Safe abortion services in Nepal: initial years of availability and utilization.
BACKGROUND
Following the liberalization of the very strict Nepalese abortion law in 2002, the first services for safe induced abortion were introduced in 2004 at the nation's largest women's hospital. This paper examines the client profile, the context of demand for services, affordability and satisfaction with services.


METHODS
Data for the analysis came from a survey of women who presented themselves at the hospital for induced abortion services and subsequently received the services.


RESULTS
Based on a survey of 672 clients, the median age was 26, and most women were married with an average of two living children. The majority reported being impregnated by the husband. Nearly three out of five gave their primary reason for termination as already having the number of children desired; another 42% cited finances. About two-thirds made the decision to abort jointly with the male partner. Most were satisfied with the services received and expenses incurred. About two-fifths reported having used a modern contraceptive method at the time the unwanted pregnancy occurred, while 22.6% reported practising either the safe-period or withdrawal methods.


CONCLUSIONS
The clinic has provided affordable, quality abortion services to women in need. Findings also suggest that many areas need services strengthened, including the continued role of the family planning program in preventing unintended pregnancies.
Thapa
Shyam
S
Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland. thapas@who.int
Malla
Kasturi
K
Basnett
Indira
I
D000028:Abortion, Induced / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D003268:Contraception Behavior / Q000706:statistics & numerical data; D003657:Decision Making; D005260:Female; D006801:Humans; D008875:Middle Aged; D009390:Nepal; D010298:Parity; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011247:Pregnancy; D012959:Socioeconomic Factors; D055815:Young Adult