Unsafe abortion�s significant contribution to maternal mortality and morbidity was a critical factor leading to\r\nliberalization of Nepal�s restrictive abortion law in 2002. Careful, comprehensive planning among a range of\r\nmultisectoral stakeholders, led by Nepal�s Ministry of Health and Population, enabled the country subsequently to\r\nintroduce and scale up safe abortion services in a remarkably short timeframe. This paper examines factors that\r\ncontributed to rapid, successful implementation of legal abortion in this mountainous republic, including deliberate\r\nattention to the key areas of policy, health system capacity, equipment and supplies, and information\r\ndissemination. Important elements of this successful model of scaling up safe legal abortion include: the preexistence\r\nof postabortion care services, through which health-care providers were already familiar with the main\r\nclinical technique for safe abortion; government leadership in coordinating complementary contributions from a\r\nwide range of public- and private-sector actors; reliance on public-health evidence in formulating policies\r\ngoverning abortion provision, which led to the embrace of medical abortion and authorization of midlevel\r\nproviders as key strategies for decentralizing care; and integration of abortion care into existing Safe Motherhood\r\nand the broader health system. While challenges remain in ensuring that all Nepali women can readily exercise\r\ntheir legal right to early pregnancy termination, the national safe abortion program has already yielded strong\r\npositive results. Nepal�s experience making high-quality abortion care widely accessible in a short period of time\r\noffers important lessons for other countries seeking to reduce maternal mortality and morbidity from unsafe\r\nabortion and to achieve Millennium Development Goals.
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