Services In Nepal Research Articles

Economics of Nepalese Telecom Industry

This paper aims to investigate the economics of Nepalese telecom industry with special reference to Nepal Telecom. The study is undertaken with the objectives to analyze Nepal Telecom as the market leader, drive an aggressive pricing model and to explore reliable telecommunication service in Nepal and become the lowest cost provider. Telecommunication at present, is the transmission of information, voice or data per time and space through electronic device. Efficiency gains and cheaper phone calls are possible from telecommunications aggressive pricing and effective customer care. The telecommunications revolution has arrived to 21st century wireless communication with fiber to the home (FTTH), 4G and 5G. The overall telecommunication market is huge. Majority of market share is needed to become a market leader. Telecom management need to formulate effective plan to achieve the target within the period of five years. Fiber to the home (FTTH) service, which includes three in one as voice, internet and IPTV has been expanded within 62 districts. Nepal Telecom has been able to expand 4G network in all 77 districts of the country with the wide coverage of 654 local bodies and 85% of the total population. FTTH is an important project as it supports the fifth-generation mobile internet (5G) which is coming to Nepal in the near future.

Gaps and evidences on programming postpartum family planning services in Nepal

Background: Postpartum family planning (PPFP) is one of the strategic efforts mentioned in the National Family Planning Strategy 2011/12 and National FP Costed implementation plan 2015-2020 of Nepal. Postpartum women are recognized as one of the groups that need attention to strengthen FP services in the country. Methods: We conducted a situational analysis in Nepal from December 2019 to May 2020, to identify the needs, gaps and provide evidence for strengthening future programming in this area using a combination of three methods: (i) non-systematic literature review using Google Scholar, Pubmed, and grey literature, (ii) secondary analysis using the dataset from Nepal Demographic and Health Survey (NDHS) 2016 that was based on a two-stage, stratified, nationally representative sample of households, and (iii) virtual assessment in purposively selected eight health facilities using a standard checklist related to PPFP. Results: Results show a lower modern contraceptive uptake (22.6%) and higher unmet need (31.5%) among postpartum women compared to all currently married women (43% and 24% respectively). Three most commonly used modern contraceptive methods among postpartum women in Nepal are injectables (8%), male condoms (7%), and oral contraceptive pills (3%). The PPFP services are available only in limited health facilities and were not integrated in Antenatal care (ANC), Postnatal care (PNC), childbirth and immunization services. Provision of family planning counseling during the ANC period is not recorded in the ANC card. Male partners do not participate in family planning counseling. Similarly, the uptake of family planning services at immunization, child health, and postnatal clinics is not recorded. Conclusion: This analysis provided evidence of the current status of PPFP in the country. There are gaps and challenges especially in strategy and guidelines, training, regular supply of commodities, awareness of PPFP, recording and reporting of PPFP. These gaps should be addressed with appropriate strategies.

Comprehensive reproductive health care services during COVID19 in Nepal: An ethical analysis through Reproductive Justice Framework

Reproductive health care services are fundamental human rights of every individual, which are also stated by various international instruments. Nepal is also part of these international commitments and has reflected its commitment in the nation’s plan, strategy, and programs. Though significant efforts have been made to fulfill and improve the sexual and reproductive health care services in Nepal, women and marginalized communities are still deprived of the services. During the COVID-19 pandemic, the utilization of reproductive health services declined which is aggravating the situation and threatening to reverse the progress made so far. The article reviews the accessibility of comprehensive reproductive health services through the framework of reproductive justice during the COVID-19 in Nepal. Reproductive Justice is not only a framework for liberty for marginalized communities but also ethical guidance for policymakers and service providers.

High coverage but low quality of maternal and newborn health services in the coverage cascade: who is benefitted and left behind in accessing better quality health services in Nepal?

BackgroundAntenatal care (ANC) visits, institutional delivery, and postnatal care (PNC) visits are vital to improve the health of mothers and newborns. Despite improved access to these routine maternal and newborn health (MNH) services in Nepal, little is known about the cascade of health service coverage, particularly contact coverage, intervention-specific coverage, and quality-adjusted coverage of MNH services. This study examined the cascade of MNH services coverage, as well as social determinants associated with uptake of quality MNH services in Nepal.MethodsWe conducted a secondary analysis of data derived from the Nepal Demographic and Health Survey (NDHS) 2016, taking 1978 women aged 15–49 years who had a live birth in the 2 years preceding the survey. Three outcome variables were (i) four or more (4+) ANC visits, (ii) institutional delivery, and (iii) first PNC visit for mothers and newborns within 48 h of childbirth. We applied a cascade of health services coverage, including contact coverage, intervention-specific and quality-adjusted coverage, using a list of specific intervention components for each outcome variable. Several social determinants of health were included as independent variables to identify determinants of uptake of quality MNH services. We generated a quality score for each outcome variable and dichotomised the scores into two categories of “poor” and “optimal” quality, considering > 0.8 as a cut-off point. Binomial logistic regression was conducted and odds ratios (OR) were reported with 95% confidence intervals (CIs) at the significance level of p < 0.05 (two-tailed).ResultsContact coverage was higher than intervention-specific coverage and quality-adjusted coverage across all MNH services. Women with advantaged ethnicities or who had access to bank accounts had higher odds of receiving optimal quality MNH services, while women who speak the Maithili language and who had high birth order (≥ 4) had lower odds of receiving optimal quality ANC services. Women who received better quality ANC services had higher odds of receiving optimal quality institutional delivery. Women received poor quality PNC services if they were from remote provinces, had higher birth order and perceived problems when not having access to female providers.ConclusionsWomen experiencing ethnic and social disadvantages, and from remote provinces received poor quality MNH services. The quality-adjusted coverage can be estimated using household survey data, such as demographic and health surveys, especially in countries with limited routine data. Policies and programs should focus on increasing quality of MNH services and targeting disadvantaged populations and those living in remote areas. Ensuring access to female health providers and improving the quality of earlier maternity visits could improve the quality of health care during the pregnancy-delivery-postnatal period.

Investigation of technical quality of antenatal and perinatal services in a nationally representative sample of health facilities in Nepal

BackgroundAccess to routine antenatal and perinatal services is improved in the last two decades in Nepal. However, gaps remain in coverage and quality of care delivered from the health facilities. This study investigated the delivery of technical quality antenatal and perinatal services from health facilities and their associated determinants in Nepal.MethodsData for this study were derived from the Nepal Health Facility Survey 2015. The World Health Organization's Service Availability and Readiness Assessment framework was adopted to assess the technical quality of antenatal and perinatal services of health facilities. Outcome variables included technical quality scores of i) 269 facilities providing antenatal services and ii) 109 facilities providing childbirth and postnatal care services (perinatal care). Technical quality scores of health facilities were estimated adapting recommended antenatal and perinatal interventions. Independent variables included locations and types of health facilities and their management functions (e.g., supervision). We conducted a linear regression analysis to identify the determinants of better technical quality of health services in health facilities. Beta coefficients were exponentiated into odds ratios (ORs) and reported with 95% confidence intervals (CIs). The significance level was set at p-value < 0.05.ResultsThe mean score of the technical quality of health facilities for each outcome variable (antenatal and perinatal services) was 0.55 (out of 1.00). Compared to province one, facilities of Madhesh province had 4% lower odds (adjusted OR = 0.96; 95%CI: 0.92, 0.99) of providing better quality antenatal services, while health facilities of Gandaki province had higher odds of providing better quality antenatal services (aOR = 1.05; 95% CI: 1.01, 1.10). Private facilities had higher odds (aOR = 1.13; 95% CI: 1.03, 1.23) of providing better quality perinatal services compared to public facilities.ConclusionsPrivate facilities provide better quality antenatal and perinatal health services than public facilities, while health facilities of Madhesh province provide poor quality perinatal services. Health system needs to implement tailored strategies, including recruiting health workers, supervision and onsite coaching and access to necessary equipment and medicine in the facilities of Madhesh province. Health system inputs (trained human resources, equipment and supplies) are needed in the public facilities. Extending the safe delivery incentive programme to the privately managed facilities could also improve access to better quality health services in Nepal.

Evaluation of teachers' self-efficacy on integration of eye health education and promotion at basic schools in Solukhumbu district, Nepal: A cross-sectional study.

Many studies have shown that eye health services in Nepal are still far behind in reaching schools. Therefore, the aim of this study is to examine the teacher's self-efficacy for the incorporation of eye health promotion activities. A cross-sectional study design was applied with a self-administrated questionnaire. A total of 292 teachers were randomly selected for this study. Male (153.38) older-aged and Dalit ethnic group (159.81) teachers, as well as teachers who had participated (146.85) in the program, had higher self-efficacy to conduct school eye health-promoting activities than non-participants in schools. But, teaching experience is not determined to get self-efficacy for testing of visual acuity. Teachers with higher qualifications are found to be skillful. The school's eye health program has not been superseded by any relevant legislation. As a result, it's critical to concentrate on provisions that may be included in the school curriculum.

Teacher benchmarking: In the context of university concerning Nepal

The purpose of this paper is to explore the practices of benchmarking teacher competencies in the higher educational institutions in Nepal. The amalgamated paper reviews on practices of benchmarking for Higher Education (HE) teachers among different institution(s) in Nepal; and finds teacher’s professional skills, levels of formal qualification of teachers including content knowledge, professional aspiration, developing a thirst for innovations, and 21st -century teaching skills and its transference to learners as accepted areas to define their competencies. Subsequent exploration of practices, experiences of engaged professionals helped us to define the reality that enables the teacher to enter HE services in Nepal. The study reveals all Universities have set criterion to be fulfilled to enter HE teaching that includes; minimum formal academic years of learning (degree), professional experiences including publications (evidence), and required content knowledge and pedagogical skills (audited through an exam). In addition, ‘acceptance’ among students and higher social capital the ‘political linkage were two non-specified areas with noted privilege for the candidate to join University teaching. These insights signal the need for a concisely defined competency framework for a conflict-free community of practice.

Smart precision agriculture but resource constrained farmers: Is service provision a potential solution? Farmer's willingness to pay for laser-land leveling services in Nepal

Farmers commonly split large, undulating crop fields, even those at similar elevation range or contour, into a patchwork of small sub-plots in plane areas of Nepal. Specifically, to ensure irrigation or rainwater throughout their cultivated rice or wheat growing areas, structures like bunds, dikes, and ditches are commonly built. These structures not only require significant labor hours to build but also incur loss of some portion of productive crop areas. Laser-land leveling (LLL) is one of the precision technologies that can prevent these area losses, save labor costs, and enhance water utilization. However, purchase of LLL system requires significant capital which could be beyond the access of low resource farmers. In this study, we examined the potential of LLL adoption in a form of service provision or fee-for-service basis among farmers in Nepal. Using an appropriate contingent valuation that maintains efficient estimation and consistent response, we found that Nepali farmers’ willingness to pay (WTP) for LLL services averages 1,550 Nepalese Rupees per hour. However, WTP is heterogeneous across farm size—top quantile farmers with relatively higher land acreages have 47% higher WTP for LLL than bottom quantile farmers. Additionally, our interval regression results show positive association of WTP with low irrigation access and with the opportunity cost of land area occupied by bunds and dikes. The results suggest for service provision support programs in LLL adoption to enhance market development of this precision technology in Nepal, specifically focusing land holders with low irrigation access in plane areas.

Improving access to quality family planning services in Nepal and Sri Lanka: insights from a South-South learning exchange.

Nepal and Sri Lanka ministries of health shared best practices and learnings, in a South-South learning exchange (SSLE) to improve access to quality and rights-based family planning services. The SSLE between the two countries followed a five-step methodology designed by the WHO, under the Family Planning Accelerator project. SSLE between the two countries started in January 2020 and is still continuing. Both countries started implementation of the learnings (step 4) at the time of preparing this manuscript (December 2021). An independent consultant from Sri Lanka carried out an evaluation, to inform future SSLEs. The evaluation included a desk review on SSLE and family planning in both countries and key informant interviews with Sri Lanka Ministries Health, WHO CO, external partners. A final evaluation of the outcomes/impact is planned in December 2022. The SSLE resulted in a systematic cross-country transfer of knowledge and implementation of the learnings. Sri Lanka implemented a web-based system for logistics management of family planning commodities and Nepal commenced implementing integrated family planning services in a decentralised environment using a lifecycle approach to improve postpartum family planning uptake. The success of this SSLE is attributed to the rigorous methodology, country-led designing of the learning agenda and process, extensive communication amongst the teams, a focus on outcomes, commitment and leadership by ministries of health in both countries. Learning and technical assistance needs of countries can be met by SSLE if national contexts, availability of resources are considered.

Decade of Inequality between the Rich and the Poor in Utilizing Antenatal Care Services in Nepal (2006-2016)

The utilization of antenatal care service (ANC) in Nepal is in an increasing trend; however, the utilization pattern differs from socioeconomic factors. Issues are the same but the utilizing pattern of ANC is not the same among women of the same age groups. The Sustainable Development Goals (SDGs) has also focused on inclusive and equitable health services, and promised to no one left behind. In this regard, this study aims to explore a decade of inequality between the rich and the poor in utilizing the ANC in Nepal using the three consecutive Nepal Demographic Health Surveys i.e., 2006, 2011 and 2016. Results suggest that women's household economies divide the pattern of ANC utilization. Despite the tremendous progress in health technologies, the utilization of ANC coverage gap between the rich and poor are still prevalent. The evidence from a decade inequality between the rich and the poor suggests that ANC services should be improved in Nepal, especially among the poor women who are concerned about their own health as well as the newborn health.

Community-based management of chronic obstructive pulmonary disease in Nepal-Designing and implementing a training program for Female Community Health Volunteers.

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity and mortality in Nepal. Female community health volunteers (FCHVs) have proven effective in the delivery of reproductive, maternal, and child health services in Nepal and recently in the prevention and management of hypertension and type 2 diabetes. Evidence on their roles in COPD management is not yet available. The aim of this study was to develop, implement, and evaluate a training program for FCHVs regarding COPD prevention and management. The training program was part of a cluster-randomized trial of a 12-month intervention to improve COPD outcomes in a semi-urban area of Western Nepal. A six-day workshop consisting of thirty hours of training was developed for FCHVs. Training materials incorporated introduction to COPD, risk factors and symptoms, COPD status assessment guide for FCHVs, guidance on breathing techniques, and exercises for people living with COPD. Pre- and post-test questionnaires were administered to assess the change in knowledge of FCHVs, post training skills assessment followed by semi-structured interviews assessed FCHVs' satisfaction with the training program. The findings of the pre- and post- test assessments showed a significant improvement in FCHVs' COPD-related knowledge from a median (interquartile range) score of 12 (3-16) before to 21 (21-22) (p<0.001) after the training program. The qualitative assessment revealed the feasibility of FCHVs' training on COPD and their acceptability to deliver the intervention package within the community. It also indicated that implementing future training with an extended period and a few days break in-between could enhance the effectiveness. Training of FCHVs in COPD management is feasible and leads to improvement in knowledge. The motivation shown by FCHVs to deliver the intervention could inform and guide community programs and policies for COPD prevention and management in Nepal and similar settings.

A study of the capabilities and limitations of local governments in providing community services in Nepal

PurposeCorruption and dishonesty in the political and bureaucratic realms have impeded the ability of local governments to provide services and social justice in Nepali society. In light of this, the purpose of this research is to answer the key research question: what are the possibilities and limitations of local government in implementing constitutionally guaranteed rights in order to transform local communities?Design/methodology/approachThis study gathered qualitative data from 14 local governments in seven provinces. A total of 56 in-depth interviews were held with elected representatives, political parties, and government officials at both the national and local levels. Both open-ended and open-structured questionnaires were employed for the interviews.FindingsThe results indicate that capacity is a major constraint for local governments, which should be addressed to achieve successful local governance, inclusive citizen engagement, and strong technical, administrative and fiscal capabilities. Lack of local autonomy, political conflict and social class differences, external engagement, and conservative hierarchic government bureaucracy are major hurdles to growing capacity.Originality/valueThis paper analyses the capacity of newly restructured local governments through qualitative approach. It attempts to understand to what extent the Nepali local governments are capable in delivering the services at the local level as closest unit of the citizens.

Inclusion of children living with disability in early childhood development and education: construction of a stakeholder‐informed framework

School‐level data shows that a large number of Children living with Disability (ClwD) are not accessing Early Childhood Development and Education (ECDE) services in Nepal (Department of Education, 2020). This research explores the factors affecting the inclusion of ClwD in ECDE programs aiming at informing policy, plans and strategies about existing barriers to early intervention and education services for ClwD. Through interviews, focus group discussions with key stakeholders and document reviews, the research identified the interconnection of several organisational and contextual factors created multiple barriers to successful inclusion. Organisational factors were: policy, attitudes, teacher efficacy, resources, coordination, communication processes and parental engagement. Contextual factors were: spirituality, caste, ethnicity, language, economic status, and geographic location. The very interactive nature of organisational and contextual factors resulted in the development of an inclusive education framework to inform future policies.

Utilization of Maternal Health Services in Slum Area of Butwal Sub-Metropolitian City

Background: High maternal morbidity and mortality has been a major public health problem in Nepal which may be due to the low utilization of maternal health services in Nepal. Utilization of maternal services is found very low in slum areas as compared to upscale areas. This study aims to find out the prevalence of utilization of maternal health services and its associated factors in slum areas of Butwal sub-Metropolitan city.&#x0D; Methods: A community based cross sectionalstudy was conducted among 202 women who had given birth to baby within 1 year. Semi-structured questionnaire and face to face interview was done to collect the data. Descriptive as well as inferential statistics were used to analyze the data.&#x0D; Results:The results showed thatabout 81.18% women had taken complete ANC and 34.65% had taken complete PNC services as per protocol of WHO. Multivariate logistic regression showed that respondent education, monthly income, nearest to health care facilities, knowledge level, and women’s autonomy was found to be associated significantly with complete utilization of ANC services. Similarly, Respondent occupation and nearest to health care facilities were found to be associated significantly with complete utilization of PNC.&#x0D; Conclusion: Though ANC utilization was found to be satisfactory but PNC utilization was found very low so more focused should be given to increase the utilization of PNC services in slum area.&#x0D;

Impact of thirteen run-of-river hydroelectric projects on land use land cover and ecosystem services in Nepal

Impact of thirteen run-of-river hydroelectric projects on land use land cover and ecosystem services in Nepal

Cost-effectiveness of psychological intervention within services for depression delivered by primary care workers in Nepal: economic evaluation of a randomized control trial.

Integrating services for depression into primary care is key to reducing the treatment gap in low- and middle-income countries. We examined the value of providing the Healthy Activity Programme (HAP), a behavioral activation psychological intervention, within services for depression delivered by primary care workers in Chitwan, Nepal using data from the Programme for Improving Mental Health Care. People diagnosed with depression were randomized to receive either standard treatment (ST), comprised of psychoeducation, antidepressant medication, and home-based follow up, or standard treatment plus psychological intervention (T + P). We estimated incremental costs and health effects of T + P compared to ST, with quality adjusted life years (QALYs) and depression symptom scores over 12 months as health effects. Nonparametric uncertainty analysis provided confidence intervals around each incremental effectiveness ratio (ICER); results are presented in 2020 international dollars. Sixty participants received ST and 60 received T + P. Implementation costs (ST = $329, T + P = $617) were substantially higher than service delivery costs (ST = $18.7, T + P = $22.4) per participant. ST and T + P participants accrued 46.5 and 49.4 QALYs, respectively. The ICERs for T + P relative to ST were $4422 per QALY gained (95% confidence interval: $2484 to $9550) - slightly above the highly cost-effective threshold - and -$53.21 (95% confidence interval: -$105.8 to -$30.2) per unit change on the Patient Health Questionnaire. Providing HAP within integrated depression services in Chitwan was cost-effective, if not highly cost-effective. Efforts to scale up integrated services in Nepal and similar contexts should consider including evidence-based psychological interventions as a part of cost-effective mental healthcare for depression.

Challenges and Prospects for Providing Radiotherapy Services in Nepal

In Nepal, the incidence of cancer in both males and females increased drastically in the last decade and is predicted to increase as well in the near future. The increase in Cancer burden could be a serious concern due to an underdeveloped national cancer control program. Around 50–60% of cancer patients require radiotherapy at some point during their illness which establishes it as an integral component of comprehensive cancer care. The current status of radiation facilities in the country is so scarce that it will be impossible to address the issue with available resources. It is high time for the authority to formulate a national cancer control program including the development of radiotherapy equipment and human resources. This article discusses the number of radiotherapy facilities, available equipment, and trained manpower in Nepal. Whether the available facilities are as per standard recommendation and will those be enough to handle the increasing load of cancer patients requiring radiotherapy in the future has been emphasized. Along with those challenges, the opportunities for developing radiotherapy facilities in Low Middle-Income countries like Nepal have been stressed out.

Determinants of Maternal Health Care Utilization in Nepal

This study aims to analyze the determinants of maternal health care utilization in Nepal. Maternal health still remains a public health problem in Nepal though it has been improving in the last decade since the number of women seeking antenatal care and opting for institutional delivery has increased. This study is based on Nepal Demographic and Health Survey data of 2016. The sample size consists of 3998 married women aged 15-49 years who had a live birth in the five years preceding the survey. Bivariate analysis is used to examine the association between adequate ANC visits and institutional delivery. A strong association is observed between women’s higher level of education and women involved in non-agricultural occupation with receipt of antenatal care and choosing of institutional delivery. The study findings conclude that there is a significant gap among different sub-groups of women in Nepal in the utilization maternal health care based on factors like women’s age, place of residence, level of education, occupation and wealth status. In order to address the existing gap and variation in ANC service utilization, particular attention should be given to women from less education, poor wealth quintile, living in rural areas, utilization of services among older age group. The results of this study put forward the need for efforts from government bodies and agencies in implementation of appropriate policies and programs to bring an improvement in the use of maternal health care services in Nepal.

Factors affecting utilization of sexual and reproductive health services among women with disabilities- a mixed-method cross-sectional study from Ilam district, Nepal

BackgroundPersons with disabilities can have physical, mental, intellectual, or sensory impairments which can hinder their social participation. Despite Sustainable Development Goals call for “universal access to sexual and reproductive health (SRH)”, women with disabilities (WwDs) continue to experience barriers to access SRH services in Nepal. This study evaluated factors affecting the utilization of SRH services among WwDs in Ilam district, Nepal.MethodsA mixed-method study with 384 WwDs of reproductive age was conducted in Ilam district, eastern Nepal. Quantitative data were collected using a structured questionnaire. Relationships between utilization of SRH services and associated factors were explored using multivariate logistic regression analysis. Qualitative data were collected from focus groups with female community health volunteers and interviews with WwDs, health workers and local political leaders. They were audio-recorded, translated and transcribed into English and were thematically analyzed.ResultsAmong 384 respondents (31% physical; 7% vision,16% hearing, 7% voice&speech,12% mental/psychosocial, 9% intellectual, 18% multiple disabilities), only 15% of them had ever utilized any SRH services. No requirement (57%) and unaware of SRH services (24%) were the major reasons for not utilizing SRH services. A majority (81%) of them reported that the nearest health facility was not disability-inclusive (73%), specifically referring to the inaccessible road (48%). Multivariate analysis showed that being married (AOR = 121.7, 95% CI: 12.206–1214.338), having perceived need for SRH services (AOR = 5.5; 95% CI: 1.419–21.357) and perceived susceptibility to SRH related disease/condition (AOR = 6.0; 95% CI:1.978–18.370) were positively associated with the utilization of SRH services. Qualitative findings revealed that illiteracy, poor socioeconomic status, and lack of information hindered the utilization of SRH services. WwDs faced socioeconomic (lack of empowerment, lack of family support), structural (distant health facility, inaccessible-infrastructure), and attitudinal (stigmatization, bad behaviour of health care providers, perception that SRH is needed only for married) barriers to access SRH services.ConclusionsUtilization of SRH services among WwDs was very low in Ilam district, Nepal. The findings of this study warrant a need to promote awareness-raising programs to WwDs and their family members, sensitization programs to health service providers, and ensure the provision of disability-inclusive SRH services in all health facilities.

Access and utilization of the youth-friendly sexual and reproductive health services in Nepal: What does literature show?

This study has attempted to assess the access and utilization of youth-friendly sexual and reproductive health services in Nepal. Different literature regarding youth-friendly sexual and reproductive health services has been reviewed using online databases. A total of 125 relevant articles were assessed for the study. The literature was categorized and analyzed with five key thematic areas: knowledge on SRH among youths, the prevalence of child marriage and teenage pregnancy, attitudes towards premarital sex, utilization of SRHs, and barriers to utilizing the SRHS. This study has found that youths do not always utilize SRHS. Various barriers exist for providing and using YFSRHs in Nepal. Nepal's adolescents and youths face problems of STIs, HIV/AIDS, early pregnancy and parenthood, difficulties accessing contraception, and safe abortion. The study has also found that many countries have single youth-friendly sexual and reproductive health policies and that utilization of SRHS is also high in those countries. Moreover, this review has also found that because of inadequate knowledge and information on SRHS, Nepalese youths are facing numerous reproductive health problems. Multiple factors contribute as barriers to utilizing the SRHS. Therefore, there is a need for a program to motivate youths to respect their right to access reproductive health information and service, ensure the availability of peer counselors in the health centers, and increase the awareness level of the community so that they can utilize the quality of SRHS.