71.3 - Nepali Times

Sixty years ago, the average lifespan of Nepalis was only 28 years. It has now risen to 71.3.

How did this happen, despite poor governance, conflict and the upheavals of the past decade in the country?

Demographers cite a confluence of factors: a sharp decline in infant and child mortality rates, improvements in health care and nutrition because of a remittance-driven rise in household income from the four million or so Nepalis living and working abroad who send home Rs1 billion a month.

The new figure for average lifespan came from the 2021 census data, which also shows that women in Nepal live on average 5.6 years longer than men. Worldwide, women tend to live longer than men because of higher mortality among young men due to lifestyle reasons, disease, profession and accidents.

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Three decades ago, the average life expectancy of Nepalis was 54.3. Going further back, to 1961, the average lifespan was only 28. These are average national statistics, and do not necessarily mean that the current generation of Nepalis are living longer — it just shows that many fewer babies are dying.

Meaning: if the mortality rate of children and adults goes down, the average lifespan goes up. And there has been a dramatic reduction in the infant mortality rate.

In 1991, 97 out of every 1,000 babies died before their first birthday. Today, the national average is down to 17. Similarly, while the child mortality rate in 1991 meant that 28 out of every 1,000 died before age five, today it has dropped to six.

Nepal’s total mortality rate has also dropped by half from 13.3 per 1,000 in 1981 to 6.8 today. Education is a factor: Nepal’s literacy rate was 14% in 1971, now there is almost 100% enrollment.

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Literacy does not just mean being able to read and write, it is directly correlated with higher income, broader knowledge and lifestyle improvements, leading to greater awareness about health-related issues. All this adds up to longer life expectancy.

Although there are still problems with access and affordability of medical care, in general the health and nutrition status of Nepalis has improved. There is a drop in the prevalence of gastric infections caused by contaminated drinking water. The incidence of tuberculosis, pneumonia and other communicable diseases have also gone down.

Instead, the main cause of death now are chronic ailments like cardio-vascular diseases, stroke, respiratory complications and highway accidents.

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Three decades ago, Nepal’s total fertility rate was 5.3, today a Nepali mother on average gives birth to only 1.94 children - this is below replacement level. It is directly the result of the greater survival rate of babies — the higher the infant mortality, the greater the tendency of parents to have more children to ensure that at least some of them live.

The decrease in the poverty rate of Nepalis also means that their nutrition level in general has gone up, although there are still pockets in the Karnali and Madhes Province where wasting and stunting among children is dangerously high.

There seem to be anomalies in the census report because it shows that Karnali Province has the highest lifespan at 72.5 and very low infant and child mortality rates. This goes against the generally accepted belief that it is the province with the lowest human development ranking.

Demographers have put forward various explanations for this, including that the 2021 census was conducted towards the tail end of the pandemic when many elderly Nepali workers had come home from India. But it could also be that Karnali families under-reported deaths to census enumerators.

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A longer average life expectancy is good news, but it has introduced the brand new problem of ageing. By 2021, the population of Nepalis older than 75 had grown to 640,000, making up 2.2% of the population.

Nepal has a demographic dividend window, but a rapidly ageing population is going to undermine that advantage in the coming decades. As in countries like Korea, Japan and parts of Europe, even in Nepal there will be fewer able-bodied citizens, leading to a reduction of tax revenue, higher insurance and health costs for the state in the coming decades.

Nepal’s policy-makers must not just have a plan for the here and now, but also for the time our children themselves become senior citizens.

Hemraj Regmi of the National Statistics Office puts it this way: “In the 1960s, a few people lived long lives. Now more people are living longer.”

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Ramesh Kumar