A decade of Nepal's family planning program: achievements and prospects.

Knowledge and practice of family planning in Nepal increased considerably from mid-1976 through mid-1986, with significant improvements in the availability of and accessibility to contraceptives. However, a proportionately larger share of the achievements were made during 1976-81 than in 1981-86. The impact on fertility of contraceptive use during the decade was minimal. Knowledge and use of reversible contraceptive methods remained very low, primarily because of the continued strong emphasis on sterilization in Nepal's family planning program. Consequently, the welfare of many couples who may be in need of contraception for spacing births, but not necessarily for terminating childbearing, does not appear to be adequately addressed by the program. A more balanced emphasis on reversible methods of contraception does not necessarily imply that a substantially higher level of contraceptive prevalence would be required to reach the fertility target. Several steps to improve program performance and contraceptive method mix are suggested.