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

Availability of NDHS surveysfor forecast<strong>in</strong>g <strong>and</strong> a shift <strong>in</strong>contraceptive commoditiesdistributedNepal has conducted fertility <strong>and</strong> family plann<strong>in</strong>g surveyss<strong>in</strong>ce 1976 for each five-year <strong>in</strong>terval; s<strong>in</strong>ce 1996 it hasconducted Demographic <strong>and</strong> Health Surveys (DHS).Nepal has already undertaken three such surveys (<strong>in</strong> 1996,2001 <strong>and</strong> 2006), <strong>and</strong> it has recently conducted ano<strong>the</strong>rone for 2011. The results of DHS 2011 are expected<strong>in</strong> October this year. These surveys provide adequate<strong>in</strong>formation on <strong>the</strong> levels <strong>and</strong> trends of contraceptivemethod mix, which can be used for estimat<strong>in</strong>g futurerequirements for contraceptives.There have been some <strong>in</strong>dications that a shift <strong>in</strong>contraceptive commodities distributed by sources <strong>in</strong>Nepal has been tak<strong>in</strong>g place (see Table 14). First, although<strong>the</strong> government sector cont<strong>in</strong>uously predom<strong>in</strong>ates as asource of any modern contraceptive method, its sharehas tended to decl<strong>in</strong>e over <strong>the</strong> years. Second, <strong>the</strong> sharesof <strong>the</strong> NGO sector <strong>in</strong> dispens<strong>in</strong>g contraceptives has alsoshown a decl<strong>in</strong><strong>in</strong>g trend. This holds true for all <strong>in</strong>dividualmodern methods except IUDs. Third, <strong>the</strong> share of <strong>the</strong>private medical sector has almost doubled between 2001<strong>and</strong> 2006; reach<strong>in</strong>g 13.8 per cent <strong>in</strong> that year after it hadbeen only 7.3 per cent <strong>in</strong> 2001. The <strong>in</strong>crease is remarkablefor all methods, especially of pills, <strong>in</strong>jectables, implants <strong>and</strong>condoms. Fourth, shops, friends <strong>and</strong> relatives have alsobecome a major source for condom.F<strong>in</strong>anc<strong>in</strong>gThe major sources of fund<strong>in</strong>g for contraceptives arepresented <strong>in</strong> Table 15. USAID is <strong>the</strong> largest funder offamily plann<strong>in</strong>g-related activities <strong>in</strong> Nepal, followed byKfW <strong>and</strong> DFID. Until FY 2000/2001, contraceptiveneeds had been fully met with donor fund<strong>in</strong>g. Thegovernment started shar<strong>in</strong>g <strong>the</strong> cost of contraceptives <strong>in</strong>FY 2001/2002. The amount has <strong>in</strong>creased from US$99,000 <strong>in</strong> 2001/2002 to US$ 140,000 <strong>in</strong> 2006/7. Thegovernment committed US$ 1,877,000 for 2006/07for contraceptives us<strong>in</strong>g a pool fund (fund created byDFID <strong>and</strong> <strong>the</strong> World Bank). There was an 87 per cent<strong>in</strong>crease <strong>in</strong> <strong>the</strong> budget from 2008/09 to 2009/10 (MoHP,USAID/DELIVER Project, 2010). In FY2009/10, <strong>the</strong>government committed 100 per cent of <strong>the</strong> public sectorprocurement needs for contraceptives, allocat<strong>in</strong>g US$2,114,300 for contraceptive procurement. Accord<strong>in</strong>g to afew key stakeholders, f<strong>in</strong>anc<strong>in</strong>g contraceptive commoditiesis not currently a problem; however, problems do exist <strong>in</strong><strong>the</strong> procurement process.Figure 4 shows <strong>the</strong> total donor expenditures for populationassistance by channel: NGO, multilateral or bilateral.Social market<strong>in</strong>g of contraceptive commodities hasTableTable15189