The USAID Adolescent Reproductive Health (ARH) project in Nepal was a multi‑year initiative that strengthened private sector engagement in adolescent‑friendly reproductive health and family planning services. It began with foundational work—orienting staff, mapping and formalizing private health facilities, piloting training programs, and establishing digital systems for monitoring and quality assurance. Over time, the project scaled up provider training in ASRH, DMPA (Sangini), HMIS/DHIS‑2, and implant procedures, while conducting whole‑site orientations and distributing adolescent‑friendly equipment. Service delivery expanded as private facilities achieved full reporting compliance and provided reproductive health services, supported by municipal coordination meetings that reinforced public‑private partnerships. Continuous monitoring and the rollout of a QA/QI system ensured steady improvements in service quality, with facilities increasingly meeting national standards. Overall, the project demonstrated a clear trajectory from system establishment and capacity building to large‑scale service delivery, quality improvement, and stronger collaboration between private providers and local governments.
The USAID Adolescent Reproductive Health (ARH) program was implemented as a collaborative initiative led by CARE Nepal, in partnership with the Association of Youth Organizations Nepal (AYON), Howard Delafield International (HDI), Jhpiego, and Nepal CRS Company.
The ARH project was implemented in 11 districts and 60 municipalities of Madhesh Province, Lumbini Province, and Karnali Province.
Nepal CRS Company led the private sector engagement and engaged 275 private sector pharmacies, polyclinics, and hospitals to improve technical capacity in promoting adolescent‑responsive products and services.
Key achievements (October 1, 2022- September 30, 2023 )
Between October 2022 and September 2023, the USAID Adolescent Reproductive Health (ARH) program in Nepal focused on building private sector capacity and establishing systems for quality service delivery. Newly recruited engagement staff were oriented through a three‑day program in Kathmandu, while 910 private health facilities were screened, 833 assessed, and 275 formally engaged via MoUs across three provinces. Training activities included ASRH sessions for 74 providers, boosting knowledge from 38% to 91%, and PBCC training for 18 staff to strengthen communication and motivation. A digital QA/QI app and web system were initiated to standardize FP/RH service quality, complemented by the distribution of IEC/BCC materials such as posters and manuals. Coordination with local governments advanced planning, budgeting, and endorsement of private facility registration guidelines, while assessments highlighted gaps in staff, infrastructure, and reporting but also strong collaboration potential. MIS integration was achieved with monitoring checklists completed for all 275 facilities, feeding structured data into the system. Preparations for Year 2 included plans to expand provider training, conduct QI visits, enhance the Meri Sangini app, and strengthen demand generation, referral mechanisms, and infrastructure support.
Key achievements (October 1, 2023- July 15, 2024 )
Between October 2023 and July 2024, the USAID Adolescent Reproductive Health (ARH) program in Nepal carried out extensive training, system strengthening, and coordination activities to enhance adolescent‑friendly services. Eleven batches of ASRH training across Karnali, Lumbini, and Madhesh equipped 217 private providers with improved counseling skills and facility space mapping, supported by PSEOs for follow‑up action plans. Fifteen Sangini training batches in 11 districts certified 305 providers to deliver high‑quality family planning services, with knowledge scores rising from 60% to 93%. Whole‑site orientations reached 1,035 staff in 275 facilities, addressing adolescent barriers and provider attitudes. Recording and reporting orientations trained 307 participants, enabling QA/QI system access and monthly FP data reporting across three provinces. Forty municipal coordination meetings engaged 782 participants, strengthening collaboration between private providers and local governments. The digital QA/QI system was launched, and quarterly assessments showed steady improvement—facilities meeting high standards increased from none to 23, while those below 60% dropped from 252 to 189—demonstrating tangible progress in service quality and compliance.
Key achievements: (July 16, 2024 – January 15, 2025)
Between July 2024 and January 2025, the USAID Adolescent Reproductive Health (ARH) program in Nepal implemented a series of capacity‑building and quality‑enhancement activities. Over 100 service providers received targeted training in HMIS/DHIS‑2, ASRH, Sangini, and implant procedures, significantly improving technical knowledge and service readiness. Service delivery was strengthened across 275 private facilities, achieving full reporting compliance and providing 96,700 family planning services. Facility upgrades included whole‑site orientations for 65 providers, adolescent‑friendly equipment distribution to 175 sites, and endorsement of regulatory guidelines in Surkhet. Monitoring and quality assurance advanced through 231 joint municipal assessments and four QA/QI rounds, raising compliance from zero to 169 facilities meeting standards, supported by client feedback from 263 respondents. Collaboration was reinforced through quarterly cluster meetings engaging 782 participants, fostering stronger public‑private partnerships and coordinated reproductive health service delivery.
The project was terminated in January 2025 in accordance with the President’s Executive Order on Reevaluating and Realigning United States Foreign Aid.. This termination was not a reflection of performance but rather a compliance measure with U.S. Government policy.
