Condoms are not domestically produced in Nepal, they are procured internationally. But are they quality tested after they have arrived in Nepal?

Condoms in briefSocial marketing has made most of us aware of condom use and the protection it offers. A condom can protect against pregnancy up to 98% of the time. Male condoms are also the only contraceptive method that has proven to provide various levels of risk reduction against sexually transmitted infections. Laboratory studies have shown that latex condoms provide an effective barrier against even the smallest STI pathogens.

With the global AIDS outbreak, internationally backed projects and key drivers like Nepal Contraceptive Retail Sales (CRS), has increased distribution of condoms.

Condom distribution in NepalIn Nepal, treatment coverage for conditions like HIV and STIs is low, so it becomes all the more important to focus on preventive and protective measures like condoms. Before the 1990s, condoms were solely distributed through primary healthcare centers and other frontline health institutions in Nepal, mostly for family planning. With the global AIDS outbreak, internationally backed projects and key drivers like Nepal Contraceptive Retail Sales (CRS), has increased distribution of condoms and also increased discussion around STD and family planning which until then were severely taboo subjects.

Condoms in huge numbers in Nepal

There are many projects that have been working in Nepal for several years to decrease HIV prevalence and encourage family planning. Saath-Saath project distributed 30 million condoms in Nepal from 2011 to 2016 in 33 districts in Nepal. It makes up a total of 100 million condoms distributed by USAID funded projects in Nepal. Similarly, Ghar Ghar Ma Swasthya (Healthy Homes) is a large scale project focussed on improving access to health products like contraceptives in hard to reach areas. With social marketing and behavior change communication, people themselves have become aware of using condoms. It has resulted in a huge demand for condoms.

Where do these condoms come from?

Condoms are not produced domestically in Nepal. Enterprises and nonprofits procure condoms from international manufacturers in countries including China, Malaysia, India, and Thailand. UNFPA, the biggest global buyer of condoms has a prequalified list of manufacturers that fulfill set requirements and qualifications. Even if the condoms are tested pre-shipment and adhere to good manufacturing practices, the condoms are shipped or sent through various methods of transport. Like any other commodity, there is a risk of damage during shipping and storage. In this scenario, it is crucial to conduct third-party testing post shipment. Interestingly in Nepal, there is neither regulation nor evidence about third-party monitoring and testing of imported condoms.  

What is post-shipment condom testing?

Shipping and improper storage could cause wear and tear to condoms. Hence condom testing is carried out to ensure that it adheres to set regulations. While the quantity, labeling, packaging materials, and markings can be checked to see if it is compliant with the requirements of the purchase order, laboratories can test the quality of the condom. These can be many like air burst tests, tensile property tests, dimension tests, leakage tests, package integrity tests, and lubricant tests.

Condom inflation test. There are many types of methods used to check condom quality.

Source

Why is post-shipment condom testing important?

A condom is a commodity and like any commodity in the market, it is crucial to ensure its quality. It is especially crucial because it is used for family planning and protecting against STIs. A substandard product leads to grave consequences, that range from getting infected from sexually transmitted infections and getting pregnant with an unplanned child. With this, it would seem very necessary that post-shipment quality assurance of condoms is given the highest priority. However, it is unfortunately not the case in Nepal.

A substandard product leads to grave consequences, that range from getting infected from sexually transmitted infections and getting pregnant with an unplanned child.

Is there any evidence of the consequences of substandard condoms?

While there have been international incidences of substandard condoms that were shipped, it is very difficult to gather evidence about the consequences of damaged condoms. It is a very personal and sensitive subject to broach, which makes it difficult to monitor condom use. Also, there are many reasons why condom use still could lead to pregnancy or infections, whether it is improper use, substandard quality or exposure through other areas of the body.

How is the situation internationally?

Each country has its own regulation regarding post-shipment condom testing. UNFPA recommends post shipment testing only when there is any evidence of damage. And the condoms are procured from a pre-qualified list of manufacturers that adhere to the requirements of most recent editions of the WHO/UNFPA specifications. In Nepal, considering the number of condoms that are imported from manufacturers from all over the world and in various shipping and storage conditions, post-shipment condom testing is crucial.

Post-shipment quality testing: Giving it due importance in Nepal

Apart from rising costs, there are many reasons for lack of motivation at various levels about post-shipment condom testing:

• Policy level: While there are national policies that cover post-shipment testing of some food commodities, currently there is no policy that talks about post-shipment monitoring and testing of condoms.
• Procurement level: Companies like Nepal Contraceptive Retail Sales, which has become synonymous to family planning and sexual health in Nepal, has no evidence of conducting post-shipment condom testing. It is crucial that key drivers initiate conversations about condom testing as a crucial part of the process at quality assurance.
• Consumer level: Consumers directly trust condoms with quality and protection. With this assumption, there is low consumer motivation to ask and inquire about the quality of the product they use.
• Lack of testing laboratories: Zest Laboratories is the only internationally accredited company in Nepal well equipped to conduct quality testing of condoms.