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Karki

with the prevalence of contraceptive use and the prevalence of abortion based on multivariable regression models for
some major sociodemographic characteristics. It, furthers, analyzes the distributional difference in unsafe abortion by
major factors, which shows that different sociodemographic factors played varied roles in affecting Nepalese young
women’s choice of contraceptive use and abortion behaviors. Overall, the sexual and reproductive health and rights
(SRHR) programs including family planning and safe abortion programs in Nepal have not been very effective in the past
two decades. Family planning and safe abortion programs need to be strengthened to achieve sustainable development
goals. The Gorkha project demonstrated provided a good example that access to contraceptive and abortion services
among disadvantaged populations could be largely improved when available services are provided to them. Post-abortion
family planning services could also increase safe abortion. To understand the complexity of sexual behavior and abortion
among the young age women and to achieve the sustainable development goals for reduction in maternal mortality risk
in Nepal, more research aiming to capture large sample using both qualitative and quantitative approaches are needed.

Acknowledgments

This paper is based on data from Nepal Demographic and Health Surveys of 2011 and 2016 and PHD Group SAAF funded
monitoring data of the project “Empowering women to access safe abortion service in Gorkha, Nepal” implemented
in Gorkha district of Nepal since mid-2018 to June 2020 that was generously funded by Safe Abortion Action Fund/
International Planned Parenthood Federation (SAAF/IPPF), London. The author is grateful to SAAF for supporting the
project implementation in Gorkha. The author would also like to thank Heidi Schroffel, Program Adviser, SAAF and
Laura Hurley, Program Adviser, SAAF, IPPF, Central Office in London for their helpful comments. Finally, the author is
grateful to insights from the editor and the two anonymous reviewers.

Conflict of interest

The author has no conflicts of interest to declare.

Funding

This research received no specific grant from any funding agency, commercial entity, or not-for-profit organization.

Author contributions
This is a single-authored paper.

Ethics approval and consent to participate

Not applicable as this study involves the analysis of secondary data collected by the DHS program, ICF, Rockville,
Maryland, USA, and monitoring data from the project which was approved by the Ministry of Health and Population.

Consent for publication
Not applicable.

Availability of data

Data utilized in this paper are from secondary sources and available to the public. The secondary data can be freely
accessed from the DHS website. The project monitoring data used in the analysis are with the author in SPSS system file
and if needed it can be made available to the publisher.

References

Anderson, T., & Kohler, H.P. (2015). Low fertility, socioeconomic development, and gender equity. Population and Development
Review, 41(3):381-407.
https://doi.org/10.1111/j.1728-4457.2015.00065.x

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