The Family Planning Association of Nepal (FPAN) is the largest non-governmental organization in Nepal. We provide a full range of reproductive health services as well as educational initiatives.

FPAN contributes 25-30 per cent of the national family planning programme effort. The Association is working in 32 districts providing services through:

• 530 rural and 12 urban outreach clinics
• 5 birthing centres
• 70 community-based distribution centers
• 133 community based outreach
• 4 comprehensive reproductive health clinics
• 27 branch/project clinics with 13,000 volunteers, 442 full time professional and clinical staff and 1,569 female Reproductive Health Volunteers covering 8 million people across the country

The government works closely with FPAN and supplies a considerable amount of contraceptives to us at local levels.

Advocating for safe abortion
  
FPAN has been advocating for safe and legalized abortion in Nepal for more than 20 years through a comprehensive campaign including national and international workshops, lobbying, awareness raising and the building of partnerships.

In 1974, FPAN highlighted the issue with a national level conference for policy makers on 'Unsafe Abortion and Its Consequences'. This was followed in the same year by a regional seminar on 'The Psychological Aspects of Abortion' organized jointly by FPAN and the Transitional Family Research Program of the American Institute for Research.

Despite strong recommendations from these events, considerable social and religious barriers continued to constrain the legalization of abortion.

FPAN continued its efforts to advocate for safe and legalized abortion in Nepal with the publication of various findings to highlight both the public health and rights-based considerations associated with the issue.

The issue was given renewed impetus following the International Conference on Population and Development (ICPD) and FPAN coordinated a further seminar in 1994 on 'Gender and Development', emphasizing women’s reproductive rights and their overall socio-economic development. This was followed by 5 regional workshops, involving policy makers on 'Population and Development'.

In 1996, an ICPD follow-up workshop was organized for parliamentarians, senior government officials and advocates to further raise the issue of legalization. The workshop was attended by 43 parliamentarians and forged a consensus on the need for legalization.

This resulted in FPAN’s drafting of the 'Pregnancy Protection Bill' which was registered in the Upper House of Parliament as a private bill by the President of FPAN Mr. Sunil K. Bhandari.

FPAN supported the Bill with a series of activities to create public pressure in favour of the bill including press conferences and a signature campaign conducted through our branch network.

The Bill continued to face a number of delays within the political process and FPAN continued with its advocacy programme including:

• a seminar for 'Policy Makers and Teachers on Reproductive Health and Sex Education' in 1996
• a seminar on 'Reproductive Rights of Adolescents and Integrated Reproductive Health Programmes' in 1997
• a workshop on 'Dissemination of Sexual and Reproductive News' for media in 1997
• a high level discussion programme on 'Sexual and Reproductive Rights of Women' for policy makers in 1998
• a national-level seminar on 'Reproductive Rights against the Backdrop of Human Rights' in 2000

These activities were accompanied by various publications and the introduction of emergency contraception and post-abortion counselling services in FPAN clinics.

Effective advocacy

Following these efforts and those of partner organizations, the Parliament of Nepal finally liberalized abortion under the 'Women’s Bill', amending the National Civil Code on 14 March 2002.

This Bill incorporates the recommendations of the 'Pregnancy Protection Bill' and received Royal Assent, passing into law in September 2002.

It guarantees conditional abortion rights to women within the first trimester (12 weeks), or up to 18 weeks if the pregnancy has resulted from rape or incest.

Furthermore, abortion is permitted at any time during the pregnancy if the physical and mental health of the mother is at risk or if the fetus is deformed.

In all cases consent from the pregnant woman is required and sex-selective abortion remains strongly punishable by law.

FPAN is now actively involved in developing quality of care protocols through our participation in various technical committees and the preparation of safe abortion services in our comprehensive reproductive health clinics. 

FPAN played a crucial role in providing women with the right to choose in Nepal and is confident that this will have a considerable impact on reducing the high rate of maternal mortality throughout the country.

As a consequence of our work however, we have lost significant funding from the US government, following the re-introduction of the Mexico City Policy (Global Gag Rule).

FPAN has been active in highlighting the injustice of this policy and its impact on women in developing countries and the Director General, Dr. Nirmal K. Bista has testified at the hearing before the Foreign Relations Committee of the US Senate, to explain how the Global Gag Rule is affecting the reproductive health and rights of women throughout Nepal.

Services

FPAN maintains community-based health services and mobile clinics, particularly in un-served areas. Services include:

• immunization
• pre- and post-natal care
• curative and preventative general health services
• laboratory analysis
• infertility treatment
• voluntary surgical contraception utilizing new techniques such as the minilaparotomy

Training

FPAN has a comprehensive training programme for all levels of staff with a view to enhance the technical capability of our staff members and to complement the national reproductive health programme.

We aim to improve the quality of training for medics, staff, volunteers and traditional birth attendants.

Collaborating with other organizations

FPAN aims to strengthen relationships and develop partnership programmes with a range of organizations, both public and private sector.

We currently chair the Non-Governmental Organization Coordination Council (NGOCC), which is instrumental in establishing functional relationships and collaborative programmes with other partner organizations.

Advocacy programme

We have a comprehensive advocacy programme including press meetings and seminars on issues such as abortion, migration and HIV/AIDS and are active in successfully raising these issues with the government.
 
Educational activities include:

• production and distribution of educational materials
• raising awareness through the media
• promoting health through youth and women's groups
• providing guidelines for service providers on maternal health (including breast feeding, oral dehydration therapy, baby care and nutrition)

FPAN also aims to strengthen its data collection, supervision, monitoring and evaluation, research and reporting systems.

Young people

FPAN provides sexual and reproductive health information and services to adolescents and young people through Youth Information Centres (YICs). We have established separate clinical services to meet their needs. SRH information and services for adolescents and young people have also been integrated into all core programmes supported by IPPF.

HIV/AIDS

We provide diagnosis and treatment services for sexually transmissible infections, particularly for high risk groups. FPAN is committed to integrating HIV/AIDS prevention, control and management programmes and activities into our existing service network. We published an HIV/AIDS strategy in 2002. These programme activities will be expanded to a larger operational area in the near future.
  
Three projects funded by the Japanese Organization for International Cooperation in Family Planning (JOICFP), UNFPA/EC and UNFPA focus on sexual and reproductive health for adolescents and young people in a rural setting.