Process Evaluation of the Implementation of the Minimum Initial Service Package for Reproductive Health in Nepal

When earthquakes struck Nepal in the spring of 2015, 1.4 million women of child-bearing age were affected. 900,000 were pregnant. The Minimum Initial Service Package (MISP) is designed for them—a set of activities, it outlines essential sexual and reproductive health support and plans for comprehensive services.

In September of 2015, we found that all MISP services and priority activities were largely available in both Kathmandu (ruban) and Sindhupalchowk (rural). Some services were only partially available, though and others were of questionable comprehensiveness and quality.

Recommendations:

• Establish a fund to finance emergency preparedness activities
• Strengthen RH coordination
• Address supply chain challenges
• Strengthen the GBV care and referral systems
• Facilitate activities to prevent maternal and newborn death and disability
• Strengthen HIV prevention and treatment
• Improve community awareness
• Ensure culturally appropriate menstrual hygiene products
• Engage at-risk groups, including adolescents, and provide appropriate services
• Invest in quality comprehensive RH services