Situation Analysis: Many challenges exist in Nepal in this respect and it relates to socio-economic problems, lack of access to quality abortion services, skilled/trained service providers and advocacy works, especially rural areas of the country.

Nepal is a Hindu kingdom and about 79% of its populations are Hindus. Hindus have their own religious norms and concepts and one of them is son preference. According to the religious norms, son is essential during "funeral pyre". Sex selection for son could be another challenge for abortion services.

The total wanted fertility is only 2.5, which clearly shows that large proportions of pregnancies are unwanted (DHS 2001). Women with unwanted pregnancy are more likely to seek abortion and are in more risks. In Nepal, most of the abortion is done in unsafe, unhygienic condition by untrained personnel and is one of the important causes of maternal mortality and morbidity. One of the main causes of maternal death is unsafe abortion and its complications.

The unwanted or unintended pregnancies are directly related to unsafe abortion. Many women do not want the loads of children and therefore want to space births. The modern family planning methods are not easily accessible in rural areas of the country.

Demographic survey (2001) shows that about eight percent of pregnancies are terminated as abortion, of which, two percent are terminated stillbirths and rest six percent as spontaneous or induced abortions. Strategic Direction Increase access to gender sensitive comprehensive abortion care (CAC) services and education by lobbying and advocating for the universal rights of women to live healthy and safe lives and thereby reducing socio-economic barriers in FPAN's operational areas.

Goal: Recognition of the universal rights of women to choose and have safe abortion services to reduce the incidence of unsafe abortion in FPAN's operational areas.

Objectives 

• To increase access to safe abortion services, post abortion care & other abortion related services & education
• To reduce socio-economic barriers (Son preference, Less concerned about women’s reproductive rights) for safe abortion services

Activities to Achieve Objectives:

• To increase access to safe abortion services, post abortion care & other abortion related services & education
• Conduct base line survey on socio cultural norms and impact of abortion at household level.
• Conduct feasibility study for cost recovery and fee charging scheme.
• Establish and maintain a national database on abortion related information by the Association.
• Advocate policy makers for expansion of service outlets.
• Identify stakeholders working in abortion activities e.g. Govt/I/NGO (Marie Stopes, CREPHA, FWLD at National level and many others at district level) and private sector (nursing homes, private practitioners, national society of gynaecologists)
• Build capacity of service providers to ensure quality safe abortion including PAC focusing on sensitisation on clients’ rights and gender issues
• Upgrade existing clinical infrastructure and establish new service delivery centres
• Develop monitoring indicators, check list for quality services.
• Integrate and expand abortion related services into existing FPAN’s service outlets.
• Establish/develop model clinics for gender and youth sensitive quality abortion services.
• Provide proper counseling on safe abortion services and post abortion care in selected clinics
• Provide post abortion contraceptives (unconditional) from FPAN's service outlets
• Provide FP services, including emergency contraception to reduce unplanned/untended pregnancies
• Establish partnership and referral linkage with relevant CBOs and primary health care institutions for access and advocacy
• Document the process of implementation and it's success

Activities to Achieve Objective:

• To reduce socio economic barriers (son preference, low priority to women’s reproductive rights) for safe abortion services
• Disseminate information on actual problems among various groups (gynaecologist, social worker, women group, lawyers, media person) on safe abortion services
• Develop gender focused advocacy package and BCC materials based on the information collected from the base line survey
• Sensitise the community to combat stigmatisation on abortion through gender focus approach.
• Undertake public awareness and community education programs about stigmatisation on abortion and dangers of unsafe abortion.
• Advocate for access to CAC services to rural women
• Documentation of advocacy efforts in Nepal, including role of FPAN for liberalization of abortion law.

Outcomes and Indicators: