Mobilising Visiting Providers to expand access to Long Acting Reversible Contraception in Ramechhap district, Nepal
Long Acting Reversible Contraception (LARC) comprises Intra-Uterine Contraceptive Devices (IUCD) and Implants. The advantages of LARC over short term methods of family planning include very high effectiveness, long duration of protection, relatively easy insertion and removal, broad eligibility for women of reproductive age, high acceptability and continuation, limited side effects, and low cost. LARC are therefore a good option for women interested in spacing childbirth. The Nepal Family
Planning Programme has included IUCDs and Implants as part of five contraceptives that should be regularly available at all government health facilities up to the level of health post with a birthing centre, where a skilled birth attendant should be in post. The reality though is that LARC are not regularly available in many health facilities or these simply deliver a very small number of LARC.
This is due to a combination of demand and supply side factors: Demand side factors include low awareness of LARC among rural women and limited mobilisation/referral of potential users, Supply side barriers include the lack of confidence of many service providers to insert and remove LARC combined with the staff shortages faced by many rural health posts in hill and mountain districts