The government has integrated Family Panning services into the primary health care network - through Female Community Health Volunteers (condom and pills), at outreach clinics (condom, pills and injectables), Maternal and Child Health clinics at district Headquarters, and at different levels of health facilities. Long Acting Reversible Contraceptive (IUCD and Implants) and permanent methods are provided at mobile clinics, at S/HP and PHCCs and above. The Nepal Health Sector Support Programme II includes targets to improve the availability of family planning services through rural health facilities with at least five family planning services is targeted at 60%. However, in practice, FP services are often unavailable due to commodity stock outs, absent health workers and overcrowded facilities that reduce the quality of counselling and services offered, particularly follow up. A key challenge facing remote districts is insufficient health workers to adequately staff across all service channels. In some districts, maternal and child health workers (MCHWs) have been ‘promoted’ to ANMs in title but lack the formal technical training and therefore are unable to provide FP methods, especially long acting reversible contraceptives (LARC). Communities living in the hill regions cite long travelling times and prevalent myths and misconceptions about FP as key barriers to accessing services and clients from disadvantaged groups do not access services as they assume they will be mistreated (NHSSP PEER).

Under this project, nurses will be called as MS Ladies ( Marie Stopes Ladies) and will be self-employed and charge users fee for their services to generate income in order to ensure the sustainability of the services to the community. She will offer all five methods of modern family planning methods (STM and LARC). Sunaulo Parivar Nepal will train and quality assures the nurses, as well as providing marketing support during an establishment phase.The best learning practices of from the model will be documented and disseminated.


This project proposes to pilot a nurse entrepreneurship franchise model in 8 districts where the unmet need of FP is very high and prevailing CPR was low.

Project Districts: Darchula, Rukum, Jajarkot, Gulmi, Tanahu, Baglung, Sindhuli and Terhathum

A social franchise encompasses a network of private health practitioners linked through contracts to provide socially beneficial services under a common brand. Generally social franchises have the following characteristics - outlets are operator-owned; payments to outlets are based on services provided; services are standardized and clinical services are offered with or without franchise-branded commodities. Marie Stopes International globally is the second largest social franchise. Marie Stopes International has been applying this franchise approach around 20 counties of the globe. MS-Lady is famous in some countries.