By Srishti Shah, Social Behavior Change Communication Specialist, MOMENTUM Private Healthcare Delivery Nepal

“Adolescents cannot openly seek support and information on contraceptive services because of how society views and treats premarital sex and adolescent sexual behavior,” explains Archana Neupane, adding, “because we cannot address their problems and queries in time, they face greater risks, such as unplanned pregnancies and unsafe abortion.” Archana co-owns Neupane Medical Hall and is also a service provider at the private health pharmacy in Bardibas Municipality in Madhesh Province, Nepal. She has been operating the pharmacy for two years. Before this venture, she owned and operated a clinic in a nearby rural area. Despite being aware of these barriers to care, Archana admits that she was previously not equipped with the skills necessary to support the contraceptive needs of adolescents and young people.

Archana’s pharmacy is one of the 105 private facilities that is partnering with MOMENTUM Private Healthcare Delivery to receive technical and managerial support to improve accessible and quality contraceptive services for adolescents and young people in Karnali and Madhesh provinces. Nearly 25 percent of all contraceptive services in Nepal are provided by the private sector, and this figure is even higher among people ages 20-24 years (NDHS 2016). Given the private sector’s role in providing health services to young people, it is important to support providers like Archana to better understand adolescents’ needs and how to address them with person-centered care.  Privacy and high-quality counseling are priorities for providers delivering adolescent-responsive services.

On average, Archana’s pharmacy receives 239 family planning related client visits per month, of which nearly one-fourth are adolescents (15-19 years) and more than half are young adults (20-29 years). In a nearly one-year period, 44,309 adolescents and 106,828 young adults obtained a short-acting contraceptive method from private sector facilities and pharmacies in Nepal that partner with MOMENTUM.

Archana was one of over 100 private health sector providers who participated in a MOMENTUM training on adolescent sexual and reproductive health carried out in November and December 2021.  The training focused on how to deliver adolescent-responsive contraceptive services through high-quality counseling and respectful and dignified treatment. It used interactive role plays and group exercises which enabled providers to reflect on their own experiences as adolescents, reminding them of the vulnerability of this particular time in young people’s lives.

The knowledge and skills from the training have helped Archana counsel adolescents and young people at her clinic who often refer their friends to her.  “Unlike providers from other health facilities, Archana and other providers at Neupane Medical Hall treat clients with care and respect. I think Archana is aware of my needs as she shared information with me about all the queries I had in mind,” shared Madhu, a 20-year-old woman originally from Sundarpur, a nearby village. Madhu received Archana’s counseling services after being referred by friends and family members. Madhu came to the pharmacy for some information on family planning and reproductive health which she feels she will need once she gets married. She recalled her school days and how her teachers skipped the chapters on sexual and reproductive health as they made everyone uncomfortable. She plans to share the information that she received from Archana with her close friends who have similar questions but don’t know where to get reliable information.