Columns
A case for sexual and reproductive health
Although Nepal has committed to protecting women, many lack access to SRH rights.
Ojaswi KC
In the span of six weeks, two of my beloved female relatives were diagnosed with severe reproductive health conditions: One with a tumour in her uterus and the other with stage two breast cancer. The news came as a shock to the family and friends. Both diagnoses could have been detected earlier with preventive care. However, like many other women, they were not encouraged to seek regular screenings.
Following the diagnosis, numerous myths and misconceptions about these organs surfaced. One of the relative’s diagnoses had some speculating that her being child-free had somehow affected her uterus. If the argument had any logic, another relative who breastfed both of her children should have been immune to breast cancer. This unfounded assumption is indirectly used as a cautionary tale for women in the family who choose to be child-free, whether by choice or for medical necessity.
Despite medical evidence, outdated beliefs on sexual and reproductive health (SRH) persist in Nepali households. These ideas passed down through generations actively shape how women seek (or avoid) medical care. Even medical practitioners sometimes dismiss symptoms, leaving women to second-guess their pain or delay checkups. Nonetheless, the incident also shaped conversations on sexual and reproductive health in my family, where it was once whispered or avoided altogether.
In some parts of Nepal, hospitals remain understaffed with scarce resources for preventive care related to sexual and reproductive health. Women who could receive treatment earlier only know about sexual and reproductive issues later in life—when it is too late. But this isn’t just limited to healthcare. It’s about a system that continuously fails women at every level. Women’s rights are being rolled back, and the fight for gender equality is being pushed aside worldwide. Every year, the same promises about improving women’s rights surface; however, these are seldom realised.
Some argue that enough has been done already, that women now have choices, that reproductive healthcare is accessible and that feminists should stop ‘complaining’. But those who say this aren’t the ones waiting in overcrowded hospitals only to be turned away simply because funding has run dry.
Following International Women’s Day (8 March), global leaders in the 69th session of the United Nations Commission on the Status of Women (March 10-21) are set to review the Beijing Declaration and Platform for Action (BPfA). The BPfA is a foundational commitment pledged in 1995. Almost 30 years after the commitment, sexual and reproductive healthcare is still out of reach for many women. Instead of moving forward with robust initiatives, the government is cutting off budgets vital for women’s health as well as hospital staff and policies. For instance, family planning programmes in district hospitals have suffered in the current fiscal year as the government didn’t allocate any budget to continue them.
The recent suspension of USAID by the US government has sparked debates; some celebrate it as a step away from foreign influence, but for a country like ours, it means job losses and the collapse of critical healthcare services. Following the order, 36 staff nurses who were recruited to promote exclusive breastfeeding across 18 federal and provincial hospitals were let go, leaving already grappling maternal health programmes in crisis. Yet, some still argue that Nepal has made ‘enough’ progress in reproductive healthcare.
Even though there have been positive initiatives like the recent HPV vaccination campaign, which aims to protect over 1.6 million adolescent girls from cervical cancer, vaccination alone won’t fix a system where women’s routine health checkups are inaccessible and education about reproductive health is limited.
Sexual and reproductive health doesn’t only concern women. It affects families and communities. The government must, therefore, move beyond symbolic gestures and invest in real solutions to bring change in women’s lives. It must make screening tests for cancer accessible and prioritise sexual and reproductive health programmes like family planning and safe motherhood in the upcoming fiscal year. Moreover, how we discuss or ignore women’s health in our homes reflects the broader gaps in policy and services. If we truly want change, the policies must go beyond the papers and improve the ground reality of women.
Advocacy for women’s sexual and reproductive health should be centred around our homes and community. We must also develop a robust sex education curriculum and teaching pedagogy. People should be taught about the consequences of the patriarchal belief system and internalised shame surrounding sexual and reproductive health.
It is about time we built a healthcare system that prioritises women not just during crises but even before they strike. If we don’t act now, the cycle of losing our women to a system that refuses to protect them before it’s too late will continue.