Who Decides?

A major proportion (29.6%) of the total population of Nepal comprises young people aged 10-24 years while among them 67.6% fall under the adolescent group (1). They have unique needs and demands as they face the transition from childhood to adulthood, seek a wide range of information on sexual and reproductive health (SRH), and lie in the most vulnerable phase of their lives. They undergo physical, emotional, and social changes which influence their feeling, thinking, and decision-making process. As per the current research experience of the organization in collaboration with four organizations of deploying the chatbots to communicate with SRHR experts and other LLM to 5,000 young people, the majority of the chatbot users had queries surrounding safe abortion and contraceptives. The noticeable trends of such queries regarding the thematic areas of Sexual and Reproductive Health and Rights (SRHR) through the chatbot interface make us clear about the pressing need for information availability to adolescents and young people. 

A total of 1165 adolescents had reported HIV infections (3.1% of total HIV-infected people) (2). Furthermore, with the national CPR of 41% (3), it seems difficult to reach the SDG target of reaching 75% CPR by the end of 2030. Also, the Adolescent Fertility Rate (AFR) is 71 per thousand, and 14% of women aged 15-19 have been pregnant. 45% of pregnancies in Nepal are unintended pregnancies while 65% of them end in abortion (4). The number of abortions per year is around 3,32,000 abortions among which 58% of them undergo unsafe abortions (5). Moreover, each passing day 720 unsafe abortion is done by women and adolescents (5). This number might go high until and unless adolescents and young people access the right information in a convenient way. This assumption is based on the fact that even after legalized abortion in 2002 in Nepal, 59% of reproductive-age women are unaware of its legality while 52% of women are unaware of the service sites (3). Moreover, the social stigma associated with SRH often prevents adolescents from seeking information from reliable sources via in-person interaction.
The limited access to SRH information and communication is due to the unfavorable socio-cultural environment, which prevents adolescents from seeking information and services due to fear of social stigma and labeling. The stigma associated with adolescents seeking information on SRH discourages them from discussing it with guardians and healthcare providers which is one of the major factors for high adolescent pregnancy in Nepal.

Although there are mobile apps and websites, they are difficult to navigate and access information from, and a lot of segregated information from various platforms makes it harder for individuals to effectively trust a source from where contextual information can be received through a single portal. Thus, the limited information on SRH, related stigmatization, and service unavailability are the root causes of the core problems.

1. National Population and Housing Census 2021

2. National Center for AIDS and STD Control 2020

3. Nepal Demographic Health Survey 2022

4. UNFPA’s State of World Population 2022

5 CREHPA 2017

To address the above-stated problem of lack of reliable information and its related consequences, we created a fundamentally new, efficient, and inclusive approach through a portal for strengthening access to the right, safe, and quality information for people to help them make informed decision-making. A user-centric portal is designed to guide individuals through a personalized questionnaire. This process aims to recommend the most suitable contraceptive method and safe abortion service centers based on their specific needs, preferences, and circumstances. Also, on our portal, the information is generated by the experts of SRHR who have been working in the field for several years in Nepal so that the information is of quality, non-discriminatory, and inclusive to young individuals, adolescents, and vulnerable as well as marginalized groups. The current policies, acts, laws, provisions, and cultural diversities of the nation are taken into consideration while feeding information on the portal. So comprehensive and accurate information about safe abortion and contraceptives can be provided through a dedicated portal to ensure bridging the gap of knowledge including the information regarding the available rights, choices, and service sites. Moreover, the problem does not revolve around knowledge availability only but the misinformation/ myths surrounding contraceptives and safe abortion are too high which can also be dealt with by equipping them with scientific and factual information around these thematic areas. The unsafe practices result in unintended pregnancies and related complications. In addition, as many people fear due to stigmatization, confidentiality, and privacy, anyone can obtain information in an accessible and convenient way.

Additionally, users can navigate to dedicated sections for different topics, ensuring they find exactly what they are looking for. The most interesting and major advantage of the portal is the personalized and individual-centric information through which one can identify the right contraceptive device for himself or herself at the moment and those intending to abort can identify the safe abortion service center. Moreover, an intuitive search function directs users to relevant articles, videos, or discussions. Additionally, arrangements will be made for professional staff to continually update content, ensuring it remains current and relevant. The integrated feedback system allows users to flag any comments, suggest improvements, or share their comments. The portal is an interesting way to advocate, share individual experiences, and provide current data, facts, and figures.

There has been a massive rise in the use of smartphones in every corner of the country which can be an efficient and rewarding way of reaching the unreached through the portal. So we intend to address the unmet sexual and reproductive health needs of all young individuals and adolescents in Nepal including the LGBTQ (lesbian, gay, bisexual, transgender, and queer) community and persons with disabilities. Because Nepal is a patriarchal society, access to even basic human rights has always been a challenge for those who are not seen as normal by our society. As people who identify as sexual and gender minorities, they fight for their identity, people with disabilities fight for basic human rights, and women fight for equality, it is impossible for these people to openly discuss their matters and raise their voices to attain their rights. For them to be able to stand up for their rights and receive the required services, the portal is helping them be equipped with the right information from the experts of SRHR, is reliable, and relevant with a gender-responsive approach. We are prioritizing equal opportunities for participation, and engagement of diverse groups of people and are creating to be reliable for the national context.

Visible Impact is a youth-led organization working for the sexual and reproductive health and rights of young people, women, and girls by unleashing their social and economic leadership through beneficiary-partnered interventions. Along with this, it ensures and promotes meaningful and inclusive youth participation and empowerment. Visible Impact has been working to ensure access to quality, stigma-free, and youth-friendly sexual and reproductive health and rights to a large number of populations throughout the country through various campaigns and initiatives.

Visible Impact has been collaborating with Diyo.AI as a downstream partner which is a company, excelling in localizing artificial intelligence (AI) solutions to make technology accessible and relevant to the Nepalese context. Their team of experienced research scientists and engineers specializes in web-based applications, allowing them to create tailored AI solutions. Diyo.AI has a strong track record in developing websites for enterprises and building Software as a Service (SaaS) web applications.

Both organizations have been working together and bringing out the expected results. The organization complements each other in the matter of their expertise and experiences in the field of SRHR and technology. With extensive experience on working with and for the community people over a long history, these organizations are capable of designing, prioritizing, and implementing solutions for the target people. Thus this team is the right team to design and deliver the solution to the people for making them able to make informed decisions.

Since we started to provide information as a service regarding safe abortion and contraceptive devices from direct personal one-on-one and our Facebook page which has 12,000 likes and we have interacted with around 5000 people. Since our interaction, we have prepared the question set which helps to speedify the process of recommendation for safe abortion and contraceptive devices. Currently, we are getting many more queries and for the inclusion of more individuals without compromising confidentiality we are in the process of deploying the interactive web portal with a dynamic content management backend and able to handle the large volume of audience at once.

Traditional platforms offer ge­neric information, but our approach is different. We have enginee­red a transformative user experience that includes a personalized questionnaire. There are no such platforms created in Nepal. This tailored pathway ensures that each individual receives recommendations on contraceptive me­thods and safe abortion service centers by specifically aligning with their unique needs and circumstances. Our platform is distinguished by its extensive experience. We don't just source information; instead, we have a dedicated team of experienced SRHR e­xperts in Nepal who meticulously curate­ it. With their vast experience, they ensure that the content is of high quality, non-discriminatory, and inclusive while­ respecting the laws, provisions, and cultural nuance­s of the nation. Our portal acknowledge­s the existing stigma surrounding reproductive­ health and ensures confidentiality. Users can confidently navigate­ this digital space, knowing that their journey will be kept private and dignified.

Impact goal for the next year:

1. To ensure improved access to our platform in Nepal, our goal is to enable 5,000 individuals to receive personalized contraceptive­ and safe abortion service recommendations by maintaining their confidentiality. This initiative supports SDG 3 by aiming to enhance access to reproductive health services.

Impact goal for the next 5 years:

1. Ensure safe Sexual and Reproductive Health and Rights (SRHR) of all people with enabled decision-making capacity on all their matters concerning sexual and reproductive health.

The organization works closely with the government throughout the year. The strong networks within the government and the recognition are one of the excellence that the organization has earned through its work, commitment, and collaboration with the government. People in Nepal trust the government-owned and government-advised informations thus the collaboration will be done with the government for the financial sustainability. The portal will be nationally recognized, validated and accomodated into the national portals. Furthermore, the reach will increase drastically through the government networks and peoples' trust. Moreover, the collaboration will be done with like-minded organizations in Nepal to integrate the portal into their existing systems so that the reach and sustainability will be maintained.