Reproductive health care and family planning among women in Nepal

Objective: To describe findings from a validated survey examining access to care, contraceptive needs, access to surgical care, menstruation-related healthcare needs, and barriers to receiving reproductive health care in Nepal. Methods: An analysis was undertaken using data obtained through a two-part population-based, cross-sectional, cluster-randomized survey corroborated by a visual physical examination performed nationwide between May 25 and June 12, 2014. Women aged 12-50 years were included. The odds of delivering exclusively in a health facility, having a cesarean delivery, and using contraception were modeled using logistic regression. Results: Overall, 876 female interviewees were of reproductive age (12-50 years). Only 237 (27.1%) women were using contraception. Maternal education was the strongest predictor of delivering exclusively in a healthcare facility (odds ratio [OR] 7.57, 95% confidence interval [CI] 4.48-12.79; P < 0.001). The odds of having a cesarean delivery were doubled by urban living (OR 2.20, 95% CI 1.09-4.13; P < 0.001). On multivariable analysis, a predictor of using contraception was a history of having given birth (OR 9.61, 95% CI 4.62-20.01; P < 0.001). Conclusion: In Nepal, reproductive healthcare disparities for women are manifold. Education for women appears to be a significant determinant of accessing reproductive health care. (C) 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.