Knowledge and utilization of family planning and safe abortion services among married women of reproductive age in the Raute community of Nepal: A census-based cross-sectional study
- 1Central Department of Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
- 2School of Public Health, Patan Academy of Health Sciences, Lalitpur, Nepal
- 3Department of Public Health, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal
Abstract
Raute the last nomadic hunter-gatherer marginalized indigenous group face disproportionate and persistent barriers to reproductive health services, including family planning and safe abortion. The lack of the pre-existing population-level quantitative reproductive health data limits the ability of health authority to design cultural-sensitive health services. This census-based cross-sectional study enrolled all 192 eligible married women of reproductive age in the Raute community of Parshuram Municipality, Dadeldhura district, Sudurpaschim Province, Nepal. Data was collected through structured interviews, and analyzed in IBM SPSS version 16. Results showed more than half of participants (53.6%) currently used family planning, with injectable contraceptives being the most common method (42.7%), followed by female sterilization (33.0%) and implants (24.3%), while condom use was negligible at 1.0%. Among non-users (46.4%), 97.7% cited lack of interest as the primary reason. Knowledge of safe abortion services was reported by 61.5% of women, yet only 8.3% had ever accessed such services, and awareness of Nepal's national safe abortion policy was critically low (10.4%). The independent predictor of current family planning utilization in the adjusted logistic regression model was non-utilization of safe abortion services (AOR = 4.275; 95% CI: 1.145–15.954; p = 0.030), suggesting that contraceptive use and abortion service use represent alternative reproductive management strategies in this community. Younger age (≤30 years) and urban residence were significantly associated with safe abortion use in bivariate analysis but were attenuated after adjustment. These findings reveal critical gaps in reproductive method diversity, safe abortion policy literacy, and male partner engagement. Community-based mobile outreach tailored to nomadic movement patterns, legal literacy programs in the local language, and strategies to engage male partners are indicated as priorities; their design should be informed by qualitative, community-engaged research into the cultural and relational dynamics that a structured survey cannot capture.
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BibTeX
@article{joshi2026knowledge,
title = {{Knowledge and utilization of family planning and safe abortion services among married women of reproductive age in the Raute community of Nepal: A census-based cross-sectional study}},
author = {Manoj Joshi and Anjali Bhatt and Anusha Sharma and Milan Thapa and Sudip Khanal},
journal = {PLOS Global Public Health},
year = {2026},
month = sep,
doi = {10.1371/journal.pgph.0006580},
url = {https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006580},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Knowledge and utilization of family planning and safe abortion services among married women of reproductive age in the Raute community of Nepal: A census-based cross-sectional study
AU - Manoj Joshi
AU - Anjali Bhatt
AU - Anusha Sharma
AU - Milan Thapa
AU - Sudip Khanal
PY - 2026
DA - 2026/09/02
JO - PLOS Global Public Health
DO - 10.1371/journal.pgph.0006580
UR - https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006580
AB - Raute the last nomadic hunter-gatherer marginalized indigenous group face disproportionate and persistent barriers to reproductive health services, including family planning and safe abortion. The lack of the pre-existing population-level quantitative reproductive health data limits the ability of health authority to design cultural-sensitive health services. This census-based cross-sectional study enrolled all 192 eligible married women of reproductive age in the Raute community of Parshuram Municipality, Dadeldhura district, Sudurpaschim Province, Nepal. Data was collected through structured interviews, and analyzed in IBM SPSS version 16. Results showed more than half of participants (53.6%) currently used family planning, with injectable contraceptives being the most common method (42.7%), followed by female sterilization (33.0%) and implants (24.3%), while condom use was negligible at 1.0%. Among non-users (46.4%), 97.7% cited lack of interest as the primary reason. Knowledge of safe abortion services was reported by 61.5% of women, yet only 8.3% had ever accessed such services, and awareness of Nepal's national safe abortion policy was critically low (10.4%). The independent predictor of current family planning utilization in the adjusted logistic regression model was non-utilization of safe abortion services (AOR = 4.275; 95% CI: 1.145–15.954; p = 0.030), suggesting that contraceptive use and abortion service use represent alternative reproductive management strategies in this community. Younger age (≤30 years) and urban residence were significantly associated with safe abortion use in bivariate analysis but were attenuated after adjustment. These findings reveal critical gaps in reproductive method diversity, safe abortion policy literacy, and male partner engagement. Community-based mobile outreach tailored to nomadic movement patterns, legal literacy programs in the local language, and strategies to engage male partners are indicated as priorities; their design should be informed by qualitative, community-engaged research into the cultural and relational dynamics that a structured survey cannot capture.
SN - 2767-3375
ER -