Page 96 - IJPS-7-1

Contraception and abortion in Nepalese young women

Table 6. Distribution of abortion cases before and during COVID-19 lockdown period
Caste/ethnic group Age group Total
15 – 19 1 20 – 24 25+ % N
(A) Abortion cases from in 2019- June 2020 including COVID-19 lockdown period*
Dalit 11.0 27.5 61.5 100.0 109
Non-Dalit 8.4 18.4 73.2 100.0 239
Total 9.2 21.3 69.5 100.0 348
(B) Abortion cases during COVID-19 lockdown period in January – June 2020**
Dalit 10.9 30.9 58.2 100.0 55
Non-Dalit 9.3 14.4 76.3 100.0 118
Total 9.8 19.7 70.5 100.0 173
1 One girl aged 14 is added. Pearson Chi-square test significant at *P < 0.10; **P < 0.05.
4. Discussion

Using both the Nepal national DHS and some project specific monitoring data, this paper reviewed the trend of proportion
of contraceptive use over time from 1996 to 2016 from several DHSs, and the prevalence of abortion among young women
aged 15 – 24 from the 2016 DHS. The study also investigated the factors associated with the prevalence of contraceptive
use and the prevalence of abortion based on multivariable regression models and examined the distributional difference
in abortion safety for some major sociodemographic characteristics.
This study revealed several findings worthy of reporting. Contraceptive use data of various years reveal that since
2006 among the currently married adolescents use of modern contraceptive methods has remained nearly constant at
14% and among all adolescents, it declined from 4.5% in 2006 to 4.2% in 2011 and further to 4.0% in 2016. The use of
traditional methods among all adolescents has increased from 0.7% in 2006 to 0.9% in 2011 and shot up to 2.3% in 2016.
Among the women aged 20 – 24, the use of contraceptive methods declined from 22.4% in 2006 to 17.9% in 2016 and
the corresponding figures for the use of traditional methods increased from 2.3% to 6.1%. These findings indicate that
either the modern methods of contraception were increasingly becoming unpopular among both the adolescent and young
women, or there was increased inaccessibility over the period. These imply that family planning programs in Nepal need
to be strengthened and the young women need education and information on the usefulness of modern contraceptive
methods instead of relying on traditional methods. Perhaps, there are misconceptions about modern contraceptives
methods which need to be removed.
Regression analyses show that women who were aged 20 – 24, from Janajati ethnic group, and in rich/richest wealth
index groups, and ever gave a birth, were more like to practice contraception than their counterparts who are adolescents,
have fewer children ever born, poorer wealth index groups, and from Chhetri/Bahun or Dalit castes. The finding that
women in their 20s are more likely to obtain an abortion than adolescents could be because the women in the former
group are sexually more active (40% sexually active within the past 4 weeks) than adolescents (15% sexually active
within the past 4 weeks) (MOH et al., 2017) and have higher chance of becoming pregnant and, therefore, have a higher
rate of unplanned pregnancies. Among the seven provinces contraceptive use was the lowest among young women from
Madhesh Province and the highest in Province 1, which calls for special focus of family planning programs in Madhesh.
Despite limitation of sample size, our regression analyses of abortion among young women aged 15 – 24 also provide
a glimpse of young women who are likely to take recourse to abortion in case that the pregnancy was unwanted. The
results showed that while women who ever gave a birth were more likely to seek an abortion compared to women who
did not give a birth, they were more likely to seek unsafe abortions. Results, further, show that women who were well-
off were more likely to seek an abortion, and that if they sought abortions, they were more likely to seek safe abortions.
Women who were using the family planning services, especially those who were using traditional methods, were likely
to seek an abortion service and obtain the abortion services at “unsafe” facilities. By contrast, those who were not using
any contraceptive methods were less likely to seek abortion services and if they obtained services, they were more likely
to obtain it from authorized facilities. Women in Madhesh Province were least likely to seek an abortion, while women in
Karnali were likely to seek abortion services. Among young women seeking an abortion, it was found that women from
the Tarai caste or the Tarai region were likely to have a safe abortion.

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