Professional Documents
Culture Documents
Background
Nepal began providing comprehensive abortion care (CAC) services in 2004 after abortion became legal in 2002. Between 2004
and 2007, cumulatively 176 CAC service sites government,
non-governmental organizations (NGOs) and private service
centers were established throughout the country (figure 1).
Although a national monitoring system of CAC services was
implemented, reporting of CAC-related complications was
incomplete. An important contributing factor was the independence of CAC and postabortion care reporting.
6%
MSI / SPN
4%
Government
Family Planning Association of Nepal (FPAN)
13%
Private
77%
Sterilization
IUD / Norplant
Pills
Methods
To better understand the incidence and severity of CAC complications, a prospective study of abortion care was conducted
at 30 randomly selected, listed CAC service sites over a threemonth period. The purpose of the study was to identify and
document the frequency and type of complications that occurred, as well as to suggest strategies to improve the monitoring
and management of complications. Complications were determined based on clinical diagnosis recorded in case papers as well
as self-reported symptoms that were followed-up, in some cases
by a clinical examination. A standard definition of complication
was not used, allowing individual providers and sites to make
various diagnoses. A majority of the clients were followed-up
through phone calls.
FINDINGS
Depo Provera
15
21
39
Condom
No Method
19
Number of Cases
100
80
60
40
20
ru
te
ru
s
ed
pe
rit
Hy
on
po
iti
vo
Tip
s
l
a
of
em
ca
i
c
nn
sh
ula
oc
k
ins
ide
ut
Of
er
fe
us
ns
ive
pr
od
uc
ts
Lo
ca
liz
et
ra
at
om
Te
nd
e
Fa
il
He
ed
ab
or
tio
n
din
g
lee
re
b
at
on
y
ve
Se
er
Fe
v
Ut
er
ine
is
ps
se
te
d
din
g
ec
lee
Su
sp
ra
te
b
isc
M
od
e
ed
Re
Of
fe
ns
iv
ta
ine
d
POC
ha
rg
e
1.5
1.3
7
6
1.0
0.57
0.5
0.03
Government
0.0
Low
Moderate
FPAN
Private
MSI / SPN
Severe
DISCUSSION
1 Sheriar, Nozer, Tank Jaydeep and Bela Ganatra. 2007. First Trimester MTP
using MVA: Report of a FOGSI multicentre study across 27 clinics. Journal of
Obstetrics and Gynecology India, 57(2): 162-166.
RECOMMENDATIONS
www.ipas.org
2009 Ipas.
CACNEP-E09