Nepal

Eighty-five percent of facilities offer all three basic child health interventions: outpatient
curative care for sick children, routine growth monitoring, and routine childhood vaccination.
Ninety-four percent of facilities provide routine vitamin A supplements for children.
ORS, zinc tablets, albendazole, vitamin A capsules, and paracetamol syrup/suspension were
available in 85 percent or more of the facilities offering child curative care services. Similarly,
amoxicillin was available in one-quarter, cotrimoxazole in one-half and gentamycin in about
two third of the facilities offering child curative care services.
A thermometer, stethoscope, and timer were available in more than 9 in 10 facilities.
Fifty-four percent of health facilities providing child curative care had soap and running water
or alcohol-based hand disinfectant for hand cleansing.
More than 7 of every 10 providers of child health services have received recent supervision,
and 3 of every 10 have received recent in-service training related to child health.
Providers assessed all three main symptoms (fever, cough/difficult breathing and diarrhea) in
one-quarter of observed consultations and checked for all three major danger signs (ability to
eat or drink anything, vomiting and convulsion) in only 2 percent of consultations.
FAMILY PLANNING SERVICES
Almost all (97 percent) health facilities in Nepal offer (that is, provide, prescribe, or counsel
clients on) at least three temporary modern family planning methods. Government health
facilities are more likely to offer modern family planning methods than private health facilities.
Combined oral contraceptive pills, male condoms, and progestin-only injectables (Depo) are
the most commonly offered family planning methods. Long-acting reversible contraceptives
(implants and intrauterine contraceptive devices [IUCDs]) are offered at half of health facilities
where family planning services are available.
Virtually all facilities where family planning services are available are able to provide male
condoms, oral contraceptives, and injectables to clients at the facility. However, only around
one in five facilities where family planning services are available provide IUCDs and implants
at the facility.
Ninety-five percent of health facilities that provide family planning methods actually had every
method they provide available on the day of the visit.
Overall, 16 percent of the interviewed family planning service providers reported that they had
received in-service training related to family planning in the 24 months before the assessment
Just over 1 in 10 family planning service providers have ever received in-service training on
long-acting reversible contraceptive methods.
Hand-washing supplies were seen in just over half of health facilities offering family planning
services.
Overall, the environment for family planning counseling is poor. Visual and auditory privacy
and confidentiality were assured in only 6 percent of the family planning consultations observed
in the survey.
There was almost no discussion of sexually transmitted infections or condoms during observed
consultations. Method-specific side effects were discussed in a little more than one in five
consultations.
xxviii • Key Findings