Central Department of Population Studies

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Vol VII, Population and Development in Nepal, May 2000

Demographic Anthropology/Social Demography In Nepal: Overview And Scope
Dilli Ram Dahal
As elsewhere in the world, demographic anthropology/social demography is an emerging new field of anthropology and demography in Nepal. This paper is an at attempt to cover two major areas in this field .The first part of the paper is an overview of the type of population research (in the field of migration, fertility and mortality) done by anthropologists in Nepal and their contributions to this new field over the years. The objective here is to provide some reading materials to students and teachers who are interested in this field. The second part of the paper argues that macro-demographic research done in Nepal have given minimal attention on "cultural variables" which are so basic in understanding the demographic process. Finally, the paper notes that there is a good scope of a graduate-level course in anthropological demography within Tribhuvan University in Nepal.

Changing Age Structure Of Nepalese Population And Its Socio-Economic And Demographic Implications
Sunil Acharya
This paper examines the changes taking place in the age structure of Nepalese population as a consequence of falling mortality and increasing life expectancy during the last few decades and the onset of fertility decline since the early 1990s. Then the paper discusses the likely implications of changing age structure on some of the aspects of population and development in Nepal.

Fertility Differentials In Nepal: An Analysis Of Some Selected Variables Of Bdc Survey Data
Bidhan Acharya
This paper uses data from Birth, Death and Contraception Survey conducted in 1996 by CDPS. Three years delay of age at marriage would contribute to decrease in CEB by almost one child. Contraception in Nepal needs to be targeted to younger age women. Women who have experience of the loss of two or more children, have high fertility rates. Women's education and occupation of their husbands are also influencing factors to reduce fertility. Communities with high age at marriage and high fertility and low age at marriage and low fertility are analyzed with the help of a composite index of age at marriage and fertility.

Proximate Determinants Of Fertility In Nepal
Bhesh Nath Sapkota
Fertility (TFR) in Nepal is high (5.5). But it still seems low compared to the Total Natural Fecundity (15.3) i.e. the maximum biological reproductive capacity. Bongaarts model is used to analyze the data from primary survey. The main fertility reducing factors in this study is the Index of Lactational Infecundability (C_i) which is due to universal breast-feeding (22 months) in Nepal. It reduces around 6 births from it's maximum biological capacity. Similarly, non-marriage phenomenon (C_i) inhibited 4 births and non-contraception (C_c) reduces about 3 births from it's maximum biological capacity.

Ready Accessibility To Contraceptives In Nepal
Ram Sharan Pathak
At the International Conference on Population and Development (ICPD) held in Cairo in 1994, 179 nations agreed that reproductive health services should be accessible to everyone by the year 2015. In reproductive health services, ready accessibility to contraceptives is one of the important concerns in family planning component of the reproductive health package. Ready accessibility to contraceptives is discussed here drawing information from 1981 Nepal Contraceptive Prevalence Survey (NCP), 1991 Nepal Fertility, Family Planning and Health Survey (NFFHS), and 1996 Nepal Birth, Death and Contraception Survey (NBDCS). According to this study, although there is no improvement in ready accessibility in 1981-1991, there is marked improvement in it during 1991-1996, as the ready accessibility increased from 29 per cent to about 53 per cent. Although there is substantial increase in ready accessibility in rural area in 1996 compared to 1991, the study, however, shows that there is marked differences by place of residence. Still more than 50 per cent of current users had no ready accessibility to contraceptives in rural area in 1996, while more than 80 per cent of current users in urban area were getting contraceptives locally.

Women's Education And Its Impact On Fertility And Child Survival
Pushp Kamal Subedi
This paper pinpoints the education-fertility-mortality linkages and illustrates the role of anthropology/qualitative methods in explaining the relationship between women's education and demographic behaviour. Educated women produce immediate impact on the society for gender inequality and improving their lives with fewer children. In addition, the maternal education plays an important role in determining child survival along with better health and nutrition for their families through women's empowerment. The anthropological demographic research is an effective way to examine relationship between education and population.

Status Of Women And Fertility In Nepal
Chandani Rana (Thapa)
This paper examines the relationship between status of women and fertility with respect to some selected socio-economic variables, viz., education, occupation, place of residence, migration status and use and non-use of contraceptives. Women having some education had the lower children ever born (CEB) and higher age at marriage (AM). The mean number of CEB for urban illiterate women is higher than rural literate women. Similarly, the mean CEB was higher for users than non-users. The mean number of CEB was higher for Tarai and mountain than that of hills. Migrant women had higher CEB than non-migrants.

Levels, Trends And Patterns Of Reproductive Health In Nepal
Prakash D. Pant
This paper has examined the levels, trends and patterns of reproductive health situation in Nepal using HMIS raw data published by MOH in their annual reports and some other sources of data such as the NFHS, 1996. The study has focused on issues related to family planning, safe motherhood, STD/HIV/AIDS and RTI, and adolescents and has broken-down the analysis at development regions covering the period 1995/96-1997/98 as per the availability of the data. The progress achieved in the overall reproductive health status in Nepal is well demonstrated. At the same time, the analysis also clearly indicates the need for further effort in improving the overall reproductive health situation in Nepal in order to improve health and well being of women in particular, and adolescents in general.

Hiv/Aids: An Emerging Issue In The Health Sector With Special Reference To Nepal
Ram Hari Aryal
Available data indicate that the spread of HIV/AIDS is fast in developing countries, as a result 95 per cent of the total infected population reside in these countries. HIV/AIDS is affecting the productive groups (18-30 years) of the population. Although the HIV/AIDS cases are found low in Nepal, if effecting preventive measures are not developed and implemented HIV will spread fast. Just over one-fourth of the reproductive age women (15-49 years) know about HIV/AIDS in Nepal. However, data reveal that if there were some contact with health system, knowledge was comparatively higher than those who have no contact at all with the health system.

Utilization Of Antenatal Care Services In Rural Areas Of Western And Mid-Western Hills Of Nepal
Laxmi Bilas Acharya
This analysis clearly suggests that Nepal government should think of improving access to the outreach services through village health workers (VHWs) and female community health volunteers (FCHVs) to improve the utilization of ANC services in the rural areas than to improve the physical access to static health posts. Analysis also indicates that improvement of the physical quality of health posts is more effective than to increase the physical access to these posts. Access was measured in terms of travel time to the nearest static health post and coverage by outreach workers. The quality of static services was defined in structural terms: physical infrastructure, number of staff, availability of drugs and holding of special MCH clinics. The initial analysis showed that no single indicator of quality was of overriding importance and therefore an overall quality index was constructed. After adjustment for access and for socio-economic characteristics of families and communities, a very pronounced relationship between overall structural quality of the nearest health post and service uptake persisted. The adjusted odds of using some form of antenatal service were 6.6 times higher in the catchment areas of high quality posts than in areas served by low quality posts. By comparison, the effects of travel time to the nearest health post are modest. Uptake of services is about twice as high when there is a health post in the community. Regular monthly visits by outreach workers or personal contact of these workers with the service users also had a marked effect on service utilization. These results suggest that investment in the quality of health posts is more important than further increases in their number and that a further expansion of outreach services is a priority.

Health Care Services In Nepal: Can User Charges Provide Welfare And Equity?
Keshab Prasad Adhikari
Universal availability of health care services have immense impact on mortality transition at first followed by an apparent transition in fertility. Easily availability of services with informed choices is a crucial question in developing country's context, since governments of developing countries are afflicted by burden of diseases and burden of resource constraints. Health is commonly used as proxy of human capital. Therefore, state can not give up its responsibility from financing in this sector. Question arises how to mitigate this in a sustainable manner. Governments of the developing countries are relying on development aid and/or external debt. Furthermore, which type of services (all preventive, promotive and curative services or only the first two) is to be the sole responsibility of the public sector needs to be identified. Since basic nature of the health can be realised within the domain of preventive and promotive services. As a result, the curative service of the health care sector can go for the market competition with appropriate user charges as a cost-recovery system. Each and every service seeker is liable to utilise the available services. Therefore, it is desirable to have a scheme like "service by self selection" under which the market is segmented and that patients or consumers are free to choose whichever section of the market is most suited to them. When they have options people will identify themselves as rich or poor. By segmenting health facility into service with charge and service without charge can relatively be maximised.

Can Child Migration In Nepal Be Explained Under The Modernization Perspective?
Yogendra Bahadur Gurung
Nepal has been struggling for modernization. It is in the transitional stage. One of the several sectors effected by this transition is children's life. The nature of the effect is that children themselves have to look for their survival. Consequently, children are leaving home for urban opportunities. Giving attention to the increasing child migration, especially, to urban areas of Nepal as indicated by several studies previously made, this paper tries to explain the migration of children under the modernization perspective. Child migration here is considered that those who move for survival opportunities in urban areas by leaving parents behind home. The livelihood problem of the family created by continuous marginalization of the poor due to unequal land distribution, massive land fragmentation, and lack of labour market in the rural areas. Population structure is relatively young due to significant decline in infant and child mortality in recent past and relatively greater opportunities for the survival are available in urban areas created by a number of means of modernization process. In these contexts, family is not able to protect their children and provide appropriate facilities that are needed for children's development. Due to gap within the inter-generation, children did not find safe future and their tastes have been changed to bright light city life that is unfit with their parents' interest. As an effect of modernization, structural differentiation explains these changes well. As a result, children have a compulsion to look for work. As a process of rural-urban labour transfer, children leave home for urban informal works as an output of capitalistic development for modernization. It indicates widening the lower limit of age that challenges the age selective theory of migration and changing sociological phenomenon that children begin to migrate themselves by leaving parents and home behind, as migrant actors.

Child Labour In Biri Industries And Schooling Of Children: A Case Study From Central Tarai Of Nepal
Govind Subedi
Utilizing data from a survey conducted by CWIN in 1999, this article examines the interrelationship between child labour in Biri industry and education of children. At present, child labour in Biri industry appears to be incompatible with schooling of children but potentially be made compatible if the local community and Biri-making households are effectively mobilized towards the importance of long-term benefit of education. Further, rising economic status of the Biri-making households is key in this aspect.

Population Ageing: Global And Nepalese Perspectives
Prem S. Bisht
This paper aims at providing a thorough analysis of the major demographic dimensions of ageing using the available data for Nepal. Nepal does not have a high proportion of the elderly persons, but its population is under the process of ageing. It is high time for Nepal to consider the issues pertaining to older population of Nepal and to focus on the challenges of the twenty-first century with regard to those issues.

Projection Of Future Population By Component Method
Dhanendra Veer Shakya
This study has attempted to project the future population of Nepal for the period 1996-2011 using component method of population projection, which projects population by age group and sex. It is assumed in this study that level of fertility in Nepal declined from 5.6 in 1991 to 5.42 in 1996. Furthermore, it is also assumed that TFR will decline from 5.42 in 1996 to 5.15 in 2001, 4.89 in 2006 and 4.65 in 2011. For mortality assumptions, the study used the Coale-Demeny West Model Life Tables of appropriate levels. It has assumed life expectancy at birth 55, 56.5, 58.8 and 61.2 years for males in the periods 1991-1996, 1996-2001, 2001-2006 and 2006-2011 respectively and 53.5, 55, 57.5 and 60 years for females in the corresponding periods respectively. Finally, assuming the insignificant effect of net migration on population size for the projection period, total population of Nepal for the years 1996, 2001, 2006 and 2011 are projected.

Health And Nutrition Status Of Children And Women In South Asia
Rafiqul Huda Chaudhury
The health and nutritional status of children and women in South Asian countries are characterised by (i) persistence of high infant and under-five mortality; (ii) large proportion of malnourished children; (iii) poor nutrition and unsatisfactory antenatal care of mothers; (iv) excess female deaths; (v) persistence of high maternal mortality; (vi) persistence of early marriage and early child bearing; (vii) persistence of high fertility; (viii) high and increasing adolescent fertility; (ix) low use of contraception and high unmet demand for family planning; and (x) increasing risk of Sexually Transmitted Diseases (STDs). Funds allocated to health sector are inadequate to improve the health and nutrition status of women and children.

NGOs Working Against Trafficking In Girl Children Of Nepal
Prabha Hamal
The main objective of the study is to identify the status of NGOs involved in rescue, rehabilitation and reintegration programmes of commercially sexually exploited girls in Nepal. This study also focuses on reaction of the society and family on the victim girls. The main finding of the study is that NGOs involved in rescue, rehabilitation and reintegration of victim girls is encouraging. However, such NGOs lack strong support from the Government side in order to implement programmes effectively.

Policy Approaches To Indigenous People's Health Issues
Balkrishna Mabuhang
Indigenous people's health issue has been neglected for a long time. International attention seems to be rising. This article reviews the efforts made by the United Nations and its allies. World Health Organization's report reveals the severe situation of the life and longevity of indigenous people due to the destruction of their habitat, dispossession of their land, and isolation from other community from time immemorial. The effort to over come this problem lacks far behind. Both indigenous people and their counterparts need to develop good understanding and partnership to address their social problems.