FEMALE STERILIZATION IN NEPAL - A COMPARISON OF 2 TYPES OF SERVICE DELIVERY

Context: During the last 30 years, outreach camps have played an incre asingly important role in Nepal's family planning program, by bringing sterilization services to mostly rural areas where they otherwise wou ld not have been available. However, some concerns have been raised ab out differences in the social and demographic characteristics and qual ity of care between permanent and seasonal or mobile service delivery sites. Methods: From a nationally representative sample of 8,429 ever- married women aged 15-49 who participated in the 1996 Nepal Family Hea lth Survey samples of 445 women who had been contraceptively sterilize d in hospitals and 372 in camps were compared for their social and dem ographic characteristics, awareness of alternative contraceptive metho ds, first contraceptive method used and regret over having undergone t he procedure. Results: Women who were sterilized in camp settings and those sterilized in hospitals differed in their place and region of re sidence, although both groups were similar in age and parity at the ti me of sterilization. Roughly 92% of hospital clients and 95% of camp c lients knew about at least one temporary contraceptive method. Four ou t of five hospital and camp clients reported that female sterilization was the first method they had ever used (80% and 82%, respectively). Nearly 12% of women who were sterilized in hospitals and 10% of women who underwent the procedure in camps expressed regret. Conclusions: Ca mps do not imply less careful screening of sterilization clients or th e provision of inferior qualify services and they represent an importa nt means of meeting couples' demand for sterilization services in area s where hospital-or clinic-based services are not available throughout the year.