Evidence collected during the COVID-19 pandemic in Nepal through interviews with health workers and health coordinators shows a reduction in service availability, service utilization, and quality of care for sexual and reproductive health services . The medical professionals and budget were focused on combating the virus leading to a reduction in other health services. Interim Guidelines was developed by the Reproductive Health sub-cluster, Family Welfare Division (FWD), and approved by the Ministry of Health and Population (MoHP) on May 21, 2020, for the continuation of essential Reproductive Health (RH) services and to minimize the impact of COVID-19 on Reproductive, Maternal, Newborn, and Child Health (RMNCH).
The guideline [2, 3] provisions the following points related to Safe Abortion Services-
- To provide Medical Abortion (MA), Manual Vacuum Aspiration (MVA), second-trimester abortion, and Postabortion Care (PAC) services and Post-abortion FP following National protocol and strict Infection Prevention and Control (IPC) and PPE guidelines.
- To mobilize Female Community Health Volunteers (FCHVs) to provide information and referrals for Safe Abortion Services (SAS), including MA.
- To mobilize trained health service providers from NGO and private sector for providing home-based MA services.
- To provide distance Health Education through digital and call channels – on Safe Abortion Services to clients seeking information, service availability, options, drug regimen and symptoms of complication.
- To provide information on availability of Safe Abortion Services by health service providers and counselors.
- To allow all chemists and pharmacists licensed by the Department of Drug Administration (DDA) and licensed service providers to store and distribute MA drugs approved by DDA.
- To promote MA self-care for MA service to reduce unnecessary health facility visits.
Following the endorsement of the guidelines, Ipas, FPAN, MSI, and PSI used various communication strategies to orient the stakeholders on the guidelines for the implementation in different contexts and with a diverse service delivery mechanism. The partners decided to collectively review the learning from the guideline implementation and generate evidence for a way forward. This brief contains the approach, learnings, and way forward.