Increasing access to family planning services through a non-health sector: Technical Integration Coverage and Access (TICA) in Nepal

Background: Family Planning (FP) is a key developmental focus for the government of Nepal. Use of modern contraceptives has stagnated at 43.2% since 2011. Unmet need for family planning (FP) in Nepal remains high at 27%. Despite relatively high unmet need, a factor contributing to this levelling of...

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Bibliographic Details
Main Authors: Ghanshyam K Bhatta, Josue Orellana, Bidya Mahat, Ishwar Nath Mishra, Chandeshwari Tamrakar, Sujit Kumar Sah
Format: Article
Language:English
Published: Health for All Nations 2017-01-01
Series:Christian Journal for Global Health
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Online Access:http://journal.cjgh.org/cjgh/index.php/cjgh/article/view/170/412
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Summary:Background: Family Planning (FP) is a key developmental focus for the government of Nepal. Use of modern contraceptives has stagnated at 43.2% since 2011. Unmet need for family planning (FP) in Nepal remains high at 27%. Despite relatively high unmet need, a factor contributing to this levelling of contraceptive use is the limited range of methods available to most clients at most sites. To address the FP need among married women of reproductive age (WRA), we tested integration of FP into agricultural programs. Aim: To assess the effectiveness of a FP program integrated into an agriculture (e.g., non-health) sector program. Methods: A descriptive cross-sectional (post interventional) study was conducted November 2015 to February 2016 among 525 WRA participating in an agriculture program. Results: The contraceptives commonly used by women in the study location were Depo Provera and Minilap. After Technical Integration Coverage and Access (TICA) interventions, almost all of the respondents (99.6%) had heard about FP of which 67.8% correctly understood FP as a method to prevent unwanted pregnancy. About 50% of the respondents were found currently using FP. The percentage of WRA aware of long-acting and permanent FP methods increased from 49.0% to 62.0% and 39.0% to 52.0% respectively. Decisions on using a FP method were predominantly made by the husband (68.0%). However, 68.4% women reported that they were accompanied by their husband. The proportion of men willing to use FP increased from 5.2% to 15.5% after TICA activities implementation. The main reason identified for not currently using FP devices was that the husband and wife were not living together (88.8%). Most of the women (98.0%) reported that FP utilization improved their quality of life. Conclusion: TICA activities were very successful in both increasing FP knowledge level as well as utilizing FP services among the targeted beneficiaries. The use of FP increased among agriculture program beneficiaries after the integration of TICA activities with a gradual shift from short-acting FP methods to long-acting and permanent FP methods. For easy integration, FP projects should also utilize existing community structures such as cooperatives, women’s groups, men’s groups, and youth clubs.
ISSN:2167-2415