Publication: An Estimate of Abortion Incidence and Unintended Pregnancies
Date
2024
Journal Title
Journal ISSN
Volume Title
Publisher
Nepal Health Research Council
Abstract
Background: After the legalization of abortion in Nepal, there has been remarkable changes in policies and service delivery. However, even after two decades of legalization, access to and use of safe abortion services remains limited. The objective of this study is to estimate the incidence of abortion and unintended pregnancies in Nepal.
Methods: A cross sectional study was conducted in 767 health facilities using structured questionnaires to assess the availability of abortion services, and 231 key informant interviews were conducted. Information on medical abortion drugs was collected from distributors and pharmacies. Abortion estimations were segmented into categories: those performed within healthcare facilities, those conducted outside healthcare facilities, and those using other traditional methods. To estimate pregnancy outcomes, we utilized secondary data from national censuses and health surveys.
Results: The total incidence of induced abortion cases in Nepal was estimated to be 333,343 for the year 2021. Only 48 percent of abortion services were provided from the listed (legal) sites and providers. The estimates showed that total facility based induced abortion in Nepal was 176,216 in 2021, more than half were medical abortions. The highest and lowest abortion cases were in Bagmati and Karnali province respectively. The result showed that more than half of the pregnancies were unintended (53.3%).
Conclusions: Despite a relatively liberal legal environment, more than half of all abortions are extra-legal in Nepal. Unintended pregnancies are also common, resulting in induced abortion. This demands for increasing access to information and services on contraception and safe abortion among women and girls.
Keywords: Abortion incidence; legal abortion; unintended pregnancy.
Description
Jagadishwor Ghimire
Ipas Nepal, Kathmandu Nepal
Bibek Kumar Lal
Family Welfare Division, Department of Health Services, Ministry of Health and Population, Nepal
Sujan Karki
Ipas Nepal, Kathmandu Nepal
Suresh Mehata
Ministry of Health, Koshi Province, Nepal
Bhogendra Raj Dotel
Anweshan Pvt Ltd, Lalitpur Nepal
Nisha Joshi
Family Welfare Division, Department of Health Services, Ministry of Health and Population, Nepal
Gauri Shrestha Pradhan
Family Welfare Division, Department of Health Services, Ministry of Health and Population, Nepal
Manish Gautam
Anweshan Pvt Ltd, Lalitpur Nepal
Deeb Shrestha Dangol
Ipas Nepal, Kathmandu Nepal
Parash Prasad Phuyal
Ipas Nepal, Kathmandu Nepal
Kritee Lamichhane
Ipas Nepal, Kathmandu Nepal
Navaraj Bhattarai
University of Tromso, Norway
Anna Lynam
Ipas USA