Two nurses visiting distant Maharudra Health Post in Baitadi had packed up, said goodbye to staff and started down the road when two local women waved down their jeep. “We want to have an implant,” they said.
The nurses told the women they would be back next week, but they insisted: “We have walked three hours, leaving our breastfed babies to get our implants.” The nurses relented, the jeep turned around and returned to the health post.
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The local women were lucky. Only half of health facilities in Nepal provide all five major contraceptives as part of their regular services. Implants and long acting reversible contraceptives (LARC) are not easily available, mainly due to lack of trained staff. Filling that gap are visiting service providers at remote health posts like this one in Baitadi.
Only 43% of all married women of reproductive age in Nepal have access to modern contraceptives, according to the Demographic Health Survey (DHS) 2016 report. Although it was only 26% in 1996, there is still a huge unmet need for family planning.
Nepal’s population clock will touch 30 million next month, but the country’s falling fertility rate means that population will stop growing in three decades after it reaches 37 million. A Nepali woman on average had 6 babies in the 1960s, now she has 2, which is below the population replacement level.
The two women who stopped the nurses were Hasa Sarki, 23, and her sister Harina, 20 (pictured, right). Hasa already has four children, and Harina has two. The sisters live in the same house in Lakhulla village, about three hours walk from the health post.
“When we heard the implant nurses were here, we took off, leaving our food and shouting to my husband to take care of the baby,” said Harina.
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