FAMILY HELATH PROGRAMME
The aims of National Family Planning is to expand and sustain adequate quality family planning services to communities through the health service network such as hospitals, Primary Health, Care (PHC) Centers, Health Posts (HP), Sub-health Posts (SHP), Primary Health Care Outreach Clinics (PHC/ORC) and mobile Voluntary Surgical Contraception (VSC) camps. The policy also aims to encourage public private partnership. Female community health volunteers (FCHVs) are mobilized to promote condom distribution and re-supply of oral pills.
Within the context of reproductive health, the main objectives of the Family Planning Program are to assist individuals and couples to:
- Space and/ or limit their children
- Prevent unwanted pregnancies
- Improve their overall reproductive health
Periodic and long-term targets for the Family Planning Program have been established as follows:
- To reduce TFR to 2.5 children per woman by 2015
- To increase the Contraceptive Prevalence Rate (CPR) to 67
Unmet Need in Family Planning
As estimated by the 2006 NDHS the CPR (all methods) was 48 percent with an unmet need of 25 percent of which 10 percent is for spacing and 15 percent is for limiting. Unmet need is much higher among couples who are not living together than among couples who are living together (NFHP II and New ERA 2010).
Safe Motherhood and New Born Care
The goal of the National Safe Motherhood Program is to reduce maternal and neonatal mortalities by addressing factors related to various morbidities, death and disability caused by complications of pregnancy and childbirth. Global evidence shows that all pregnancies are at risk, and complications during pregnancy, delivery and the postnatal period and difficult to predict. Experience also shows that three key delays are of critical importance to the outcomes of an obstetric emergency: (i) delay in seeking care, (ii) delay in reaching care, and (iii) delay in receiving care. To reduce the risks associated with regnancy and childbirth and address these delays, three major strategies have been adopted in Nepal:
- Promoting birth preparedness and complication readiness including awareness raising and improving the availability of funds, transport and blood supplies.
- Encouraging for institutional delivery.
- Expansion of 24-hour emergency obstetric care services (basic and comprehensive) at selected public health facilities in every district.
Since its initiation in 1997, the Safe Motherhood Program has mode significant progress in terms of the development of policies and protocols as well as expansion in the role of service providers such as staff nurses and ANMs in life saving skills. The revised Safe Motherhood and Neonatal Health Long Term Plan (SMNHLTP 2006-2017) includes: recognition of the importance of addressing neonatal health as an integral part of safe motherhood programming; the policy for skilled birth attendants; health sector reform initiatives; legalization of abortion and the integration of safe abortion services under the safe motherhood umbrella; addressing the increasing problem of mother to child transmission of HIV/ AIDS; and recognition of the importance of equity and access efforts to ensure that most needy women can access the services they need.
The Goal of MNHLTP
Safe-motherhood and neonatal health aims at improving maternal and neonatal health and survival, especially of the poor and excluded. The main indicators for this include reduction in maternal mortality ratio and neonatal mortality rate.
Key Indicators of Safe Motherhood Programme
|Indicators||SLTHP 1997-2017||MDG 2015||NHSP2||Current status||Years||Sources|
|Maternal mortality ratio (MMR)||250||134||250||192||134||281||2006||NDHS|
|Infant mortality rate (IMR)||34.4||34||46||38||32||46||2011||NDHS|
|Total fertility rate (TFR)||5.05||2.5||3.0||2.75||2.5||2.6||2011||NDHS|
|Contraceptice prevalence rate (CPR)||58.2||67||48||52||67||43||2011||NDHS|
|Neonatal mortality rate (NMR)||–||16||30||23||16||33||2011||NDHS|
|% of delivery assisted by SBA||60||60||40||60||36||2011||NDHS|
|% of women who took iron tablets or syrup during the pregnancy of their last birth||–||82||86||90||79.5||2011||NDHS|
|% of institutional delivery||40||40||27||35||40||35||2011||NDHS|
|% of EOC met need||–||–||–||43||49||15.3||2010||HMIS|
|% of caesarean section||–||–||4||4.3||4.5||4.9||2010||HMIS|
|Obstetric case fatality rate||–||–||<1||<1||<1||2.7||2010||HMIS|