How do you see the role of Marie Stopes International in Nepal supporting to reduce the maternal mortality?
Marie Stopes Nepal provides women a safe, legal and confidential service for Family Planning and Safe Abortion whenever she wants or needs our services. By doing this we hope that women will choose safe and legal services. We hope they will come to our centres where we have trained staffs and follow-up on our clients to avoid complications. By doing this we prevent unsafe abortion which as we all know is one of the leading causes of maternal mortality.
As Marie Stopes is one of the pioneer organizations working in Nepal to support safe motherhood and safe abortion, how do you see four decades of journey in Nepal?
Nepal should be so proud of where it is in terms of legislation of abortion. Abortion was legalized in 2002, far sooner than so many other countries, to the recent declaration that abortion services will be free in government facilities. Marie Stopes International as well as several other key organizations supported the government in this journey, we are proud of this fact but there is still some way to go, women are still dying from unsafe abortion meaning we can still do better together.
Despite all our efforts, large numbers of young mothers are dying due to unsafe abortion. How do you look at it?
One of the key problems we see is awareness, women don’t know abortion is legal in Nepal, in fact only 38% of people in Nepal know this. Coupled with stigma and embarrassment women are choosing either uncertified over-the-counter medicines with no support or follow up, or uncertified clinics. In many cases women uses traditional methods. In my views, I wish that women knew not only that it was legal, but that they had the confidence to know that at Marie Stopes Centres we provide care completely confidentially, and if women cannot afford our services we will offer them free of cost. Our helpline 16600119756 (ntc) and 9801119756 (ncell) can help any women who have questions. We are a call away. They can call us for any sexual and reproductive health queries. Our trained counselors are here every day from 7:00 am to 7:00 pm.
For me in a country with such a progressive law, in a world where many other women in other countries are not so fortunate, its desperately sad that this happens in Nepal. We need to make women feel safe and un-judged so that they are empowered to opt for the safe choice.
In the last four decades, what is the state of Marie Stopes presence in Nepal?
Marie Stopes started operating in Nepal in 1994 in collaboration with our implementing partner Sunaulo Parivar Nepal. When Marie Stopes started its family planning work here in country abortion was still illegal, our teams worked hard to support the government in its tremendous efforts to change the law and were successful in 2002. Maire Stopes Nepal expanded rapidly both in terms of mobile and static clinics. Today we run full-fledged 36 clinics in 31 districts to provide women with sexual and reproductive health choices, especially family planning and safe abortion. Likewise, we coordinate with local government in rural Nepal through our outreach mobile camps in six districts. We are supporting government both in terms of service delivery and providing capacity building and quality assurance for public providers and service delivery sites in close collaboration with the Family Health Division.
Global community has accepted the importance of safe abortion to reduce the risk of women through SDGs, how do you look at it?
Safe abortion spans several the SDG’s, notably; maternal health, integration of reproductive rights into national strategies, and gender equality. The SDG’s make the final goal, gender equality a more prominent focus than ever before. Safe abortion gives women back the power to make decision about her future. Whether its economic empowerment though the decision not to continue with a pregnancy she cannot afford, or whether it’s for another reason giving women safe choices gives her the rights she deserves.
How many women received the service offered by Marie Stopes International in the last forty years?
In just four decades, we have touched the lives of more than 120 million women and girls, giving them the power to take control of their futures and have children by choice, not chance. Today, more than 21 million people worldwide are using a method of contraception provided by us. Right now, women and girls in 37 countries are using our services so that they can have the life that they want, whether that means completing their studies, starting a career, or providing better care for their families. Day by day, woman by woman, Marie Stopes International is making the world a better place. We have achieved many things over the last 40 years, but there is still so much to do. Hundreds of millions of women worldwide continue to live in a world without choice, lacking the basic contraceptive methods they need to prevent an unwanted pregnancy. Each year, deprived of access to safe abortion services, millions of women resort to unsafe methods to end a pregnancy, often risking disability and death.
What is the plan for coming years?
Nepal goes from strength to strength in terms of provision of services. But there is room to develop further. Marie Stopes is strong in its mission, children by choice not chance, and to deliver this mission we will do several things:
We will continue to offer service though our centres, we offer a unique service at Marie stopes, our service providers are trained rigorously so we can guarantee the highest possible quality of services, we have rehabilitated out centres to give them a new look and feel, and the little things have not been forgotten, after your service feel free to apply lipstick and freshen up in our recovery room. We know how to treat our clients and it’s at the centre of everything we do.
Our Outreach or visiting providers support the government by sending our highly trained doctors and nurses to offer long term and permanent methods of family planning in government health facilities. We will continue to do this and expand to ensure more people in Nepal get the method of family planning they choose
Marie Stopes Nepal is always innovative; our Marie Stopes Ladies are nurses who work in their community offering family planning discretely and conveniently. She also sells basic health products and are primarily located where other health services are hard to reach.
Marie Stopes Nepal will response to the demand here in Nepal, wherever Family Planning is needed or abortions wanted we will make sure there is safe, quality and affordable provision
How do you see the current policy of Nepal on safe abortion? Are there enough clinics in the context of growing youth population of Nepal need for safe abortion?
The law is strong but the policy complex. One of the gaps in my view now is in second trimester service provision. When a woman wants an abortion in the later stages of pregnancy it’s often a much harder decision for her and it’s also medically much riskier. Some providers take advantage of this vulnerability. The current policy prevents registered providers such as MSI from providing second trimester services yet many unregistered providers offer this service, often exploiting women financially. As Marie Stopes Nepal, I would like to see registered providers such as us able to offer safe services to women in line with the WHO guidelines. We encourage women who find themselves in this difficult situation to call our call centre so we can advise on the safest course of action. Many women die because of unsafe second trimester abortions in Nepal, we would like to support he government in reducing this.
Generally, there are many providers, but it’s often unclear to women which are safe. Marie Stopes Nepal specializes in youth clients and our providers get special training on how to best support our youth clients. This is lacking overall in Nepal however.