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Health facility; listed facility; post abortion care; safe abortion; service readiness.

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Area of Science:

  • Public Health
  • Reproductive Health
  • Healthcare Services

Background:

  • Health service readiness is crucial for quality care access.
  • This study assesses Nepal's health facilities' readiness for comprehensive abortion services.
  • Focus is on availability and quality of care for abortion services.

Purpose of the Study:

  • To analyze the readiness of health facilities in Nepal for comprehensive abortion services.
  • To identify gaps in the availability and quality of abortion care.
  • To inform policy and practice for improving safe abortion services.

Main Methods:

  • Cross-sectional study design.
  • Multi-stage sampling approach for health facility selection.
  • Survey of 767 health facilities across 30 Municipalities in Nepal.

Main Results:

  • Only 29% of surveyed facilities (223 out of 767) offered abortion services.
  • Service provision varied: 92% offered medical abortion, 48% manual vacuum aspiration, 18% dilation and evacuation, 18% medical induction.
  • Significant gaps identified: 7% lacked trained providers, 29% were non-compliant with legal requirements, and 13% lacked short-acting contraceptives.

Conclusions:

  • Most health facilities in Nepal are not ready to provide Safe Abortion Services (SAS), failing to meet minimum legal and quality criteria.
  • Urgent, collaborative efforts are needed among policymakers, administrators, and providers to improve SAS.
  • Recommendations include policy updates, strengthening Public-Private Partnerships (PPPs), and ensuring comprehensive SAS financing and implementation.