Ipas Nepal is a branch of the international NGO Ipas recently registered as a local NGO and working closely with the Family Health Division of the Department of Health Services to support the national safe abortion programme, through the Technical Committee for the Implementation of Comprehensive Abortion Care (TCIC). Ipas-Nepal is housed in the Department of Health Services (DoHS), ensuring regular and close collaboration with the Family Health Division, National Health Training Centre and National Health Education Information Communication Centre.
Ipas has supported TCIC since it was established in late 2002, following the passing of the bill, in March 2002, that legalised abortion in Nepal. As a multi-partner forum, with membership drawn from various government divisions and ministries, non-government organisations and professional bodies, the role of TCIC is to advise and support the government in implementing the reformed abortion law. This includes drafting manuals, establishing and managing the training programme and public sector services, setting standards and monitoring procedures for both public and private services, and initiating information and behaviour change activities, including development of printed materials and radio/TV spots.
Two multi-partner working groups of TCIC provide technical advice, one for information dissemination and the other for clinical services and training. An Advisory Board, chaired by the Director General of the DoHS is responsible for major strategic decisions and recommendations.
From the initial stages of the programme, TCIC has received technical and financial support from Ipas for programme development, clinical techniques and training curricula, benefiting from their global experience. SSMP also provided support for infrastructure, equipment and development of IEC materials. Other international partners included Programme for Appropriate Technology in Health (PATH) (link to website), which supported the development and piloting of a behaviour change communication strategy based on dialogue techniques and the German Technical Assistance (GTZ) Health Sector Support Programme (link to website).
Key national partners include Forum for Women Law and Development (FWLD) (link to website), Centre for Research in Environment Health and Population Activities (CREHPA) (link to website), Family Planning Association of Nepal (FPAN) (link to website), Safe Motherhood Network Federation (SMNF) and Marie Stopes International (MSI) – local branch Sunaulo Parivar Nepal (link to websites), all of which are members of the TCIC working groups and participate in programme planning. TCIC has therefore been a pioneer of successful public private partnership, providing evidence for the potential of non-government players to complement and supplement limited government resources and increase the choice of services available to women.
TCIC and SSMP
As one of the few major donor programmes operating in Nepal and not bound by the global gag rule, SSMP/Options has been an essential player in the drive to ensure safe abortion is integrated under the safe motherhood umbrella, rather than being a vertical “stand alone” programme. Thus the SSMP/Ipas-Nepal partnership has been important in ensuring coverage of this important service. Abortion service data is now collected as part of the national health information management system and standardised communication messages about safe abortion are disseminated as part of reproductive health initiatives.
In a the relatively short period since legalisation, the safe abortion programme achieved remarkable progress, with Comprehensive Abortion Care (CAC) services now available, either through public or private/NGO sector providers, in all 75 districts of Nepal. Comprehensive Abortion Care includes a safe clinical technique, such as manual vacuum aspiration, with effective pain management, counselling and provision of a post abortion contraceptive method, provided in a clean woman friendly environment. The alternative of medical abortion is now also available.
Ipas-Nepal worked with NHEICC to develop the following IEC material:
- Safe abortion poster
- Poster showing the legal conditions of safe abortion
- Leaflet about abortion
- Post abortion flier, including summary information about contraceptive methods