Availability and acceptability of medical abortion in Nepal: health care providers' perspectives

Abstract

Abortion was legalised in Nepal in September 2002 and manual vacuum aspiration is the main procedure used for safe abortion. Although medical abortion has not yet officially been introduced in Nepal, with the highly porous Indo-Nepal border and the easy availability of mifepristone and misoprostrol in Indian chemists' shops, it is possible the drugs are entering from Indian markets illegally. This study aimed to gauge current awareness of the availability of medical abortion drugs in Nepal and explore what health professionals and paramedics felt about the use of medical abortion to expand access to safe abortion in the country. Data were drawn from interviews with private obstetrician-gynaecologists, general physicians, paramedics, ayurvedic and homeopathic practitioners and chemists in 24 urban municipalities and peri-urban areas in Nepal. Various types of allopathic and indigenous forms of medicine for menstrual regulation in the Nepalese market were widely known whereas knowledge of the availability of mifepristone and misoprostrol was low. Almost all respondents had a positive view of the potential for providing mifepristone and misoprostol in Nepal and most thought that obstetrician-gynaecologists, general physicians and other certified abortion care providers should be able to provide the drugs. Many respondents were interested in doing so themselves. Registration of mifepristone and misoprostrol is the key to introducing medical abortion in Nepal and should happen as soon as possible.