Balaram Chaulagain

A group consisting of one or two parents and their children is called family and planning is known as process of making plans for something. Hence, the process of planning the number of children of any family interval between births by using birth control measure is called family planning. The main aim of a family planning programme is to ensure that individuals and couples can fulfill their reproductive needs by using an appropriate family planning method based on informed choices.
Each and every country of the globe must be committed to ensuring that citizens have access to voluntary family planning services. Family planning is central to women's empowerment, reducing poverty and achieving sustainable development. When a woman or girl has access to family planning services, she can easily shape her life and avail of more education, seek better jobs. In the long-run, she can contribute to her family, society and nation as a whole.

Crucial role
In recent years, Nepal has made remarkable progress in many reproductive health outcomes, including family planning. The contraceptive prevalence rate (CPR) among married women of reproductive age has increased remarkably. CPR is a widely used indicator to understand usage of contraceptive methods among married couples. Similarly, prevalent total fertility rate (TFR) has also gone down considerably. However, a great number of women of reproductive age in Nepal are not using contraceptives even though they want to avoid pregnancy for at least two or more years. Adolescents, who comprise around 20 percent of Nepal's population, are believed to be crucial to the county's future. Such a large group of young people may contribute to the nation’s economic growth, development and innovation. But more than 50 per cent of girls still get married before 20. This is a matter of serious concern. These girls enter into married life without the necessary information and knowledge about sexual and reproductive health, jeopardising their rights, health and wellbeing.
Nepal has already revitalised her commitment to maintaining and sustaining the family planning programme launched since long. Considering the significance of family planning, the government of Nepal has to continue increasing its budget for this sector. The country has already become a federal republic. In this context, the nation has committed to make available family planning services to one and all.
The number of family planning users has been targeted one million and the proportion of demand satisfied to 71 per cent by 2020. So long as we fail to lay special focus on meeting the family planning need of adolescents and youths, the unwanted birth rate will go up and may hamper further development of the country. Over three million women and girls are using modern methods of contraception as the country continues to step up efforts. Some consider access to safe, voluntary family planning as a human right and central in gender equity.
As per a rough estimation, some 225 million women worldwide want to avoid pregnancy but they are not supplied easily supplied safe and effective family planning methods. Most of them live in poorest of the poor countries in the world. The government of Nepal is committed to providing individuals and couples access to voluntary family planning services. In our context, family planning is a priority programme of the Ministry of Health and Population.
The government aims to promote advocacy for family planning, enhance knowledge of service providers on contraceptive technology and improve operational research. Voluntary surgical contraceptive (VSC) methods like vasectomy for male clients and laparoscopy operation for female service seekers are abundantly using surgical methods of permanent sterilisation process. Besides, condom for male and Depo-Provera injection, contraceptive pills, intra-uterine contraceptive device (IUCD), etc. are temporary means of family planning being offered free of cost.
Birth spacing methods such as three monthly injectable hormone like Depo-Provera, oral pills and male condoms are freely supplied by the government through its peripheral health infrastructures like health posts, primary healthcare centres and hospitals. Ward based Family Health Care Volunteers (FCHVs) have also been mobilised across the country.

Long way to go
Moreover, such contraceptives are also made available through private practitioners at nominal rates. Spacing and permanent both methods are on the rise in our country for population control. CPR is a major indicator for monitoring and evaluating the national family planning programme. Family planning and human rights are two faces of the same coin. As such, so long as we fail to comply with the spirit of universal value of human rights, the moral values of essential health care service to all will go down to drain. In 2015, all members of the United Nations committed to Sustainable Development Goal (3.7) to ensure universal access to sexual and reproductive healthcare service, including family planning. Although Nepal has made dedicated efforts to accomplish this goal, the country still has a long way to go for that.

(Chaulagain is a retired public health officer. balaram.sharmac@gmail.com)