Experts warn prolonged supply disruptions may increase unintended pregnancies and unsafe abortions. A 2022 report from UNFPA shows half of Nepal’s pregnancies are unintended, with nearly two-thirds ending in abortion.
Health facilities across Nepal are grappling with an acute shortage of contraceptive services, posing a serious setback to the country’s family planning efforts. According to a report in the The Kathmandu Post, state-run health clinics have not received key contraceptive supplies, including the widely used shot Depo‑Provera and intrauterine devices (IUDs), for months. This has raised concern among health officials and experts.
Officials from the Health Logistics Management Centre in Bagmati Province say only about 200 doses of Depo-Provera and 350 IUDs remain in the provincial store – stocks held back deliberately amid rising demand from peripheral health facilities. “We have been unable to supply Depo-Provera, intrauterine devices (IUD) to health facilities for months due to the lack of those means in stock,” said Nelson Mahat, the centre’s information officer.
The procurement gap is not isolated to Bagmati Province – similar shortages have been identified in other provinces, including in remote regions such as Karnali, where local offices have reported only a dozen or so doses remaining at district levels.
Health ministry officials and programme managers attribute the shortfall to a convergence of factors:
- The failure of federal agencies to initiate procurement of essential contraceptive commodities since 2024.
- The rapid appreciation of the US dollar against the Nepali rupee, which has driven up the cost of imported supplies.
- The suspension of funding from the United States Agency for International Development (USAID) earlier in the year, which previously supported contraceptive supply lines.
- Reduced national budget allocation for family-planning services despite escalating demand. For instance, officials say the Programme needs roughly Rs 540 million annually but currently receives only about Rs 100 million.
Dr Pawan Jung Rayamajhi, director of the Management Division at the Department of Health Services, confirmed that procurement is “still in process and it is taking time”.
Consequences for Reproductive Health
The shortage comes at a time when contraceptive demand is increasing. Depo-Provera is among the most commonly used modern methods in Nepal, providing an injectable alternative to pills or implants. IUDs are also widely used – a small T-shaped device inserted into the uterus and capable of providing protection for up to 10 years.
Experts warn that prolonged disruption in supply could lead to a rise in unintended pregnancies and unsafe abortions. According to the 2022 United Nations Population Fund (UNFPA) report “Seeing the Unseen”, half of all pregnancies in Nepal are unintended and nearly two-thirds of those end in abortion.
Indeed, studies show that only about 59 per cent of women who obtain an abortion go on to use a modern contraceptive method within six weeks – and the figure declines further over time.
Government Response and Outlook
In response to the crisis, officials say some supplies sourced through UN agencies have just arrived and will be distributed to health facilities “at the earliest”. The Family Welfare Division has acknowledged the gap and said that health facilities that have leftover stock have been asked to share with those facing acute shortfalls.
However, many obstacles remain. Budgets are tight across the health sector, and procurement cycles are reportedly delayed. A July editorial in The Kathmandu Post, titled “Year of broken promises”, pointed out that even essential services – including free contraceptives like Depo-Provera – have failed to meet promise levels.
Nepal’s modern contraceptive prevalence rate has increased over the years (from 26 per cent in 1996 to about 43 per cent in 2022) and the unmet need for family planning remains around 21 per cent of married women. But the current supply disruption threatens to reverse that progress.
In under-resourced rural districts, where access to health facilities is already limited, women may find it impossible to obtain the method they prefer, pushing them towards riskier alternatives or none at all. That, in turn, carries a heavier burden: more unintended pregnancies, higher demand for abortion services, greater strain on maternal health programmes and potentially, a rise in maternal and neonatal morbidity and mortality.
On the Ground
Health workers in district offices describe agonising scenarios. In Jajarkot, for example, the district health office reported only 50 doses of Depo-Provera remaining, with local health facilities already facing empty stocks. “Women seeking the service will be deprived if the birth control shots are not supplied immediately,” said Krishna Bahadur Khatri of the Jajarkot health office.
Regular users of the injection method now face long waits, or are being told that their usual method is unavailable – forcing them to switch to pills or condoms, or forego family planning entirely.
For Nepal to maintain gains in reproductive health and safeguard women’s access to choice, timely procurement of family-planning commodities is a must – not just for short-term relief but for system resilience. Experts say that maintaining buffer stocks covering 18–24 months is critical; earlier warnings in 2023 noted that stock coverage had already slipped dangerously low.
Health policymakers may need to revisit budget allocations, strengthen procurement mechanisms, diversify funding sources and reinforce partnerships with development agencies. Without such action, the current shortage could permeate through Nepal’s health system with far-reaching consequences.
Says Khatri, “For women across the country – especially in rural and marginalised communities – access to free contraception is not just a matter of convenience, but one of agency, health and rights.”
“The current disruption reminds us that policy commitments must be matched by reliable supply chains and funding if they are to matter on the ground.”
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