong>ndecreased slightly from 1991 to 1996 <strong>and</strong> <strong>the</strong>n rema<strong>in</strong>edaround 6 per cent until 2006. This is <strong>the</strong> only methodwhose use has decreased. Use of <strong>the</strong> pill rema<strong>in</strong>s very low,with only 3.5 per cent us<strong>in</strong>g this method <strong>in</strong> 2006. IUDhas been available s<strong>in</strong>ce 1976 but its use rema<strong>in</strong>s very low(only 0.7% <strong>in</strong> 2006). The use of <strong>in</strong>jectables has <strong>in</strong>creasedsubstantially (from 0.1% <strong>in</strong> 1981 to 10.1% <strong>in</strong> 2006). Theuse of condoms has also <strong>in</strong>creased, but by 2006 only 4.8Table3175