Family planning vital in post-quake Nepal

The 70th session of the United Nations General Assembly is currently underway in New York. This meeting of the world's leaders will see the adoption of a new set of global goals – the Sustainable Development Goals – that aim to transform the world over the next 15 years. Goal 3 calls for ensuring universal access to sexual and reproductive health-care services, including family planning.

SINDHULI/NUWAKOT, Nepal – Before Nepal’s devastating April earthquake, 35-year-old Tanka Kumari Bishankhe regularly received contraceptive injections. She had already had three children since getting married at age 15. Together, she and her husband decided to not have more.

But when the earthquake struck, their home in the remote Shitalpati Village, in Sindhuli District, was badly damaged, and the family planning card she used to track her injections disappeared. Unable to determine when she was next due for her contraceptive shot, Ms. Bisankha became pregnant.

Today, she and her husband are worried about providing for another child. They already struggle to earn enough to feed their children twice a day. Ms. Bisankha says she wished she had known to use other family planning methods, like condoms, as a back-up when she lost her injection schedule.

“Sometimes we learn a big lesson of life when it’s already too late,” she said. “I am sharing my experiences with other couples so that they can learn something in time... After my children grow up, I will teach them to decide when and how many children they should have.”

Restoring women’s access

Through its flagship supplies programme, UNFPA has long helped the government and local partners offer a variety of contraceptive options to women and men.

Since the earthquake, UNFPA and partners have been working to help restore women’s access to family planning in areas where health facilities have been damaged or destroyed. UNFPA-trained health workers and community volunteers are also spreading the word about how to access family planning and use it effectively.

These efforts were recently recognized by the government for contributing to the country’s development.

“Deciding on the number of children means greater happiness,” said Mr. Majhi, 42. He and his wife, Tara Kumari Majhi, 37, have decided to use family planning. “Most of our relatives and villagers of our age have at least four children, but we didn’t go for more than two.”

Like Ms. Bisankha, Ms. Majhi also used contraceptive injections to avoid pregnancy, and she, too, lost her injection schedule when her home was flattened in the earthquake.

But Ms. Majhi approached local health workers to ask how to continue using family planning.

She learned about a UNFPA-supported reproductive health camp taking place near their village. The two-day camp offered family planning counselling, as well as maternal health care for pregnant women and new mothers, and a host of other health services.

“We cannot stop disasters, but we can stop unplanned pregnancies,” Ms. Majhi said.

Microplanning for family planning

UNFPA is currently working with health posts to closely analyse local-level family planning use. This information is helping health officials develop strategies to improve women’s access to contraceptive information and supplies.

“We have started analysing the overall health status, including family planning, in the village development committee” – the smallest administrative unit in Nepal – “before and after the earthquake,” said Gyan Chandra Rajbanshi, the Shitalpati health post chief. “Women from marginalized communities are still deprived of family planning services, and they need more attention.”

The effort to reach these women, called ‘microplanning’ has been implemented in all 54 health facilities in Sindhuli District. A government review of 30 facilities that had implemented microplanning showed that contraceptive prevalence rate had increased from 34 percent to 45 percent.

Volunteers are also working to raise awareness of family planning options and services. Sharmila Dangol, 35, and her husband, for example, are encouraging other couples in their area, Nuwakot District, to learn about contraceptives.

“Many families in Nuwakot are poor. Family planning helps reduce poverty and is a key to prosperity,” Ms. Dangol said.

Volunteers also explain that by preventing unintended pregnancies, family planning lowers the incidence of death and disability related to pregnancy complications.

“I think family planning helps save lives,” said Budimendo Tamang, 22, “and brings health benefits to every family.”