Adolescent Contraception in Public Health Policies and Practices in Nepal: A Narrative Review

ABSTRACT

Policies play a critical role in creating an enabling environment for adolescent contraceptive use, a key intervention for reducing adolescent pregnancy and its associated health and socioeconomic consequences. This review assessed the extent to which Nepal's national policy framework supports adolescent contraception and explored implementation and coherence gaps across the health system. A narrative review of national health policy documents developed, endorsed, or revised by the Government of Nepal between 1998 and 2025 was conducted following the 1994 International Conference on Population and Development Program of Action. Thirty documents, including constitutional provisions, policies, strategies, Acts, regulations, and program guidelines related to adolescent contraception, were systematically reviewed using the World Health Organization's health system building blocks framework. The review found that Nepal has progressively strengthened its policy commitment to adolescent contraception through a rights‐based and adolescent‐responsive framework aligned with international commitments. Successive policies consistently promote equitable access to adolescent‐friendly contraceptive services and define responsibilities across the federal health system, demonstrating strategic policy coherence. However, gaps in operational coherence and implementation persist across the health system building blocks, including governance, service delivery, financing, the health workforce, commodity management, and health information systems. Limited operational guidance, weak intergovernmental coordination, the need for regular policy review and updates, and insufficient adolescent engagement continue to constrain effective policy implementation. Although Nepal has established a comprehensive policy foundation for adolescent contraception, future efforts should focus on strengthening operational coherence and ensuring consistent implementation across the federal health system to improve equitable access to adolescent contraceptive services.