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Kathmandu

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Revision as of 19:04, 16 September 2017 by Lani314 (talk | contribs) (→‎Abortion)
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OVERVIEW

Kathmandu.jpg

Contraception (Birth Control)

General Note: There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click here.

Laws & Social Stigmas

In Nepal, you can purchase oral contraception (birth control pills) without a prescription.[1] [2] According to a 2015 report, it's estimated that 52.4% of Nepali women (who are of reproductive age and married or in unions) use some form of contraception, including traditional methods, and 23.9% have unmet family planning needs. The most common forms of contraception were female sterilization (18.3%), injectables (13.2%), birth control pills (4.8%), male sterilization (4.8%) and withdrawal, also known as the "pull-out method" (3.9%). It was found that only 3.8% of Nepali women used condoms as their primary form of contraception. Meanwhile, there was very low usage of IUDs (1.7%) and contraceptive implants (1.3%).[3]

What to Get & Where to Get It

  • You can purchase condoms in Nepal at pharmacies, general stores, certain department stores and non-governmental organizations, like Marie Stopes International. There are also locally-produced condom brands, such as Dzire Dotted Condom and Dhaal Deluxe Condoms, which are produced by Nepal CRS Company. If you go to Marie Stopes Nepal, you'll probably get Jodi Condoms, which is the condom brand that MSI International endorses. Finally, if you prefer to purchase condoms online, there are certain online retailers that sell condoms to the Nepalese market and can deliver condoms to your Nepalese address. Some of these online companies are Mero Shopping, which sells brands like Ocean Premium, Kohinoor Moods, or Care to Beauty, which sells Durex condoms. However, if you purchase online, the price for a box of condoms will typically be much higher than if you purchase them in person in a Nepalese pharmacy or store.
  • You can purchase oral contraceptives (birth control pills) without a prescription at pharmacies. Some of the international brands you can expect to see are Duoluton L, Ovral, Lo-Femenal and Nordette.[4] You can also find Nilocon White, which is a low-dose oral contraceptive that was launched by Nepal CRS Company in the 1980s, and it may only be available in Nepal.
  • You can get an IUD in Nepal. If you have issues with your IUD (such as cramping, pain, etc), you can call Meri Saathi Free Helpline on 16600119756 (ntc) or 9801119756.
  • You can get contraceptive implants, including brands like Norplant and Jadelle, at government hospitals and health care organizations. For Nepali women, it's totally free.[5]

Costs

  • Condoms - If you go to Marie Stopes Nepal, you can probably get a box of condoms for a reduced price or free. If you go to a Nepalese store, you can purhcase Dhaal Deluxe Condoms for about Rs. 5 at Nepalese stores, as of 2017.[6] For a box of Dzire Dotted Condoms, you can expect to pay Rs. 35 at Nepalese stores, as of 2017.[7] However, if you would like to buy condoms online, you can expect to pay anywhere between Rs.50-Rs.2300 for a box of condoms.
  • Birth Control Pills - For Nicolon White, you can expect to pay around Rs. 50 for a one-month supply (as of 2017). For Duoluton L, you can expect to pay Rs. 223.2 for a one-month supply (as of 2017).

Emergency Contraception (Morning After Pill)

 
One brand of the morning after pill in Nepal

Important Notes: Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC as soon as possible after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click here and here.

Laws & Social Stigmas

In Nepal, you can purchase emergency contraception (the morning after pill) from pharmacists without a prescription.[8] However, the overall knowledge of emergency contraception in the country remains relatively low. In 2011, it was found that 28.8% of women of reproductive age had knowledge of emergency contraception.[9]

What to Get & Where to Get It

  • You can find emergency contraception (the morning after pill) at pharmacies, IPPF-affiliated system and social marketing programs (eg PSI, DKT, MSI and PSIA).[10] Some of the brands you can expect to see are Contragest, E-72, e-Con, Feminor, i-pill, Max-72, Pregnon and Unwanted 72.
  • If you can't access dedicated emergency contraception in Nepal, you have other options. You can use regular birth control pills as replacement EC. To do this, you can take Duoloton L or Ovral. For these brands, you take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later. Alternatively, you can also take Lo-Femenal or Nordette. For these brands, you take take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later. Finally, you can also have an IUD inserted, which can help prevent pregnancy after unprotected sex.[11]

Costs

In some Nepalese pharmacies, you can expect to pay around Rs. 80 for a single pack of i-pill or E-Con.[12] Generally speaking, you can expect to pay between Rs. 70-160 for a single pack of emergency contraception.[13]

Sexually Transmitted Infections (STIs/STDs)

Important Notes - Learn about PEP and PrEP: If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click here. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click here.

Laws & Social Stigmas

In Nepal, it is estimated that 0.2% of the population is infected with HIV, as of 2015.[14] According to a 2015 UN Report, the majority of new HIV infections (85%) are sexually-transmitted.[15] The key affected populations include injection drug users, sex workers, transgender people and migrant laborers. However, it is important to remember that HIV impacts all people from all walks of life, and one should always use protection. For a detailed report on HIV in Nepal, click here.

Testing Facilities

Support

Costs

Medications & Vaccines

Laws & Social Stigmas

What to Get & Where to Get It

  • There is currently no PrEP available in Nepal, as of September 2017.[16]

Costs

Menstruation

Note: In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click here. To learn more about menstrual underwear, click here.

Laws & Social Stigmas

What to Get & Where to Get It

  • You can find pads in numerous markets in Nepal. They are more commonly used than tampons, menstrual cups or other menstrual products.
  • You can find tampons in certain stores, especially those that target foreigners, in larger Nepalese cities, like Kathmandu. However, they are less commonly used than pads, and the selection of available tampon brands available is rather limited.
  • While menstrual cups are not commonly sold in Nepal, there are some interesting initiatives and organizations working on the issue, which we list below:
    • Putali Nepal: This organization is focused on starting a conversation about menstrual hygiene in Nepal as well as providing RubyCups to women in Nepal. Here's more information rom the organization (September 2017): "We sell and work with the brand Ruby Cup. You can purchase it in Kar.ma Coffee, a café in Jhamsikhel, Patan, which is involved in social projects working with local producers of coffee and supporting other projects like Dharti Mata, producer of reusable sanitary pads." "We sell the normal size, which is suitable for everyone. In case of a special request of e.g. young girls we have a few samples of the small size available. It comes in the colors pink and blue and costs Nrs. 2200." "Besides making Ruby Cup available for individuals our main focus lies on the education about menstrual hygiene management and Ruby Cup, since menstrual cups are a new method for periods in Nepal. We give trainings to staff members of organisations working in the field of reproductive health or women empowerment and groups of women of all ages. In our 2-3 hours sessions our Nepali trainers Saniya and Shristi teach them about the usage of Ruby Cup (insertion, removal, cleaning, storing) and create a platform for every single participant to speak about personal experiences. For many of them this moment is the first time they speak about the topic of menstruation. Besides we give a short review of what periods are and give tips for maintaining menstrual hygiene in the Nepali cultural context. Another tool to train younger girls and boys is the Menstupedia Comic book. We sell it to organisations which use it for their work in schools and communities in whole Nepal. We ourselves give trainings in schools in Kathmandu Valley with this resource. "
    • DivaCups for Nepal: This is a GoFundMe campaign from a female traveler who wanted to bring DivaCups to Nepal.

Costs

Gynecological Exams

Laws & Social Stigmas

What to Get & Where to Get It

  • Suphatra Koirala at CIWEC Clinic: This doctor and clinic was recommended by a Kathmandu local. She says, "I've been very impressed by my obgyn at CIWEC. Suphatra Koirala is the Dr. It's pretty pricey there, around US$30 for a quick visit, $60 for a longer consultation."
  • Dr. Gerda Pohl at at CIWEC Clinic: This doctor and clinic was recommended by a Kathmandu local.
  • Dr. Abha Shaky Shrestha at Grande International Hospital: This doctor and clinic was recommended by a Kathmandu local. She says, "My ob/gyn at Grande Hospital is impressive as well, Dr. Abha Shaky Shrestha. My husband is Nepali so I get the Nepali price, it's under $4.50 for a visit, $10 for an ultrasound. Grande International Hospital is #1 in Nepal and I'm an American confident delivering there." Address: Tokha Rd, Kathmandu 44600, Nepal. Hours: Open 24 hours. Phone: +977 1-5159266.
  • Furthermore, gynecologists are available in nearly all hospitals. each Hospitals. The hospitals which are near to Tribhuwan International Airport are: 1)Om Hospital and Research centre pvt. ltd. chahabil,kathmandu, 2)Kathmandu medical College Teaching Hospital, Sinamangal,kathmandu 3)medicare Hospital,chahabil

Costs

Pregnancy

Laws & Social Stigmas

What to Get & Where to Get It

Costs

Abortion

Important Note: There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click here.

Laws & Social Stigmas

In Nepal, abortion is legally available upon request for up to 12 weeks of gestation. This means that, for all women, they can obtain an abortion for nearly all reasons during this period. Furthermore, younger women should be turned away or discriminated against because of their age.[17] However, it is illegal to request an abortion due to the sex of the child.[18] After 18 weeks of gestation, abortion is only legal if the pregnancy in cases of rape or incest. It should be noted that, if any time in the pregnancy, a physician believes that an abortion is advisable, or if the pregnant woman's physical or mental health is at stake, or if there is serious risk of fetal malformation, an abortion can also be legally permitted.[19]

What to Get & Where to Get It

  • In Nepal, there are two main forms of abortion procedures: MVA-manual vacuum aspiration (also known as "surgical abortion") and MA, medical abortion (also known as "the abortion pill"). We'll discuss both options below:
    • Manual-Vacuum Aspiration (also known as "MVA" or "surgical abortion") - This is a procedure that's available in Nepal. For more information on how it works, click here.
    • Medical Abortion (also known as "MA" or "the abortion pill") - This is when you use a combination of pills to induce abortion. In Nepal, it is performed within the first 9 weeks of gestation.[20] In Nepal, you can find this combination of pills (Misoprostol and Mifepristone), but they may be under different brand names. Typically, Misoprostol goes under the brand names Isovent, Misoprost, and Zitotec in Nepal.[21]
  • You can find abortion services in all 75 districts of Nepal, including in mountainous and remote areas (in addition to Kathmandu and urban centers). The government of Nepal certifies the health facilities that perform abortions, and they also certify the trained health care providers.

Useful Contacts/Resources:

  • Marie Stopes Nepal: This is an international health organization with clinics around the globe, specializing in sexual and reproductive health care. They often provide abortion services and, when they don't, they can often refer people to appropriate resources. For more information, you can call them on their Meri Saathi Free Helpline:16600119756 OR 9801119756(NCELL). Address: GPO Box No. 11254, Char Khal Adda, Dillibazar, Kathmandu
  • Family Planning Association of Nepal: This is the official family planning organization in Nepal, which is associated with the government. They may be a good resource to learn about abortion policy, what's available, your rights, etc.

Costs

The cost of an abortion in Nepal will vary, largely depending on whether you seek out public or private health care services. If you visit a public Nepali hospital, the fee should be around Rs. 1000 (as of 2015). However, we're not sure if this fee only applies to Nepali nationals, or if it apples to all people who seek out care in public facilities. We're still trying to gather information on average costs for an abortion at a private clinic or hospital in Nepal.[22]

Advocacy & Counseling

Laws & Social Stigmas

What to Get & Where to Get It

Costs

List of Additional Resources

References