KATHMANDU, July 10

As the World Population Day is being marked with the theme ‘Vulnerable Populations in Emergencies’ across the globe on Saturday, a comprehensive study reveals that Nepal’s vulnerable population, aged 10-19 years, is still deprived of proper access to adolescent friendly health services.

A recent study conducted by the Centre for Research on Environment Health and Population Activities, in association with Family Health Division under the Ministry of Health and Population and the Country Offices of United Nations Population Fund and United Nations Children’s Fund, has noted that the existing health services and facilities are not accessible, appropriate and acceptable to the adolescents that account for nearly a quarter of country’s population.

Assessing supply side constraints that affect the quality of AFHS and the barriers for service utilisation, the study found that some traditional beliefs and practices actively prevented adolescents, particularly girls, from being able to access facility-based services contributing to a fear of ramifications from parents or community leaders, community gossip or loss of reputation if they were found to be accessing sexual and reproductive health services.

“While most adolescents are aware of some of the physical changes of puberty, comprehensive knowledge about SRH is low and only half of adolescents have discussed puberty with parents or received information through schools,” the study added. Despite strong socio-cultural disapproval of premarital sex, one in five unmarried boys aged 15-24 years report having had sex. On one hand, some studies have suggested that the prevalence of premarital sex among males, particularly in urban areas, is increasing and on the other, the studies noted that one in eight unmarried females had ever had sex. Key supply-side challenges identified by the study conducted among 72 stratified health facilities in different districts include insufficient training and supervision of AFHS providers, inadequate resources to upgrade facility environments to ensure privacy, and lack of monitoring and supervision from district level to support initiation as well as ongoing implementation of the SRH Programme.

The most significant demand-side barriers relate to low awareness of AFHS among adolescents and their own embarrassment seeking SRH services, as well as community-level socio-cultural norms and attitudes regarding adolescent SRH, the study said, identifying an insufficient numbers or maldistribution of health providers as another significant challenge being faced by heath facilities.

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