The aim of our expedition to the Kalikot District in the far west of Nepal was to understand the reproductive behaviour in the region, and the use of family planning methods. The reason for choosing this particular area of healthcare is because maternal health has such a huge impact on the rest of the family; large numbers of children leads to a higher infant mortality, malnutrition, and lower levels of education. For the mother, there are also significant risks attached to having large numbers of successive pregnancies.
We interviewed 100 men and women within the reproductive age group from various villages within the district. We managed to collect a large amount of data, which has been painstakingly analysed, and is in the process of being written up for publication.
One of the most striking findings was the large number of births in the district. If you look at Graph1 you can see that for every decade of reproductive life, women have approximately 2 children. If family planning were being used when families were complete, you would expect to see the graph tail off much lower. This indicates little or ineffective family planning.
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| Graph 1 - Average parity in each age group |
Many of the families had experienced an infant or child death – 15% of our sample. The commonest causes were preventable such as chest infection, diarrhoea, and malnutrition. But most often, people did not know the cause of death, unable as they were to get to a doctor before the child died.
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| Graph 2 - Causes of childhood deaths |
Knowledge of family planning was mixed, however a 30% of women had never even heard of family planning – a shocking figure when you consider the importance of its use.
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| Graph 3 - Knowledge of family planning |
When we looked into education levels, it became clear that education has a direct impact on knowledge of family planning, and the incredibly low level of education in this area has had an impact on the use of family planning.
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| Graph 5 - Levels of education |
These findings are just a few of the mountain we compiled, but show a huge need for improved family planning in the area. I plan on presenting the overall findings to the Nepalese Family Planning Association (NFPA) in late March, and we hope to raise more funds this year to help train healthcare workers in the area specifically in family planning techniques.If you are able to offer a donation, your money will affect thousands of lives, by empowering women to take control of their family size. To donate please go to
Kate Yarrow, Doctors for Nepal Founder and Chairman of Trustees
