To cite the article: Nawa Raj Subba. (2010). Medical Abortion Pilot Study in Jhapa Nepal. Ministry of Health District Public Health Jhapa Nepal. 

Background: Medical vacuum abortion is a common practice of getting an abortion. But it requires medical facility, trained manpower, and resources. It is also inaccessible to many people due to geography and economic condition. So women who have within 12 weeks of pregnancy if wish to have an abortion will have an option of medical abortion by oral medicine. District Public Health Office Jhapa in collaboration with IPAS conducted a pilot project in 7 health institutions Mechi zonal hospital, Surunga PHC, Dhulabari PHC, Sanischare PHC, MSI Damak, MSI Birtamod, and FPAN in 2009-10.

Methodology: Training for these 7 health institutions took place. Minimum fees Rs. 300 was charged to the clients. People who are very poor were waived by the committee. Female community health volunteers also got an orientation of the program. Pregnancy testing kit was provided to all FCHVS of pilot study areas. FCHVs Service registration and reporting were incorporated with regular HMIS system. Misoprostol was oral tablets provided during a pilot study.

Findings: A total of 59% of women took medicine at the clinic and 41% administered at home. Among them, 43% came to the clinic for follow up and 31% monitored through the telephone. Rest 26% did not contact. Administration of Misoprostol among 845 women resulted in 98% abortion complete and 2% remained pregnant. After medical abortion 46%, women adopted Family Planning methods and 54% did not use any FP means. By age distribution, women taking medical abortion service were 44% from 25-30 years age group. Similarly, 27% of women were from the 20-24 age group, 14% from the 31-40 age group. Five percent of women were below 20 years age group who took medical abortion service in the pilot study. By ethnicity, 49% of women were from upper-class groups and 37% of women were from disadvantaged non-Dalits Terai groups. Dalits (6%), relatively advantaged Janajatis (3%), disadvantaged non-Dalits terai groups and religious minorities (1%) took medical abortion service from the pilot study service outlets.

Medicine proved to be sound in technology. The program was demanding to rest of the areas. It is replicable in terms of sound technology and demand.

Recommendation: It is possible to use as a means of family planning. So, It is urgent to make them aware of FP and side effect of medical abortion for the health.
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