access to safe abortion care, the government of Nepal recently announced
that abortion services will be available free of charge at public
health facilities. Abortion has been legal in Nepal since 2002 and is
available in all 75 districts, but cost has been one of the key barriers
preventing many women from getting services.
“This is a breakthrough for safe
abortion care in Nepal,” says Dirgha Raj Shrestha, Ipas Nepal acting
country manager. “The fees the government has been charging for services
have been a barrier for too many women—especially for poor,
marginalized, adolescent and hard-to-reach women.”
Women’s health and reproductive rights
organizations, including Ipas, had advocated for the policy change,
which was announced last month by the Minister of Finance. “It was a
collective effort by partner organizations,” according to Madhabi
Bajracharya, Ipas Nepal program advisor. “Our advocacy has paid off, and
we are proud that we have helped to ensure the reproductive health and
rights of women in Nepal.”
Ipas is now working with the Ministry of
Health and Population and other government officials to ensure that
free services become a reality. A working group has been formed to
develop implementation guidelines and set budgets for covering supplies
and other costs.
Prior to 2002, abortion was illegal in
Nepal; the legal code essentially equated abortion with homicide and
unsafe abortion contributed in large measure to maternal deaths. In the
years since, Ipas and other groups have worked with the government to
expand safe abortion care across Nepal. There now are 832 public and
private sites across the country where women can obtain abortions. Based
on findings in eight districts, this expansion of care helped Nepal
nearly halve its maternal mortality ratio in the decade between 2002 and
2012.
But, says Shrestha, even with the
announcement of free care at government facilities, challenges remain.
“We still need to work hard to implement the program in such a way that
all women get free, safe abortion services,” he says. “What we want to
hear is that no woman in Nepal has to leave a health facility without
getting services due to cost or any other barriers.”
Related reading
Implementation of legal abortion in Nepal: A model for rapid scale-up of high-quality care
Pathways to Safe Abortion in Nepal: Ipas Research Brief
Nepal receives MDG Award for improving maternal health
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