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Nepal

Articles by Nepal

hiv-test

IPPF marks World AIDS Day by announcing the launch of a special program to roll out new biomedical HIV prevention methods

IPPF provides comprehensive sexual and reproductive health care to clients around the world. HIV testing, prevention, and treatment services are essential parts of our integrated sexual and reproductive health care package. To expand the choices individuals have to protect themselves from HIV, IPPF is excited to announce a special program to provide the newest methods of HIV prevention - injectable PrEP (a 2-monthly injection of cabotegravir-LA) and the vaginal ring (a monthly vaginal ring of dapivirine), as well as expanding where oral PrEP is offered. This program is being launched through a consortium of IPPF Member Associations called the Consortium to Advance Access to new HIV Prevention Products (CAAPP) - led by Family Planning Association of India, and including the Family Life Association of Eswatini, Lesotho Planned Parenthood Association, Family Planning Association of Malawi, Federation of Reproductive Health Associations, Malaysia, Family Planning Association of Nepal, and Planned Parenthood Association of Thailand. We hope this program will increase access to the number of ways people can protect themselves from HIV, supporting individual's choice to find an HIV prevention method that works for them.

pleasure-workshop
21 August 2023

लाज (Shame): Reflections on workshops to deconstruct pleasure

Amidst the different dos and don’ts of sex and desire, have you ever paused and thought - what does ‘pleasure’ mean to me?  I asked the same question to participants in our workshop लाज (Shame): Deconstructing Pleasure. The aim of the workshop was to create an intentional space for our participants to redefine their desires, pleasures and intimacy beyond societal pressures.  I conducted a total of 4 workshops in both Pokhara and Kathmandu, Nepal from December 2021 to May 2022. The workshops consisted of 60 AFAB (Assigned Female at Birth) participants, who came together to reflect on their relationship with pleasure, specifically self-pleasure, and deconstruct the guilt, shame and stigma associated with it in our Nepali society.  Here are some of my reflections from facilitating these pleasure workshops, as well as four activities that can help you create your own pleasure practice:  Understand pleasure beyond penetration In Nepal due to cultural taboos around sexuality, conversations around pleasure are often hushed and pushed to private spaces. The limited knowledge that does exist in public, defines pleasure as only accessible through penetrative sex (penis in vagina), which ideally should take place within a marriage. Since only 18.4% of people with vulvas orgasm through vaginal sex alone, this narrow understanding largely prioritises the sexual pleasure of cis-het men, creating a pleasure gap. Additionally, it erases queer expressions and practices of pleasure since it equates pleasure to only exist within heterosexual (opposite-sex) relationships.  In order to decentralise this single narrative of pleasure, we started our workshop with The Pleasure Project’s prompt,  “I get pleasure from…”. The prompt facilitated participants to take a step back and think about the activities they received pleasure from.  The answers we received included both sexual and non-sexual activities, ranging from masturbation, to eating, to reading books. This activity allowed us to establish that the only universality to pleasure is that it is subjective to each one of us and our unique needs. It also helped us expand the narrow understanding of pleasure and emphasise the importance of non-sexual activities in our pleasure script. While pleasure innately is not sexual, given the taboo, the workshop then proceeded to encourage participants to think about their experiences specifically related to sexual pleasure. 

Menstrual cups
28 May 2023

Tackling Taboos and the Fear of Using a Menstrual Cup

In many cultures and societies, individuals with vaginas are accustomed to thinking that touching and peeking at their genitals is inappropriate or that taking ownership and autonomy of our own body and pleasure seems a whimsical story. The way we are constantly lectured about our bodies has informed our ideas and attitudes around sexual and reproductive health, particularly menstrual health.  I live in Nepal, where menstruation has been, and still is, a taboo. A few years ago, I signed up for the social networking platform Clubhouse, where I joined virtual ‘rooms’ where people talked openly about menstruation and menstrual cups. Being a newbie to menstrual cups while at the same time advocating their use, I felt proud and excited every time I shared or heard people talking about it.

SPRINT
26 April 2022

SPRINT: Sexual and reproductive health in crisis and post-crisis situations

  The SPRINT Initiative provides one of the most important aspects of humanitarian assistance that is often forgotten when disaster and conflicts strike: access to essential life-saving sexual and reproductive health services. We build capacity of humanitarian workers to deliver essential life-saving sexual and reproductive health services in crisis and post-crisis situations through the delivery of the Minimum Initial Service Package (MISP) for reproductive health in emergencies.   Through funding from the Australian Government's Department of Foreign Affairs and Trade (DFAT), our SPRINT Initiative has brought sexual and reproductive health to the humanitarian agenda, increased capacity and responded to a number of humanitarian emergencies. Australia has funded the SPRINT initiative since 2007. Since then, the SPRINT initiative has responded to 105 humanitarian crises and worked with partners in 99 countries. SPRINT has reached over 1,138,175 people, delivering 2,133,141 crucial SRH services, and continues to respond to ongoing emergencies. In each priority country, we work with an IPPF Member Association to coordinate and implement life-saving sexual and reproductive activities. Through these partnerships, SPRINT helps strengthen the enabling environment, improve national capacity and provide lifesaving services during times of crisis. You can read more about IPPF Humanitarian’s Programme here. Australia's location in the Indo-Pacific provides DFAT with a unique perspective on humanitarian action. Australia is committed to helping partner governments manage crisis response themselves. This is done through building the capacity of the national government and civil society to be able to respond to disaster. DFAT also works with experienced international partners to prepare for and respond to disasters, including other donors, United Nations agencies, the International Red Cross and Red Crescent Movement and non-government organisations.          

Dhriti, who is a sex worker in Nepal
16 December 2021

Nepal: Ensuring safe and compassionate SRH services for sex workers during COVID-19

“Even though we know we shouldn’t be ashamed to seek medical treatments, sometimes we are ashamed to go to clinics for check-ups,” said Dhriti* (pictured above), a 24-year-old sex worker in Kathmandu, Nepal.   In nearly every country around the world, the stigmatization of sex workers creates barriers to sex workers accessing sexual and reproductive healthcare. These barriers have been compounded and exacerbated throughout the COVID-19 pandemic as a result of lockdown measures and the diversion of medical staff and resources. As a result, many young sex workers like Dhriti – who have a heightened risk of contracting COVID-19 due to the nature of the work – are reluctant to come forward and seek help, and they are largely excluded from government pandemic response measures and programs.    22-year-old Anisha* is also a sex worker in Kathmandu. She added that during the lockdown, many sex workers faced significant or total loss of income and were forced to put themselves at risk to earn enough money to eat.   “We lied to police officers at checkpoints in the city and made our way to places where we could get our clients,” she said. “We were scared because of the coronavirus but there was no work or money for us.” 

A photo of Sanjiya Shrestha speaking
13 December 2021

'Khaskhus': an innovative group chat in Nepal supports people living with disabilities during COVID-19

“Menstruation does not stop just because of lockdown,” says Sanjiya Shrestha (pictured), a Peer Educator at the Family Planning Association of Nepal, an IPPF Member Association.  But when the second wave of the COVID-19 pandemic hit Nepal in early 2021, it had a profound impact on the lives of women, girls and people living with disabilities. Strict measures imposed during the country’s second national lockdown restricted access to and availability of essential sexual and reproductive health services including sanitary kits, maternal health care, safe delivery services, contraception, abortion services, and many others.   “During COVID-19, we were not able to be close to anyone or touch each other. Even getting outside to buy sanitary items was difficult,” said Shrestha, who is visually impaired. “But some people with disabilities require care from others, and they need to be close together. It was difficult for people in wheelchairs and visually impaired people to get outside. In that way, the pandemic has had an even greater impact on people with disabilities.” Greater need brings innovation  The Family Planning Association of Nepal (FPAN) works with over 200 clinical service providers and over 600 community-based distributors to ensure women and girls get access to essential SRH services during this critical health emergency. With the support of the Australian Government, FPAN has also partnered with a number of community-based organizations including the Blind Youth Association Nepal, the Nepal Disabled Women Association, Community Based Rehabilitation and Action on Disability Rights and Development Nepal.   Part of Shrestha’s work as a peer educator is to regularly conduct training sessions to educate people about gender and sexual and reproductive health issues. She also organizes health camps in rural communities and explains contraceptives and birth control measures for people living with disabilities.   But during the lockdown, she needed an innovative way to communicate with vulnerable people and ensure they get access to reliable sexual and reproductive health information and services. Shrestha decided to launch a talk and text group chat, which she named ‘Khaskhus’, or ‘special talk’, in English.  “There are some things that cannot be covered in trainings and seminars, but these gaps can be filled by this group,” she said.   At first, the group was made up of visually-impaired youth, but Shrestha says it has grown to include a range of different people.  “Now, everyone who is interested can join and share with those around them. Through this group, we talk about sexual and reproductive health, life skills, and development. Everyone in our group talks openly... we share our experiences and we have learned many new things from this discussion.”  Direct and inclusive support  As government-imposed movement restrictions gradually loosen in Nepal, FPAN staff and volunteers continue to meet the needs of community members by providing essential SRH materials and services, such as condoms, pills and emergency contraceptive, pregnancy tests, and referrals for sexually transmitted infections and abortion cases to an FPAN branch clinic.   Thirty-year-old Sunita Duwal lives with a physical disability. Her husband, Suman Palikhel, uses a wheelchair. The couple receives information from FPAN on family planning and reproductive health and they volunteer by coordinating home deliveries of essential items across the capital, Kathmandu.   “I used to feel a little hesitant and ashamed to talk about these issues,” said Palikhel. “But FPAN has brought about some changes in our lives... we even share this information with others.”  Duwal said the organization has played a crucial role in educating people about COVID-19 and delivering essentials directly to vulnerable people.  “One of my friends told us that during the coronavirus period, she was experiencing continued bleeding from her menstrual cycle. We shared this issue with FPAN and they sent a technical person to help her,” she said. “There was another physically disabled person with a spinal injury who needed diapers and a catheter. During the lockdown period, we delivered much-needed items such as masks, sanitizers, gloves, face shields, Dettol and soap to people’s homes.”  Since June 2021, FPAN has been working in 15 districts most affected by COVID-19 through 15 family health clinics, 15 community clinics and 210 volunteer-run community-based distribution outlets. As part of its emergency response to the COVID-19 pandemic in Nepal, FPAN is filling an important gap as a result of the diversion of medical equipment and staff that were usually involved in SRH delivery services to fulfil other emergency health needs.   “This support has brought about a lot of change for us,” said Duwal. “We have learned that without sharing our problems and having a two-way communication, we cannot solve our problems. This outlook has helped us out.” 

Healthcare worker with combipack.

In pictures: Innovating during COVID-19

Women around the world have faced multiple barriers to accessing safe abortion care during the COVID-19 pandemic including the de-prioritization of sexual and reproductive healthcare, overwhelmed health systems and restrictions on movement. The COVID-19 crisis has sparked innovation among IPPF Member Associations who responded swiftly by developing new approaches to reach women with safe abortion care including telemedicine and home-based provision of medical abortion. Strong evidence generated from this work supports the continuation and strengthening of these approaches beyond the end of the pandemic. Cameroon Cameroon National Planning Association for Family Welfare (CAMNAFAW) To ensure that quality abortion care can be provided to women during travel restrictions, CAMNAFAW’s service providers travel to partner clinics in underserved areas and to clients’ homes to provide medical and surgical abortion care. This model of taking safe abortion care closer to women will continue even with easing of travel restrictions, as this has been found to be an effective and acceptable approach to increasing access.Photo: IPPF/Xaume Olleros/Cameroon Share on Twitter Share on Facebook Share via WhatsApp Share via Email Guinea Association Guinéenne pour le Bien-Etre Familial (AGBEF) Building on lessons learned during the Ebola crisis in Guinea, AGBEF quickly took measures to prevent infection in its clinics to continue providing sexual and reproductive healthcare, including surgical and medical abortion, in a safe environment. AGBEF donated protective materials to communities, including hand-washing stations, face masks and antibacterial gel, alongside messaging on infection prevention. This community visibility reassures clients they can safely attend AGBEF clinics for abortion and contraceptive care.Photo: AGBEF/Guinea Share on Twitter Share on Facebook Share via WhatsApp Share via Email India Family Planning Association of India (FPA India) FPA India and partners advocated to have sexual and reproductive healthcare, including abortion, recognized as essential by the government, which meant FPA India could continue healthcare delivery during the national lockdown. To reduce in-person clinic visits, FPA India established teleconsultation and counselling for abortion care, and is continuing to provide in-clinic care for both medical and surgical abortion. Photo: IPPF/Alison Joyce/India Share on Twitter Share on Facebook Share via WhatsApp Share via Email Nepal Family Planning Association of Nepal (FPAN) FPAN and partners advocated for interim approval of home provision of medical abortion and telemedicine for abortion counselling during COVID-19. FPAN is now implementing these approaches, ensuring continued access to abortion care in Nepal, where many people live in remote locations with limited mobility, which has been further restricted by COVID-19 lockdowns. Photo: FPAN/Nepal Share on Twitter Share on Facebook Share via WhatsApp Share via Email Pakistan Rahnuma – Family Planning Association of Pakistan (Rahnuma-FPAP) Rahnuma-FPAP and partners successfully advocated for the government to class sexual and reproductive healthcare as ‘essential’, which enabled the team to continue providing post-abortion care during the pandemic. Rahnuma-FPAP expanded its telemedicine and home-based provision for menstrual regulation counselling and post-abortion care. These new approaches have ensured continued access to services for clients unable to reach clinics.Photo: Rahnuma-FPAP/Pakistan Share on Twitter Share on Facebook Share via WhatsApp Share via Email Palestine Palestinian Family Planning and Protection Association (PFPPA) In response to the government-mandated closure of its clinics, PFPPA quickly established a toll-free call centre which provides consultations, counselling, referrals and follow-up, including consultation for abortion care through a harm reduction approach, ensuring that women are provided with accurate information. Due to its success, PFPPA is exploring options for continuing this healthcare delivery model beyond the pandemic, with the aim of keeping it free of charge for users.Photo: SAAF/Samar Hazboun/Palestine Share on Twitter Share on Facebook Share via WhatsApp Share via Email Sudan Sudan Family Planning Association (SFPA) Following a nation-wide shutdown in April, SFPA  established  a call centre to increase access to healthcare, including abortion and contraceptive counselling and referrals.  An unexpected outcome of the new call centre is that it has reached an increased number of young women who regularly call to discuss their reproductive health and rights. SFPA  is working  towards institutionalizing this model for continuation beyond the pandemic.Photo: SFPA/Sudan Share on Twitter Share on Facebook Share via WhatsApp Share via Email Togo Association Togolaise pour le Bien-Etre Familial (ATBEF) ATBEF adapted its mobile application ‘Infos Ado Jeunes’, adding a toll-free teleconsultation service for young clients to use to access abortion consultations and pre- and post-abortion counselling. This app has given young clients ongoing access to care when they face challenges travelling to clinics. It has also eased overall client flow in clinics at a time when social distancing is being implemented.Photo: ATBEF/Togo Share on Twitter Share on Facebook Share via WhatsApp Share via Email

Some IPPF volunteers - Zero Discrimination Day
28 February 2019

1 March: Zero Discrimination Day

On Zero Discrimination Day, IPPF stands for respect, dignity, compassion and care for all. We are committed to providing quality healthcare to every person that visits one of our Member Association’s clinics, regardless of their age, sex, gender identity, race, ethnicity, sexual orientation, religion, economic status or anything else.  When you provide healthcare with dignity and respect, you can inspire others to do the same. Meet some of people who were so motivated by the discrimination-free healthcare they received from our Member Associations, or by the potential to support their communities in need, that they decided to become much-valued volunteers. Lakshmi from Nepal, living with HIV – Community care mobiliser with the Family Planning Association of Nepal “I made a plan that I would come back home [to Palpa], disclose my status and then do social work with other people living with HIV, so that they too may have hope to live. I said to myself: I will live and I will let others living with HIV live.” Read more about Lakshmi Leilani, a trans woman from Tonga – Volunteer at the Tonga Leiti Association, supported by Tonga Health Family Association “I think Tonga Family Health has done a lot up to now. They always come and do our annual HIV testing and they supply us [with] some condoms.They really, really help us a lot. They [are the] only one that can understand us.” Read more about Leilani Eric from the USA – Outreach volunteer for the Planned Parenthood Federation of America  “The first thing I do when I have hardcore substance abusers sitting in front of me, I first show them identification, I let them know I understand just how they feel. I’ve been there feeling hopeless, helpless, confused about where to turn.” Read more about Eric Hasina from India – Sex worker and volunteer at the Family Planning Association of India “Selling my body doesn’t make me a bad person, but working as a peer educator has helped enabled me to help many like me.” Read more about Hasina Milan from Nepal, living with HIV – Community care mobiliser with the Family Planning Association of Nepal “There are 40 children in this area living with HIV,” he says. “I talk to them, collect information from them and help them get the support they need. And I tell them: ‘If I had given up at that time, I would not be like this now. So you also shouldn’t give up, and you have to live your life.” Read more about Milan Joseph from Botswana, a gay man living with HIV – Client at the Botswana Family Welfare Association “I never have any problems coming here. I feel comfortable here. At [the government clinic] there is no privacy; most of my friends are there. Sometimes if you go there you find them suspecting something, and everyone will be knowing your status. That’s why I prefer BOFWA [Botswana Family Welfare Association].” Read more about Joseph

Muna receiving her implant

"I’m so happy I now don’t have to worry about contraception for another five years”

In August 2017, weeks of continued and heavy rainfall across Nepal resulted in flash floods and landslides that affected 36 of the 75 districts. Many people lost their homes or were displaced. It was estimated that of those affected, 112,500 were women of reproductive age, including 8,694 pregnant women.  IPPF Humanitarian, through their Member Association, The Family Planning Association of Nepal (FPAN), activated its emergency response system early on. With funding support from the Australian Government, FPAN and IPPF Humanitarian initially mobilised their response in four of the worst affected districts (Sunsari, Saptari, Bardiya, and Dang). Mobile medical camps were established to meet the sexual and reproductive health needs of the affected population, including through the distribution of short and long acting methods of contraception, STI and HIV screening, and GBV referrals. In collaboration with the USAID-SIFPO project, services were then expanded into five more affected districts. IPPF Humanitarian spoke with 21-year old Muna in her home district of Sunsari in Nepal.  “I got married at 16 years old and have two children, a four-year-old girl and two-year-old boy.  In my caste, we get married early, so my parents took me to get an arranged marriage. I was in the 8th class at the time, and returned to school after I got married, but only lasted one year.  My husband works in construction and had to stop working for two weeks when the floods came. When he doesn’t work, he doesn’t get paid, so it’s been very difficult.  A FPAN social worker told me about the mobile medical camp today. I used to be on the three-month injectable but today I changed to the five-year implant in my arm.  When my youngest child was eight months old I found out I was pregnant again. I decided to discontinue that pregnancy, so I took the five small tablets given to me by my neighbourhood doctor. I was two months pregnant at the time.  From this, I had two days bleeding and cramp like pain, and then weakness. I decided to abort that pregnancy because my youngest will still only eight months old, and I didn’t want any more children.  If I had more than two children, it would be very difficult to feed and educate them, and would badly affect my body too. I’m so happy I now don’t have to worry about contraception for another five years.” Want to know more about safe abortion access? Join IPPF'S I Decide movement

Young man
01 December 2017

The college student using music to tackle HIV stigma

Compared to many developing countries, HIV prevalence in Nepal is low. Yet there are deep and complex problems around HIV. Stigma remains a huge problem. People living with HIV say they have faced enormous discrimination, including being ostracized by their communities, bullied at school and work, and exposed to insults and even violence.   HIV services and support are central to the work of the Family Planning Association of Nepal (FPAN). Its staff and volunteers run services around the country, providing HIV counselling, education on prevention and treatment, and community home-based care services. People living with HIV are at the forefront of this work: FPAN employs thousands of community home-based care mobilisers who are themselves HIV-positive, meaning they are able to provide people with clear, sensitive and empathetic support that draws on their own experiences.    Photography © IPPF/Jon Spaull  Read Milan's story and watch the video

hiv-test

IPPF marks World AIDS Day by announcing the launch of a special program to roll out new biomedical HIV prevention methods

IPPF provides comprehensive sexual and reproductive health care to clients around the world. HIV testing, prevention, and treatment services are essential parts of our integrated sexual and reproductive health care package. To expand the choices individuals have to protect themselves from HIV, IPPF is excited to announce a special program to provide the newest methods of HIV prevention - injectable PrEP (a 2-monthly injection of cabotegravir-LA) and the vaginal ring (a monthly vaginal ring of dapivirine), as well as expanding where oral PrEP is offered. This program is being launched through a consortium of IPPF Member Associations called the Consortium to Advance Access to new HIV Prevention Products (CAAPP) - led by Family Planning Association of India, and including the Family Life Association of Eswatini, Lesotho Planned Parenthood Association, Family Planning Association of Malawi, Federation of Reproductive Health Associations, Malaysia, Family Planning Association of Nepal, and Planned Parenthood Association of Thailand. We hope this program will increase access to the number of ways people can protect themselves from HIV, supporting individual's choice to find an HIV prevention method that works for them.

pleasure-workshop
21 August 2023

लाज (Shame): Reflections on workshops to deconstruct pleasure

Amidst the different dos and don’ts of sex and desire, have you ever paused and thought - what does ‘pleasure’ mean to me?  I asked the same question to participants in our workshop लाज (Shame): Deconstructing Pleasure. The aim of the workshop was to create an intentional space for our participants to redefine their desires, pleasures and intimacy beyond societal pressures.  I conducted a total of 4 workshops in both Pokhara and Kathmandu, Nepal from December 2021 to May 2022. The workshops consisted of 60 AFAB (Assigned Female at Birth) participants, who came together to reflect on their relationship with pleasure, specifically self-pleasure, and deconstruct the guilt, shame and stigma associated with it in our Nepali society.  Here are some of my reflections from facilitating these pleasure workshops, as well as four activities that can help you create your own pleasure practice:  Understand pleasure beyond penetration In Nepal due to cultural taboos around sexuality, conversations around pleasure are often hushed and pushed to private spaces. The limited knowledge that does exist in public, defines pleasure as only accessible through penetrative sex (penis in vagina), which ideally should take place within a marriage. Since only 18.4% of people with vulvas orgasm through vaginal sex alone, this narrow understanding largely prioritises the sexual pleasure of cis-het men, creating a pleasure gap. Additionally, it erases queer expressions and practices of pleasure since it equates pleasure to only exist within heterosexual (opposite-sex) relationships.  In order to decentralise this single narrative of pleasure, we started our workshop with The Pleasure Project’s prompt,  “I get pleasure from…”. The prompt facilitated participants to take a step back and think about the activities they received pleasure from.  The answers we received included both sexual and non-sexual activities, ranging from masturbation, to eating, to reading books. This activity allowed us to establish that the only universality to pleasure is that it is subjective to each one of us and our unique needs. It also helped us expand the narrow understanding of pleasure and emphasise the importance of non-sexual activities in our pleasure script. While pleasure innately is not sexual, given the taboo, the workshop then proceeded to encourage participants to think about their experiences specifically related to sexual pleasure. 

Menstrual cups
28 May 2023

Tackling Taboos and the Fear of Using a Menstrual Cup

In many cultures and societies, individuals with vaginas are accustomed to thinking that touching and peeking at their genitals is inappropriate or that taking ownership and autonomy of our own body and pleasure seems a whimsical story. The way we are constantly lectured about our bodies has informed our ideas and attitudes around sexual and reproductive health, particularly menstrual health.  I live in Nepal, where menstruation has been, and still is, a taboo. A few years ago, I signed up for the social networking platform Clubhouse, where I joined virtual ‘rooms’ where people talked openly about menstruation and menstrual cups. Being a newbie to menstrual cups while at the same time advocating their use, I felt proud and excited every time I shared or heard people talking about it.

SPRINT
26 April 2022

SPRINT: Sexual and reproductive health in crisis and post-crisis situations

  The SPRINT Initiative provides one of the most important aspects of humanitarian assistance that is often forgotten when disaster and conflicts strike: access to essential life-saving sexual and reproductive health services. We build capacity of humanitarian workers to deliver essential life-saving sexual and reproductive health services in crisis and post-crisis situations through the delivery of the Minimum Initial Service Package (MISP) for reproductive health in emergencies.   Through funding from the Australian Government's Department of Foreign Affairs and Trade (DFAT), our SPRINT Initiative has brought sexual and reproductive health to the humanitarian agenda, increased capacity and responded to a number of humanitarian emergencies. Australia has funded the SPRINT initiative since 2007. Since then, the SPRINT initiative has responded to 105 humanitarian crises and worked with partners in 99 countries. SPRINT has reached over 1,138,175 people, delivering 2,133,141 crucial SRH services, and continues to respond to ongoing emergencies. In each priority country, we work with an IPPF Member Association to coordinate and implement life-saving sexual and reproductive activities. Through these partnerships, SPRINT helps strengthen the enabling environment, improve national capacity and provide lifesaving services during times of crisis. You can read more about IPPF Humanitarian’s Programme here. Australia's location in the Indo-Pacific provides DFAT with a unique perspective on humanitarian action. Australia is committed to helping partner governments manage crisis response themselves. This is done through building the capacity of the national government and civil society to be able to respond to disaster. DFAT also works with experienced international partners to prepare for and respond to disasters, including other donors, United Nations agencies, the International Red Cross and Red Crescent Movement and non-government organisations.          

Dhriti, who is a sex worker in Nepal
16 December 2021

Nepal: Ensuring safe and compassionate SRH services for sex workers during COVID-19

“Even though we know we shouldn’t be ashamed to seek medical treatments, sometimes we are ashamed to go to clinics for check-ups,” said Dhriti* (pictured above), a 24-year-old sex worker in Kathmandu, Nepal.   In nearly every country around the world, the stigmatization of sex workers creates barriers to sex workers accessing sexual and reproductive healthcare. These barriers have been compounded and exacerbated throughout the COVID-19 pandemic as a result of lockdown measures and the diversion of medical staff and resources. As a result, many young sex workers like Dhriti – who have a heightened risk of contracting COVID-19 due to the nature of the work – are reluctant to come forward and seek help, and they are largely excluded from government pandemic response measures and programs.    22-year-old Anisha* is also a sex worker in Kathmandu. She added that during the lockdown, many sex workers faced significant or total loss of income and were forced to put themselves at risk to earn enough money to eat.   “We lied to police officers at checkpoints in the city and made our way to places where we could get our clients,” she said. “We were scared because of the coronavirus but there was no work or money for us.” 

A photo of Sanjiya Shrestha speaking
13 December 2021

'Khaskhus': an innovative group chat in Nepal supports people living with disabilities during COVID-19

“Menstruation does not stop just because of lockdown,” says Sanjiya Shrestha (pictured), a Peer Educator at the Family Planning Association of Nepal, an IPPF Member Association.  But when the second wave of the COVID-19 pandemic hit Nepal in early 2021, it had a profound impact on the lives of women, girls and people living with disabilities. Strict measures imposed during the country’s second national lockdown restricted access to and availability of essential sexual and reproductive health services including sanitary kits, maternal health care, safe delivery services, contraception, abortion services, and many others.   “During COVID-19, we were not able to be close to anyone or touch each other. Even getting outside to buy sanitary items was difficult,” said Shrestha, who is visually impaired. “But some people with disabilities require care from others, and they need to be close together. It was difficult for people in wheelchairs and visually impaired people to get outside. In that way, the pandemic has had an even greater impact on people with disabilities.” Greater need brings innovation  The Family Planning Association of Nepal (FPAN) works with over 200 clinical service providers and over 600 community-based distributors to ensure women and girls get access to essential SRH services during this critical health emergency. With the support of the Australian Government, FPAN has also partnered with a number of community-based organizations including the Blind Youth Association Nepal, the Nepal Disabled Women Association, Community Based Rehabilitation and Action on Disability Rights and Development Nepal.   Part of Shrestha’s work as a peer educator is to regularly conduct training sessions to educate people about gender and sexual and reproductive health issues. She also organizes health camps in rural communities and explains contraceptives and birth control measures for people living with disabilities.   But during the lockdown, she needed an innovative way to communicate with vulnerable people and ensure they get access to reliable sexual and reproductive health information and services. Shrestha decided to launch a talk and text group chat, which she named ‘Khaskhus’, or ‘special talk’, in English.  “There are some things that cannot be covered in trainings and seminars, but these gaps can be filled by this group,” she said.   At first, the group was made up of visually-impaired youth, but Shrestha says it has grown to include a range of different people.  “Now, everyone who is interested can join and share with those around them. Through this group, we talk about sexual and reproductive health, life skills, and development. Everyone in our group talks openly... we share our experiences and we have learned many new things from this discussion.”  Direct and inclusive support  As government-imposed movement restrictions gradually loosen in Nepal, FPAN staff and volunteers continue to meet the needs of community members by providing essential SRH materials and services, such as condoms, pills and emergency contraceptive, pregnancy tests, and referrals for sexually transmitted infections and abortion cases to an FPAN branch clinic.   Thirty-year-old Sunita Duwal lives with a physical disability. Her husband, Suman Palikhel, uses a wheelchair. The couple receives information from FPAN on family planning and reproductive health and they volunteer by coordinating home deliveries of essential items across the capital, Kathmandu.   “I used to feel a little hesitant and ashamed to talk about these issues,” said Palikhel. “But FPAN has brought about some changes in our lives... we even share this information with others.”  Duwal said the organization has played a crucial role in educating people about COVID-19 and delivering essentials directly to vulnerable people.  “One of my friends told us that during the coronavirus period, she was experiencing continued bleeding from her menstrual cycle. We shared this issue with FPAN and they sent a technical person to help her,” she said. “There was another physically disabled person with a spinal injury who needed diapers and a catheter. During the lockdown period, we delivered much-needed items such as masks, sanitizers, gloves, face shields, Dettol and soap to people’s homes.”  Since June 2021, FPAN has been working in 15 districts most affected by COVID-19 through 15 family health clinics, 15 community clinics and 210 volunteer-run community-based distribution outlets. As part of its emergency response to the COVID-19 pandemic in Nepal, FPAN is filling an important gap as a result of the diversion of medical equipment and staff that were usually involved in SRH delivery services to fulfil other emergency health needs.   “This support has brought about a lot of change for us,” said Duwal. “We have learned that without sharing our problems and having a two-way communication, we cannot solve our problems. This outlook has helped us out.” 

Healthcare worker with combipack.

In pictures: Innovating during COVID-19

Women around the world have faced multiple barriers to accessing safe abortion care during the COVID-19 pandemic including the de-prioritization of sexual and reproductive healthcare, overwhelmed health systems and restrictions on movement. The COVID-19 crisis has sparked innovation among IPPF Member Associations who responded swiftly by developing new approaches to reach women with safe abortion care including telemedicine and home-based provision of medical abortion. Strong evidence generated from this work supports the continuation and strengthening of these approaches beyond the end of the pandemic. Cameroon Cameroon National Planning Association for Family Welfare (CAMNAFAW) To ensure that quality abortion care can be provided to women during travel restrictions, CAMNAFAW’s service providers travel to partner clinics in underserved areas and to clients’ homes to provide medical and surgical abortion care. This model of taking safe abortion care closer to women will continue even with easing of travel restrictions, as this has been found to be an effective and acceptable approach to increasing access.Photo: IPPF/Xaume Olleros/Cameroon Share on Twitter Share on Facebook Share via WhatsApp Share via Email Guinea Association Guinéenne pour le Bien-Etre Familial (AGBEF) Building on lessons learned during the Ebola crisis in Guinea, AGBEF quickly took measures to prevent infection in its clinics to continue providing sexual and reproductive healthcare, including surgical and medical abortion, in a safe environment. AGBEF donated protective materials to communities, including hand-washing stations, face masks and antibacterial gel, alongside messaging on infection prevention. This community visibility reassures clients they can safely attend AGBEF clinics for abortion and contraceptive care.Photo: AGBEF/Guinea Share on Twitter Share on Facebook Share via WhatsApp Share via Email India Family Planning Association of India (FPA India) FPA India and partners advocated to have sexual and reproductive healthcare, including abortion, recognized as essential by the government, which meant FPA India could continue healthcare delivery during the national lockdown. To reduce in-person clinic visits, FPA India established teleconsultation and counselling for abortion care, and is continuing to provide in-clinic care for both medical and surgical abortion. Photo: IPPF/Alison Joyce/India Share on Twitter Share on Facebook Share via WhatsApp Share via Email Nepal Family Planning Association of Nepal (FPAN) FPAN and partners advocated for interim approval of home provision of medical abortion and telemedicine for abortion counselling during COVID-19. FPAN is now implementing these approaches, ensuring continued access to abortion care in Nepal, where many people live in remote locations with limited mobility, which has been further restricted by COVID-19 lockdowns. Photo: FPAN/Nepal Share on Twitter Share on Facebook Share via WhatsApp Share via Email Pakistan Rahnuma – Family Planning Association of Pakistan (Rahnuma-FPAP) Rahnuma-FPAP and partners successfully advocated for the government to class sexual and reproductive healthcare as ‘essential’, which enabled the team to continue providing post-abortion care during the pandemic. Rahnuma-FPAP expanded its telemedicine and home-based provision for menstrual regulation counselling and post-abortion care. These new approaches have ensured continued access to services for clients unable to reach clinics.Photo: Rahnuma-FPAP/Pakistan Share on Twitter Share on Facebook Share via WhatsApp Share via Email Palestine Palestinian Family Planning and Protection Association (PFPPA) In response to the government-mandated closure of its clinics, PFPPA quickly established a toll-free call centre which provides consultations, counselling, referrals and follow-up, including consultation for abortion care through a harm reduction approach, ensuring that women are provided with accurate information. Due to its success, PFPPA is exploring options for continuing this healthcare delivery model beyond the pandemic, with the aim of keeping it free of charge for users.Photo: SAAF/Samar Hazboun/Palestine Share on Twitter Share on Facebook Share via WhatsApp Share via Email Sudan Sudan Family Planning Association (SFPA) Following a nation-wide shutdown in April, SFPA  established  a call centre to increase access to healthcare, including abortion and contraceptive counselling and referrals.  An unexpected outcome of the new call centre is that it has reached an increased number of young women who regularly call to discuss their reproductive health and rights. SFPA  is working  towards institutionalizing this model for continuation beyond the pandemic.Photo: SFPA/Sudan Share on Twitter Share on Facebook Share via WhatsApp Share via Email Togo Association Togolaise pour le Bien-Etre Familial (ATBEF) ATBEF adapted its mobile application ‘Infos Ado Jeunes’, adding a toll-free teleconsultation service for young clients to use to access abortion consultations and pre- and post-abortion counselling. This app has given young clients ongoing access to care when they face challenges travelling to clinics. It has also eased overall client flow in clinics at a time when social distancing is being implemented.Photo: ATBEF/Togo Share on Twitter Share on Facebook Share via WhatsApp Share via Email

Some IPPF volunteers - Zero Discrimination Day
28 February 2019

1 March: Zero Discrimination Day

On Zero Discrimination Day, IPPF stands for respect, dignity, compassion and care for all. We are committed to providing quality healthcare to every person that visits one of our Member Association’s clinics, regardless of their age, sex, gender identity, race, ethnicity, sexual orientation, religion, economic status or anything else.  When you provide healthcare with dignity and respect, you can inspire others to do the same. Meet some of people who were so motivated by the discrimination-free healthcare they received from our Member Associations, or by the potential to support their communities in need, that they decided to become much-valued volunteers. Lakshmi from Nepal, living with HIV – Community care mobiliser with the Family Planning Association of Nepal “I made a plan that I would come back home [to Palpa], disclose my status and then do social work with other people living with HIV, so that they too may have hope to live. I said to myself: I will live and I will let others living with HIV live.” Read more about Lakshmi Leilani, a trans woman from Tonga – Volunteer at the Tonga Leiti Association, supported by Tonga Health Family Association “I think Tonga Family Health has done a lot up to now. They always come and do our annual HIV testing and they supply us [with] some condoms.They really, really help us a lot. They [are the] only one that can understand us.” Read more about Leilani Eric from the USA – Outreach volunteer for the Planned Parenthood Federation of America  “The first thing I do when I have hardcore substance abusers sitting in front of me, I first show them identification, I let them know I understand just how they feel. I’ve been there feeling hopeless, helpless, confused about where to turn.” Read more about Eric Hasina from India – Sex worker and volunteer at the Family Planning Association of India “Selling my body doesn’t make me a bad person, but working as a peer educator has helped enabled me to help many like me.” Read more about Hasina Milan from Nepal, living with HIV – Community care mobiliser with the Family Planning Association of Nepal “There are 40 children in this area living with HIV,” he says. “I talk to them, collect information from them and help them get the support they need. And I tell them: ‘If I had given up at that time, I would not be like this now. So you also shouldn’t give up, and you have to live your life.” Read more about Milan Joseph from Botswana, a gay man living with HIV – Client at the Botswana Family Welfare Association “I never have any problems coming here. I feel comfortable here. At [the government clinic] there is no privacy; most of my friends are there. Sometimes if you go there you find them suspecting something, and everyone will be knowing your status. That’s why I prefer BOFWA [Botswana Family Welfare Association].” Read more about Joseph

Muna receiving her implant

"I’m so happy I now don’t have to worry about contraception for another five years”

In August 2017, weeks of continued and heavy rainfall across Nepal resulted in flash floods and landslides that affected 36 of the 75 districts. Many people lost their homes or were displaced. It was estimated that of those affected, 112,500 were women of reproductive age, including 8,694 pregnant women.  IPPF Humanitarian, through their Member Association, The Family Planning Association of Nepal (FPAN), activated its emergency response system early on. With funding support from the Australian Government, FPAN and IPPF Humanitarian initially mobilised their response in four of the worst affected districts (Sunsari, Saptari, Bardiya, and Dang). Mobile medical camps were established to meet the sexual and reproductive health needs of the affected population, including through the distribution of short and long acting methods of contraception, STI and HIV screening, and GBV referrals. In collaboration with the USAID-SIFPO project, services were then expanded into five more affected districts. IPPF Humanitarian spoke with 21-year old Muna in her home district of Sunsari in Nepal.  “I got married at 16 years old and have two children, a four-year-old girl and two-year-old boy.  In my caste, we get married early, so my parents took me to get an arranged marriage. I was in the 8th class at the time, and returned to school after I got married, but only lasted one year.  My husband works in construction and had to stop working for two weeks when the floods came. When he doesn’t work, he doesn’t get paid, so it’s been very difficult.  A FPAN social worker told me about the mobile medical camp today. I used to be on the three-month injectable but today I changed to the five-year implant in my arm.  When my youngest child was eight months old I found out I was pregnant again. I decided to discontinue that pregnancy, so I took the five small tablets given to me by my neighbourhood doctor. I was two months pregnant at the time.  From this, I had two days bleeding and cramp like pain, and then weakness. I decided to abort that pregnancy because my youngest will still only eight months old, and I didn’t want any more children.  If I had more than two children, it would be very difficult to feed and educate them, and would badly affect my body too. I’m so happy I now don’t have to worry about contraception for another five years.” Want to know more about safe abortion access? Join IPPF'S I Decide movement

Young man
01 December 2017

The college student using music to tackle HIV stigma

Compared to many developing countries, HIV prevalence in Nepal is low. Yet there are deep and complex problems around HIV. Stigma remains a huge problem. People living with HIV say they have faced enormous discrimination, including being ostracized by their communities, bullied at school and work, and exposed to insults and even violence.   HIV services and support are central to the work of the Family Planning Association of Nepal (FPAN). Its staff and volunteers run services around the country, providing HIV counselling, education on prevention and treatment, and community home-based care services. People living with HIV are at the forefront of this work: FPAN employs thousands of community home-based care mobilisers who are themselves HIV-positive, meaning they are able to provide people with clear, sensitive and empathetic support that draws on their own experiences.    Photography © IPPF/Jon Spaull  Read Milan's story and watch the video