**This publication is a follow-up research in Nepal led by APA Member Amit Timilsina, from recommendations in APA's CSO SRHR self-care initiatives in Asia Pacific publication. You can find the advocacy toolkit here.
Introduction
Sexual and Reproductive Health and Rights (SRHR) have been promoted globally, yet sexual
and reproductive health (SRH) interventions are seldom evaluated from the perspective
of service users and service providers. Very little is known about whether and why various
target groups including general women are (or are not) practicing SRH -related self-care
practices. This study explored SRH self-care practices and facilitators and barriers to the
adoption of SRH self-care among reproductive-age women of Nepal.
Methods
In this descriptive qualitative study, we conducted in-depth interviews in June 2022 with ten
married women of reproductive age (service users) and four SRHR service providers (program
managers and health service providers) in Nepal. Thematic analysis was conducted
for data analysis.
Results
We found that commonly practiced self-care practices were self-administration of contraceptives,
self-management of pain, self-monitoring of pregnancy, self-awareness and seeking
medical abortions (tele-abortion), self-medication for pre-exposure prophylaxis for HIV,
and self-testing for HIV and pregnancy. The multi-level barriers to SRH self-care were poor
knowledge and perceived lack of need for SRH self-care, limited access, and negative
behaviors from the service providers. The program-related barriers included lack of evidence,
limited financial resources, lack of accountability, and limited knowledge and skills
among service providers on SRH self-care measures. Peer support, an increasing number
of service sites, and access to and use of digital (health) tools emerged as the facilitators of
SRH self-care.
Conclusions
The findings of this study suggest that addressing barriers such as poor knowledge, limited
access, and negative attitudes while leveraging facilitators such as peer support and digital
tools is essential for promoting and enabling effective SRH self-care among women. Population-
wide awareness programs supplemented by increasing service sites are essential for
increasing SRH self-care practices.
