Nepal Conflict Aggravates Women's Reproductive Health Risks

UNITED NATIONS, New York — Nepal’s 10-year conflict is aggravating problems in providing vital reproductive health services, especially obstetric care. This has put many thousands of women and adolescents at risk, according to UNFPA, the United Nations Population Fund.

As part of an inter-agency humanitarian appeal launched today, UNFPA is asking donors for $1.3 million to expand maternal health and family planning services for poor people displaced or affected by the conflict. An additional $600,000 is requested for counselling and support of vulnerable adolescents.

Fighting between government forces and the Communist Party of Nepal (Maoist) has claimed 12,000 lives and caused up to 400,000 people to flee from rural villages. The displaced face insecurity, discrimination, hunger, inadequate shelter and limited access to health services and schools. People living in contested areas suffer in a variety of ways, from the stifling of economic development to the interruption of services.

Women and girls have been severely affected. Both the displaced and those remaining in conflict zones face a heightened risk of sexual and gender-based violence.

Fighting, kidnappings, blockades and curfews have crippled medical services and cut off supplies of drugs and other essentials. Attacks have damaged many health facilities, and staff are often reluctant or unable to travel in rural areas. Many women are reported to have died during childbirth because they could not reach emergency obstetric care.

Even before the conflict, Nepal had Asia’s second highest incidence of maternal death (after Afghanistan), 740 per 100,000 live births. Most Nepali women give birth at home. Only one delivery in eight is attended by a doctor or a midwife. Many women live in villages without roads or transport to health facilities.

To meet reproductive health needs, UNFPA plans to work with the Ministry of Health and Population local health officers, Women Development Offices, and others to expand care, including emergency services, in conflict-affected rural areas (in Saptari, Mahottari, Rautahat, Kapilvastu, Dang and Dadeldhura districts) and among displaced persons and urban host populations (in Kathmandu, Nepalgunj, Gularia and Pokhara). Partners from non-governmental organizations known for their innovative approaches will help to address sensitive issues like sexual violence and to reach vulnerable groups.

The effort will strengthen the capacity of government and NGO providers to offer family planning; prevention of HIV and other sexually transmitted infections; and prenatal care, skilled delivery attendance and emergency referrals, and post-natal visits. Women with gynaecological conditions such as uterine prolapse will be screened and referred for surgery or treatment.

UNFPA will also train medical staff, strengthen communications and logistics, and support advocacy campaigns to raise public awareness on reproductive health issues.

Impact on adolescents

The conflict has had a particularly harsh impact on the lives of adolescent boys and girls. Gunmen have frequently invaded schools or ordered them closed. Teachers have been kidnapped and intimidated. Students travelling to and from schools are routinely captured and forced to transport supplies for the rebels. Fear has led many to drop out and flee to safer areas.

To help adolescents deal with the trauma they have endured, UNFPA plans to provide psychosocial counselling for those at risk and referrals for those needing specialized care. To reduce the vulnerability of youth, it will establish watch groups, and develop programmes to sensitize security forces on gender-based violence and enlist their support in protecting adolescents from sexual exploitation. Efforts will also be made to increase the access of out-of-school adolescents to sexual and reproductive health programmes.

The programme will also offer scholarships for internally displaced young people, and organize adolescent reproductive health youth camps in six districts (Kapilvastu, Dang, Dadeldhura, Jumla, Dailekh and Surkhet).

“Ensuring the reproductive rights of women and adolescents is critical in emergency situations,” says Junko Sazaki, UNFPA Representative in Nepal. “We will work hard to raise the funds required, and will work closely with our partners to effectively address the human needs arising from the conflict in Nepal, as part of a coordinated United Nations response.”

***

In response to humanitarian crises worldwide, UNFPA provides assistance to meet women’s reproductive health needs - including family planning, prenatal care, assisted delivery, and emergency obstetric care – and to protect women and adolescents from sexual violence.

Contact Information:

Junko Sazaki, junko.sazaki@undp.org or

William A. Ryan, mobile +66 9 897 6984, ryanw@unfpa.org