A Baby Later, Not Now: Why Many young women in Nepal still lack access to family planning

Zenana Desk

Kathmandu (Nepal), September 21, 2026: Nepal has made progress in expanding access to family planning, but a substantial gap remains among its youngest married women.

A new study examining nationally representative data from Nepal has found that nearly three in 10 adolescent girls and young women aged 15–24 still had an unmet need for family planning in 2022.

The study, published in the Maternal and Child Health Journal on August 11, analysed data from the 2011, 2016 and 2022 Nepal Demographic and Health Surveys to examine how family-planning needs among young women have changed over time and which groups continue to face greater gaps.

The researchers describe unmet need for family planning as the gap between a woman’s reproductive intentions and her use of contraception. In practical terms, it can include women who want to delay their next pregnancy or do not want another pregnancy but are not using a contraceptive method.

Progress has been made — but the gap has not disappeared

Nepal’s overall unmet need for family planning has declined substantially over the past decades.

According to the 2022 Nepal Demographic and Health Survey, unmet need among women of reproductive age fell from 32% in 1996 to 21% in 2022.

The new research shows that progress among adolescent girls and young women has also been substantial.

But the remaining gap is significant.

For a 20-year-old woman who wants to postpone pregnancy, for example, having a contraceptive method available somewhere in the country does not necessarily mean that she can obtain it easily, use it consistently or make the decision independently.

That distinction is at the heart of the issue.

Family planning is also about who gets to make the decision

Access to contraception is often discussed as a question of availability: Is a health centre nearby? Are contraceptive methods in stock? Are services affordable?

For young married women, however, the decision can involve another layer — who has a say in when a pregnancy should happen.

Earlier research from Nepal has identified factors such as age, education, place of residence, household circumstances, number of children, approval from a husband and communication between spouses as being associated with unmet family-planning needs.

The new study adds to that body of evidence by specifically examining adolescent girls and young women over three rounds of national survey data.

Why young women need a different conversation

A young married woman may want to delay her first pregnancy, space her children or stop having children altogether.

Her reasons can vary.

She may want to continue her education. She may be working. She may already have a young child. She may be concerned about her health or finances. Or she may simply not want another pregnancy yet.

But the ability to make that decision depends on more than knowing that contraception exists.

Young women need accurate information, confidential services, affordable methods and the freedom to discuss contraception without fear or stigma.

The study’s focus on women aged 15–24 is therefore important. Adolescence and early adulthood are periods when reproductive decisions can have long-term consequences for education, employment, health and family life.

Not every unmet need looks the same

The researchers also examined different forms of unmet need, including the need to space births and the need to limit future births.

That distinction matters.

A woman who wants to wait three years before having another child has a different reproductive intention from a woman who does not want any more children.

Treating both situations simply as “contraceptive use” can hide what women are actually trying to achieve.

Understanding whether young women want to postpone, space or stop pregnancies can help health programmes provide services that correspond to their individual needs.

Why the remaining gap matters

Unmet family-planning needs can contribute to unintended pregnancies, which can affect maternal and newborn health and may interrupt education or employment.

For younger women, the consequences can extend beyond healthcare.

An unplanned pregnancy can alter whether a girl remains in school, whether a young woman can continue working and how early she assumes long-term caregiving responsibilities.

This is why family planning is not only a reproductive-health issue.

It is also connected to education, economic independence, gender equality and the ability to make decisions about one’s own future.

Nepal’s next challenge may be reaching the women who remain outside the system

The decline in unmet need shows that Nepal’s family-planning programmes have made progress.

The remaining gap raises a different question:

Who are the young women who are still being missed?

The answer is unlikely to be the same everywhere.

Young women living in remote communities may face physical barriers to health facilities. Others may have access to services but lack privacy. Some may know about contraception but worry about side effects. Others may face opposition from partners or family members.

The researchers’ findings therefore point towards the need for more targeted, youth-centred approaches rather than assuming that a single family-planning strategy will work equally well for every young woman.

The choice behind the statistic

“Unmet need” can sound like a technical public-health term.

Behind it is a much simpler question:

Can a young woman decide if and when she wants to become pregnant — and can she get the support she needs to make that decision safely?

Nepal has moved considerably closer to answering that question.

But with nearly three in 10 young women in the study population still experiencing unmet family-planning needs in 2022, the latest research suggests that access alone is not the end of the story.

The next challenge is making sure that young women can turn reproductive intentions into real choices.

The study analysed data from the 2011, 2016 and 2022 Nepal Demographic and Health Surveys and examined currently married adolescent girls and young women aged 15–24. The findings describe associations in population-level survey data and do not establish that any single factor causes unmet family-planning needs.