Female Sterilization in Nepal: A Comparison of Two Types of Service Delivery

Abstract

Outreach camps have played an important role during the past 30 years in making sterilization accessible to rural women in Nepal. In 1996 42% of all sterilization clients (50% of males and 39% of females) received services from camps. Concerns have been raised however about the quality of care in these camps. The present study compared the social and demographic characteristics and sterilization experiences of 445 women who had been contraceptively sterilized in public hospitals and 372 women who underwent the procedure in temporary camps. Study respondents were drawn from a nationally representative sample of 8429 ever-married women who participated in the 1996 Nepal Family Health Survey. Both groups were similar in terms of age and parity at the time of sterilization and educational attainment but camp patients were more likely to be rural and from the Terai plains region. 80% of hospital and 82% of camp clients reported that sterilization was the first contraceptive method they had used. 12% of women who underwent sterilization in hospitals and 10% who received the procedure in camps expressed post-sterilization regret but this outcome was unrelated to attributes of the service delivery site. These findings suggest that camps do not imply less careful screening of sterilization clients or an inferior quality of services. Rather they appear to represent an important means of meeting couples demand for sterilization services in rural areas where hospital- or clinic-based services are not available throughout the year.