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collaborate with the government entity to implement development activities. Provision of safe abortion services calls for,
among other things, training of health personnel, supply of drugs, and equipment, record keeping of clients receiving
service and follow-up of abortion clients for 2 weeks and taking care of post abortion complications (PAC). From January
2019 to end of June 2021, 348 women received safe abortion service in the project areas. Of them only four women had
PAC and they were well taken care of following the procedure.
Monitoring data from PHD Group’s project in the Gorkha district indicate that despite difficult times due to COVID-19
lockdown which caused cancellation/postponement of several proposed project activities a large number of women and
girls utilized safe abortion service. During the first 3 months of this period, the number of women and girls accessing safe
abortion service was 67 (23 among women aged 15 – 24 and 44 among women aged 25+), while the corresponding figure
increased to 106 (28 among women aged 15 – 24 and 78 among women aged 25+) in the following 3 months, representing
a growth of 58.2% during the lockdown (Figure 2).
A number of reasons have been put forward for the increase in client flow during the pandemic. First, due to
mothers’ group meetings which are organized by Female Community Health Volunteers (FCHVs) attended by women of
reproductive age (WRA), more girls and women in villages are now aware that abortion is legal. Second, project employed
Female Field Facilitators (FFFs) and FCHVs do compassionate counseling to local women and girls about abortion and
sometimes help them visit safe abortion facility. Third, free and quality safe abortion service is available. Fourth, local
safe abortion facilities are never stock out with necessary drugs and the service is available 24 hours and 7 days a week.
Fifth, service facility is readily accessible and nearby. Sixth, due to lockdown, women and girls are unable to visit health
facility for contraception, and in several cases, the facilities are facing shortage of contraceptives resulting in more girls
and women getting pregnant. Seventh, due to lockdown, frequency of meetings of family members increased giving rise
to more unplanned pregnancies compared to other normal times making girls and women to opt for abortion. Eighth, due
to introduction of sexuality education in schools by the project, adolescent girls and boys are aware of consequences of
unwanted pregnancies and what to do about them. Finally, due to project and other development activities, women and
girls are more empowered, have learned about reproductive health and rights, and make their own decision about sex and
sexuality.
The monitoring data of the GSA project indicate that adolescents and youth aged 15 – 24 from Dalit community were
significantly more likely to utilize safe abortion service before the COVID-19 pandemic. For instance, during January
2019 – June 2020, among the 15 – 19 and 20 – 24-year olds combined, the proportion of Dalit youth utilizing safe
abortion service in the project areas was 38.5%, while among their high caste or non-Dalit counterparts, the corresponding
proportion was 26.8% (Table 6A). During lockdown period from March 24, 2020, to July 21, 2020 too, the proportion
of Dalit youth utilizing safe abortion service stood at 41.8% which was significantly higher than the proportion of 23.7%
utilizing safe abortion service among the non-Dalit or Chhetri/Bahun and Janajati youth (Table 6B). Although as the
national data show proportionately that fewer Dalit women were aware that abortion is legal in Nepal than their non-Dalit
counterparts, they utilized safe abortion service more in PHD Group project catchment areas. Field enquiry revealed that
over two-thirds of the under 20 women and girls were unmarried, although marital codes were not included in the data
set due to sensitivity.

Figure 2. Safe abortion client flow before and during COVID-19 lockdown, Jan-June 2020

International Journal of Population Studies | 2021, Volume 7, Issue 1 89