Browsing by Author "Shahi, Suruchi"
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Publication A Critical Analysis of Safe Abortion Road Map in Nepal(Nepal Health Research Council, 2024) Ghimire, Jagadishwor; Maharjan, Sanju; Kattel, Pratikshya; Dangol, Deeb Shrestha; Lal, Bibek Kumar; Joshi, Nisha; Shrestha, Gauri Pradhan; Suwal, Archana; Bhattarai, Ojasbi; Shahi, Suruchi; Gautam, Manish; Bhattarai, Navaraj; Mehata, Suresh; Dotel, Bhogendra Raj; Karki, SujanBackground: Abortion was legalized by the 2002 Muluki Ain to combat the surging rates of maternal mortality and morbidity. By 2021, the Maternal Mortality Rate plummeted to 151 from 539 in 1996. The decline in the abortion-related maternal mortality attributes to the implication of progressive abortion policies that includes expanded safe abortion services introduction of medical abortion, constitutional recognition of abortion, the mandates by Safe Motherhood and Reproductive Health Rights Act, and free-of-cost abortion services in government health facilities. This review study delves into exploring the contemporary abortion policies and its implications on women’s access to safe abortion services as well as the factors that affect the access. Methods: This study incorporates findings from extensive desk review of abortion services in Nepal. Results: The 2021 safe abortion services Program Implementation Guideline aims to expand safe abortion sites; however, the Nepal’s challenging geography ensues its inequitable distribution, especially in mountainous area. Policy provisions on information and financial accessibility to abortion are well navigated by the Safe Motherhood and Reproductive Health Rights Act and regulation but consistent to sporadic gaps in its implementation were comprehended in this study. This paper further discussed the Safe Motherhood and Reproductive Health Rights Act’s regressive mandate of 28-week gestational limit at any condition and the role of gender in abortion decision-making under the pretext of factors influencing safe abortion services. Conclusions: The review study recommends strategies: improving capacity for abortion services under federalism, combating stigma, improving the private sector’s readiness, and building a resilient health system. Keywords: Accessibility; availability; legalization; quality; safe abortion.Publication Community Perception of Abortions in Different Districts of Nepal(Nepal Health Research Council, 2025) Shahi, Suruchi; Maharjan, Sanju; Gautam, Manish; Lamichhane, Parash prasad; Phuyal, Parash Prasad; Dotel, Bhogendra; Karki, SujanAbstract: Background: Abortion remains a significant public health concern in Nepal, contributing to maternal mortality and posing a complex challenge to women’s reproductive health. This study explores the complex nature of community perceptions regarding attitudes and perceptions on abortion, perceived factors influencing abortion, perceived consequences of abortion, and existing modern and traditional practices of abortion in Nepal. Methods: A qualitative study was conducted across 12 districts in Nepal, involving 228 community members, including community healers, Female Community Health Volunteers, women leaders, in-laws, and men. Data was analyzed by applying a thematic analysis approach. Results: Findings highlighted a dichotomy in knowledge of abortion, encompassing both progressive views (considering it a women’s right) and regressive notions (viewing it as a sin). Participants also recognized the positive aspects of abortion, such as its role in reducing maternal mortality ratios and improving child health. The study identified factors influencing abortion decisions like the desire to limit family size, entrenched gender dynamics with strong son preference, and pregnancies resulting from relationships outside marriage. Furthermore, abortion was also perceived as a solution for pregnancies arising from rape, incest, or with fetal disabilities. Participants shared a range of consequences associated with abortion, including prevalent misconceptions. They indicated that modern abortion practices like the use of abortion pills were on the rise compared to traditional methods. Nevertheless, unsafe self-medication remained a concern, particularly among rural women. Conclusions: To address these challenges effectively, it is imperative to understand the underlying reasons behind these perceptions and develop targeted interventions that enhance women’s access to safe abortion in Nepal.