Public health expert Aruna Uprety was flying from Dolpo to Nepalganj a few years ago when she struck up a conversation with a <a href="https://nepalitimes.com/news/1-in-2-pregnancies-in-nepal-unintended">pregnant woman</a> who told her she was travelling to the city for a doctor’s appointment.&nbsp; Uprety’s initial happiness at learning that rural women were actively seeking <a href="https://nepalitimes.com/latest/3-nepali-mothers-still-die-daily-at-childbirth">prenatal care </a>turned into shock when the woman, who had two daughters, said she would terminate her pregnancy if the ultrasound showed a female foetus.&nbsp; When Uprety recounted her conversation with nurses at a hospital in Nepalganj, they did not bat an eyelid, telling her that pregnant people came from all over the Karnali to get ultrasounds for <a href="https://nepalitimes.com/news/nepal-s-missing-girls">sex-selective abortions</a>. &nbsp; This example, multiplied tens of thousands of times every year, is visible in the 2021 census data: there are significantly more male than <a href="https://nepalitimes.com/news/fatal-discrimination">female live births</a> in Nepal, giving the country one of the highest sex ratio at birth (SRB) in Asia. SRB indicates the number of boys born for every 100 baby girls. Globally, biological birth ratios are slightly biased towards male babies, and the theoretical or expected SRB is 105 males per 100 female live births. Higher values indicate much higher numbers of newborn boys than girls.&nbsp; According to the 2021 census, Nepal has a SRB of 112 males per 100 females, up from 106 recorded in the 2011 census. &nbsp;Dhanusa district bordering India has the highest SRB (133) while Mustang in the trans-Himalaya has 92 boys per every 100 girls born. The Madhes (118) has the highest SRB among Nepal’s provinces.&nbsp; Experts are worried that this trend could lead to long-term <a href="https://nepalitimes.com/news/nepals-demographic-window-is-closing">demographic disparities</a>, and say there has not been enough research into the drivers of this imbalance. “Nepal’s skewed <a href="https://nepalitimes.com/here-now/future-proofing-nepal-s-population-strategy?s=04">sex ratio</a> at birth is one of the most concerning demographic issues,” says Yogendra B Gurung of the Central Department of Population Studies at Tribhuvan University.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025030704034_17e79dea4ed359ae991a9be6a1c765538cebd2640dcb3075b7175ae3055404ac.jpg" data-media-id="editor_6" data-image-id="2025030704034_17e79dea4ed359ae991a9be6a1c765538cebd2640dcb3075b7175ae3055404ac" data-rendition-name="original" width="926" height="385" loading="lazy" alt="The slaughter of our daughters NT"> <figcaption>Source: 2021 NEPAL CENSUS </figcaption> </figure>  Contributing to this is gender-biased sex selection (GBSS) and other forms of <a href="https://nepalitimes.com/editorial/quality-of-equality-for-women">discrimination and inequality </a>enabled by <a href="https://nepalitimes.com/opinion/perpetuating-patriarchy-in-nepal">Nepal’s patriarchal</a>, socio-cultural, traditional structures.&nbsp; Gender-biased sex selection determines the outcome of a pregnancy, and can be postnatal or prenatal. Postnatal sex selection can be due to neglect, differences in <a href="https://nepalitimes.com/news/covid-undermines-nepals-mother-child-gains">maternal nutrition</a> and child care, or infanticide of a girl child.&nbsp; Prenatal gender-biased sex selection occurs prior to or during conception, either by the selection of a particular sex during <a href="https://archive.nepalitimes.com/article/nation/freezing-a-future-family-IVF-embryo-surrogacy,3881">fertilisation</a>, or through termination of pregnancy when the sex of the foetus is determined. Across the world, GBSS is an outcome of a preference of sons over daughters.&nbsp; The census result proves that &nbsp;Nepalis are increasingly opting for sex selection and consequently, sex-selective abortions through the use of prenatal diagnostic technologies to determine the sex of a baby, even though the law prohibits clinics from revealing the sex of a foetus.&nbsp; Read also: <a href="https://nepalitimes.com/here-now/saving-nepali-mothers-on-mother-s-day">Saving Nepali mothers on Mother’s Day</a>, Naresh Newar “There are three detriments that enable gender-biased sex selection: our socio cultural norms, and the <a href="https://nepalitimes.com/here-now/female-foeticide-to-football">preference of sons over daughters</a>, and <a href="https://nepalitimes.com/opinion/comment/tech-and-transition-in-nepal">the availability of technology</a> that is able to determine the sex of a foetus,” explains Apekchya Rana Khatri at the United Nations Population Fund (UNFPA) in Kathmandu. “We analysed the <a href="https://nepalitimes.com/news/nepal-s-demographic-dividend">social and demographic trends</a>, and identified Nepal as one of the countries where GBSS prevails based on the prevalence of these three issues.” Many Nepali families prefer sons because they are still expected to solely carry forward the family lineage, provide economic benefit to the family and actively engage in society, take care of their parents in their<a href="https://nepalitimes.com/news/home-sweet-home-for-older-nepalis"> old age</a>, perform <a href="https://nepalitimes.com/news/nepal-quake-survivors-wait-for-kin-to-return">funeral rites</a>, and gain inheritance.&nbsp; Imbalanced sex ratio at birth is not just a problem in Nepal. The sex ratio at birth of countries in the region, including India and China reflect socio-cultural norms that ascribe more importance to boys. &nbsp; Sex ratio at birth in India (108) is mostly due to cultural factors, while in China (112) it is a legacy of the previous One Child Policy. The imbalance has actually begun to improve in the past years in both countries. However, in Nepal, the opposite has happened: SRB rose from 104 in 2001 to 106 in 2011 to 112 in 2021.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025030704034_824d9daf1f2b630bcdae6edba2a14733593c119f87b2fb5426103a8121907309.jpg" data-media-id="editor_17" data-image-id="2025030704034_824d9daf1f2b630bcdae6edba2a14733593c119f87b2fb5426103a8121907309" data-rendition-name="original" width="894" height="542" loading="lazy" alt="The slaughter of our daughters NT"> <figcaption>Source: 1952/54-2021 NEPAL CENSUSES</figcaption> </figure>  The 2021 census also shows that sex ratio at birth in Nepal’s urban municipalities is 114 -- higher than rural municipalities (109). This is in contradiction to the belief that <a href="https://archive.nepalitimes.com/news.php?id=4975">discrimination against girl children</a> is less among educated and better off city dwellers than in <a href="https://nepalitimes.com/banner/this-is-how-to-upgrade-nepals-rural-health">rural areas</a>. &nbsp; Better <a href="https://nepalitimes.com/news/nepalis-are-dying-because-they-are-poor">access to healthcare institutions</a> might also account for higher sex ratio at birth in urban areas. In the case of Madhes Province, access to both legal and unsafe abortion across the border could be why SRB is higher. Read also: <a href="https://nepalitimes.com/news/1-in-2-pregnancies-in-nepal-unintended">1 in 2 pregnancies in Nepal unintended</a> “Nepal’s sex ratio at birth shines a light on the <a href="https://nepalitimes.com/opinion/comment/coping-with-patriarchy">deeply-entrenched patriarchy in our country</a>,” says demographer Gurung. “And it also clarifies the misconception that traditional and <a href="https://nepalitimes.com/here-now/ill-fitting-in-nepali-society">conservative mindsets</a> and <a href="https://nepalitimes.com/news/nepal-s-caste-struggle">discriminatory practices </a>exist exclusively in <a href="https://nepalitimes.com/here-now/nepal-s-rural-lifeline">rural communities</a>, because the data points to educated, economically well off people engaging in practices like GBSS.” Historically, <a href="https://nepalitimes.com/review/nepal-s-remittance-villages">agrarian societies</a> like Nepal preferred to have many sons because men were considered better suited to physical work. Today, many Nepalis hope to have male children so that they can <a href="https://nepalitimes.com/banner/making-overseas-migration-better">migrate overseas</a>, earn livelihoods, and support their families.&nbsp; “Although evolving political, legal, and social systems have given women more robust rights to education and rights to inheritance, and ensured their participation in the workforce, the implementation of interventions is another matter,” says Aruna Uprety. “Our cultural and especially <a href="https://nepalitimes.com/here-now/tolerating-nepal-s-religious-tolerance">religious practices</a> have continued to reinforce gender inequality.” Experts say they have been unable to collect relevant data from <a href="https://nepalitimes.com/opinion/is-free-health-care-possible-in-nepal">medical and health facilities</a>.&nbsp; “Even when we identify the issues contributing to sex-selective practices, we are largely working on assumptions because there is no officially-backed data about sex-selective abortions through legal channels or unofficial and unsafe providers,” says Won Young Hong, UNFPA Country Representative for Nepal. “We need to obtain more data from <a href="https://nepalitimes.com/news/healthcare-moving-from-hospitals-to-homes">hospitals</a>, clinics and the many other service providers so that we can conduct more extensive research.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025030704034_a8bfc315b27a4db412109a547d483e2d3b571957a67c6bf4e5e3cbd6debe403b.jpg" data-media-id="editor_31" data-image-id="2025030704034_a8bfc315b27a4db412109a547d483e2d3b571957a67c6bf4e5e3cbd6debe403b" data-rendition-name="original" width="925" height="584" loading="lazy" alt="The slaughter of our daughters NT"> <figcaption>Source: 2021 NEPAL CENSUS</figcaption> </figure>  Another dimension to sex determination, selection, and sex-selective abortion is that it is not always a pregnant person’s choice to <a href="https://archive.nepalitimes.com/news.php?id=5884">terminate a pregnancy</a> if they find their child is female. Studies at local levels have revealed that husbands and mothers-in-law play pivotal roles in decision-making regarding prenatal sex determination. Nepal’s decreasing total fertility rate also contributes to a warped sex ratio at birth. Two decades ago, Nepal’s total fertility rate was 4.6, today a Nepali mother on average gives birth to only 2.1 children -- which is at replacement level. And since Nepalis are having fewer children, especially if they plan to have only one child, they want to make sure they have a son. Studies by the Center for Research on Environment Health and Population Activities (CREHPA) show that while neither women nor men have a preference for the sex of their child during the birth of their first child, having a female child first will lead to a preference for sons from the second birth, the preference increases in subsequent birth orders.&nbsp; Although Nepal’s sex ratio at birth is skewed towards boys, the country has more women than men, as differences in lifestyles contribute to a higher male mortality rate. The 2021 census shows that Nepal’s sex ratio is 95.6 males per 100 females. However, the male to female ratio from ages 0-19 has gone from 102 in 2011 to 107 in 2021, mainly due to rising sex ratio at birth. In the coming decades, the number of females above age 19 will decline.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025030704034_36447ddf5354ec42a8fdf566ba8ee1d0c8fc0c6b0fae798d2cc49beaa04d5c6d.jpg" data-media-id="editor_33" data-image-id="2025030704034_36447ddf5354ec42a8fdf566ba8ee1d0c8fc0c6b0fae798d2cc49beaa04d5c6d" data-rendition-name="original" width="852" height="679" loading="lazy" alt="The slaughter of our daughters NT"> <figcaption>Source: 2021 NEPAL CENSUS</figcaption> </figure>  The number of males under 20 being higher also proves that gender-biased sex selection has been going on in Nepal for at least the three decades, says Gurung.&nbsp; “Nepal’s sex ratio at birth could indicate a larger demographic shift in the long run where the male population outnumbers the female population,” he adds.&nbsp; This would in turn have an impact on fertility, male-female partnerships and marriage dynamics, the work force, and Nepal’s existing social structures as a whole. In particular, a population significantly skewed towards males might make women and girls more vulnerable to abuse, sexual exploitation and assault, trafficking, forced marriages, and other serious crimes, say experts.&nbsp; Studies have also found that birth registration right after the birth of a child is not common in Nepal, and some couples register the birth of sons and ignore daughters, which may be reflected in fewer recorded female live births.&nbsp; Cultural norms and practices do not change despite laws, and Nepal needs to do much more to change societal values, protect, and educate its women and girls. UNFPA, for example, in 2021 supported the Ministry of Health and Population to draft the first-ever national strategy to address gender-biased sex selection, its implementation already in place. The agency's Ruparantan program also equips adolescent girls with practical skills and knowledge on gender equality and decision-making.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250307040328_777fae9a19465a149ba0fd0b41cd0e6dde0d4a0f46128bf2a39191974a4b6cf2.jpg" data-media-id="editor_34" data-image-id="20250307040328_777fae9a19465a149ba0fd0b41cd0e6dde0d4a0f46128bf2a39191974a4b6cf2" data-rendition-name="original" width="1828" height="1254" loading="lazy" alt="The slaughter of our daughters NT"> </figure>  But for this to work, new policies and political will to implement them by the government are critical. Strong regulatory mechanisms to monitor prenatal sex determination technologies will also be required. In addition, Nepal needs systems in place to guarantee safety and security of its ageing population, so that there are less financial and socio-cultural pressure on sons to take care of their families, and less incentives for parents to opt for male children. &nbsp; “The state needs to prepare to provide adequate services for the elderly population, especially with the anticipation of the growth in ageing population,” says Won Young Hong at UNFPA.&nbsp; India has stricter regulations over the use of prenatal diagnostic technologies to determine the sex of a baby, as well as rigorous campaigning across state and national levels like the Beti Bachao Beti Padhao program that have helped address the country’s declining female births.&nbsp; Nepal also needs to address the drivers of its skewed sex ratio at birth while safeguarding the <a href="https://nepalitimes.com/banner/support-for-reproductive-health-of-nepali-women">reproductive rights of women</a> and the right to safe abortions.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025030704034_2631b558d26c555d1d2944e6837fd6447cad40da7ae5a1685c3c0ec44d895f5d.jpg" data-media-id="editor_36" data-image-id="2025030704034_2631b558d26c555d1d2944e6837fd6447cad40da7ae5a1685c3c0ec44d895f5d" data-rendition-name="original" width="637" height="696" loading="lazy" alt="The slaughter of our daughters NT"> <figcaption>Sex ratio at birth (2021) in selected Asian countries. Source: OUR WORLD IN DATA</figcaption> </figure>  Access to these services have contributed significantly to lowering the <a href="https://nepalitimes.com/here-now/why-has-progress-in-saving-women-s-lives-stalled">maternal mortality rate</a>. Abortions are important for medical emergencies, for <a href="https://nepalitimes.com/news/justice-eludes-many-rape-survivors">survivors of sexual assault</a>, for <a href="https://nepalitimes.com/banner/no-conceivable-reason-for-unwanted-pregnancies">family planning</a>, and to ensure the right of women to choose what to do with their own body. “Safe abortion is a right, and cutting off access to it will not stop gender-biased sex selection,” says Aruna Uprety. “Legality has no bearing on people’s decisions-- women were getting abortions in private facilities across Nepal and India even when it was not yet legal.” What is needed is a multi-sectoral approach that addresses existing socio-cultural norms, what <a href="https://nepalitimes.com/news/the-goal-is-empowerment-and-independence-of-women">women need to be empowered</a> and linked to jobs, as well as policies that promote women and girls, giving them <a href="https://nepalitimes.com/here-now/sky-is-the-limit-for-nepal-s-women-scientists">opportunities</a>.&nbsp; Adds Uprety: “Socio-cultural interventions are just as important as legal and policy ones, and we cannot address society’s preference for sons unless we look critically at our patriarchal cultural practices. <a href="https://nepalitimes.com/opinion/no-state-for-women">Gender discrimination</a> is a cross-cutting issue.” &nbsp; This article is brought to you by <a href="https://nepalitimes.com/" target="_blank">Nepali Times</a>, in collaboration with <a href="https://inpsjapan.com/en/" target="_blank">INPS Japan</a> and <a href="https://sgi-peace.org/" target="_blank">Soka Gakkai International</a>, in consultative status with UN ECOSOC.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250307140328_30c3782f9c09219bf1c249b51483a3cfb7a53a06d117d2aebd23ca7080d12758.jpg" data-media-id="editor_46" data-image-id="20250307140328_30c3782f9c09219bf1c249b51483a3cfb7a53a06d117d2aebd23ca7080d12758" data-rendition-name="original" width="680" height="103" loading="lazy" alt="SDG logo"> </figure>

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The slaughter of our daughters

Nepali Times: What are the main demographic trends that will affect Nepal in the next 30 years? Won Young Hong: There are two major demographic trends we see on the horizon in Nepal in the next 30 years. The first of these is the age of the population. We expect fertility rates to continue to decline, as in many other countries in the region. It dropped from 4.6 children per woman in 1996 to 2.1 in 2022. This indicates a shift towards smaller family sizes in Nepal.&nbsp; The working-age population between 15-64 years is 64.6%, and this will peak in 2051 at 69.4% before starting to decline to 66.7% in 2061. At the same time, the proportion of people aged 60 and above increased from 7.6% in 2011 to 9.0% in 2021.&nbsp; The UN projections estimate that the share of the elderly population will continue to grow in the next few decades until one in five people (22.4%) are elderly in 2061. The second major demographic trend relates to migration, both within Nepal and overseas. According to the 2021 census, around 2.2 million Nepalis were living abroad in 2021. This trend is likely to continue as most young people seek opportunities abroad. Internal migration is also a major trend.&nbsp; Between 2011 and 2021, the population share in the Tarai increased from 50.3% to 53.6%, while in the hills, it decreased from 43% to 40.3%, and in the mountain region, it declined from 6.7% to 6.1%.&nbsp; There is significant internal migration from rural to urban areas in search of better job opportunities and improved living conditions, leading to rapid urbanisation. By 2021, about 27.1% of the population resided in urban areas, up from 22.3% in 2011, while the share of the population living in peri-urban areas remained similar at around 39%.&nbsp; The share of the rural population declined from 38.5% to 33.2% during the same period. Urban areas, especially the Kathmandu Valley, have seen significant population growth, while over half of rural municipalities have seen negative growth. Provincial capitals like Biratnagar and Janakpur have seen population surges. Current trends indicate a rising share of the urban population and a shrinking rural population in the future. How can Nepal avoid the mistakes of some other Asian countries in responding to low fertility? It is an important question, and there are no fixed answers because each country is unique in many ways. Low fertility levels are a global trend, and no single country has managed to reverse this through policies despite a variety of initiatives being introduced. There are many lessons to be learned.&nbsp; It is clear that policies with an exclusive focus on the reproductive function of women with cost-based financial support without addressing structural issues affecting reproductive decisions made by men and women are largely unsuccessful.&nbsp; It is important for Nepal to analyse the issues and develop a context-driven and evidence-based approach to responding to the needs of people. Generally, policy is most effective in supporting people's choices when it responds to the diverse needs of individuals.&nbsp; For example, it is crucial to recognise the impact of the disparities between paid employment and raising children and close that gap with financial support for families with limited incomes. At the same time, employment needs to support women and men with children so they can balance family life and activities with work. Less rigid 9–5 working hours and accessible and high-quality childcare support are just a few of the measures that can help.&nbsp; Employers need to be encouraged to recognise that people with children in the workplace have needs and that there are systemic barriers for parents that have wider social impacts. These can be broken down with greater accommodation of the diversity of preferences of adults as to their choices of when and how many children they want to have.&nbsp; Policies need to create family and child-friendly societies focused on the health, education, and well-being of children and families at large to be successful. Public spending is another such tool, with levels of public funding for families closely linked with period fertility rates as well as cohort family size. There also needs to be individual choices available including in relation to sexual and reproductive health and rights and family planning.&nbsp; There is no one-size-fits-all solution. UNFPA is encouraging this kind of learning and knowledge sharing across countries because there is a huge increase in countries with declining populations, and we believe there are important lessons to be shared across the region and the wider globe. And it is imperative that policies be developed now rather than in a reactive manner.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20240714020756_22823ab3f792d6bcc5169b6912021be51006b65c1dda95771fbed1293fccdf6f.jpg" data-media-id="editor_0" data-image-id="20240714020756_22823ab3f792d6bcc5169b6912021be51006b65c1dda95771fbed1293fccdf6f" data-rendition-name="original" width="1060" height="1500" loading="lazy" alt="Won Young Hong UNFPA"> <figcaption>Photo: UNFPA ASIA</figcaption> </figure>  How serious is the anomaly in male: female ratio in Nepal? I would say any population anomaly has serious impacts. Nepal exhibits a skewed sex ratio at birth, with 112 boys born for every 100 girls, according to the 2021 census. This is higher than the biologically normal range of 102 to 107 males per 100 females, indicating potential sex selection practices. The disparity is particularly pronounced in Madhes province, where the sex ratio at birth is 118, compared to the lowest ratio of 106 in Kosi province.&nbsp; This imbalance is concerning as it mirrors trends seen in countries like China (112) and India (108), where cultural preferences for male children have led to significant gender imbalances. The preference for male children can have long-term social impacts, including an imbalance in the population structure related to gender disparity and discrimination.&nbsp; This might include a decline in marriages and partnerships, which can further increase the risks of human trafficking, gender-based violence, and other forms of harm. Nepal needs to identify the underlying drivers and address them with appropriate policy measures. In countries where over the long term there was this kind of imbalance, we see challenges, including a shortage of domestic labour in the workforce, a rapid reduction of fertility levels, and very few tools to reverse these trends. How are population dynamics, gender relations, migration and dropping fertility rate impacting Nepal’s population? The large proportion of the population that is young can potentially bring an enormous demographic dividend with investments in education, healthcare, and infrastructure. There is, however, a limited time window to seize this opportunity of about 30 years, when the population dynamic momentum will reverse as the lower rates of fertility start to impact working age groups and the percentage of the elderly will continue to increase.&nbsp; As the population ages and the proportion of young to old reverses, profound policy-level challenges arise. To take advantage of the window of a demographic dividend, targeted investments that directly benefit young people, including girls, need to be made now while fully implementing a wider range of socio-economic initiatives at all levels in line with the national development vision. We are seeing some really key results in Nepal’s legal framework and policies, including special measures to promote women in public life. At the same time, gender inequality remains a significant challenge, with persistent disparities in public and private spaces.&nbsp; Such persistent gaps, combined with social and economic factors like rising living costs, education costs for children, and childcare costs, will continue to discourage young women and men from having children.&nbsp; For that to happen, there needs to be a family-friendly environment for young people, women and men, to pursue a family life that includes raising children at home and being balanced with the workplace.&nbsp; This brings me on to the second part of your question on migration. The impact is, of course, profound. As people move abroad or to cities, the population landscape changes. If the large numbers of people overseas decide not to return, it will definitely contribute to the low fertility trends in the medium to long term. Equally, as people move to cities from rural or remote areas, there is a huge risk of leaving these areas barren and depopulated, leaving only an ageing population.&nbsp; These population flows require careful policy intervention and incentives to encourage people to invest in Nepal. It is welcome that the government is discussing ways to allow migrants to vote so their preferences can be reflected in the legislature and policymaking and future opportunities that encourage them to return to the country. UNFPA has been involved in helping the Nepal government plan for the demographic window? What have some of your main suggestions been? We do support the Government of Nepal in the area of the demographic window, and the first part of this relates to generating data and evidence that take into account demographic shifts and other megatrends in development policies and plans, as we recognise that without disaggregated, high-quality data and evidence, it will not be possible to achieve inclusive and sustainable development, including economic growth.&nbsp; Evidence is key to good decision-making, and the decisions made today can profoundly impact population dynamics in the future. As such, we support timely, high-quality, and disaggregated data generation that is essential for identifying those furthest behind. A second and related part supports the strategic use of evidence, including data, to improve understanding of the population and demographic structure of Nepal in actual policy decisions. We work with government decision-makers at all levels and civil society to translate data and evidence into pragmatic policies, such as the population policy, that respond to existing and future needs, including the sexual and reproductive health and rights of women and men.&nbsp; Population policy is very important to Nepal, and our experience across the globe shows that to future-proof population policy, it needs to respond in a holistic manner to the socio-economic changes we are witnessing and respond to the diverse needs of young people.&nbsp; To do this, it needs to examine a wide range of issues, including budgetary ones, affecting family decisions, and gender inequality. It is critical for Nepal to expand its understanding of population issues and build an integrated planning framework to respond to the new population trends.

Future-proofing Nepal’s population strategy

https://youtu.be/VaSUaALct0oParvati Thapa, 39, looks lost as she wanders into the district hospital in this isolated northwestern corner of Nepal. She and her husband have walked a whole day to get here, and they just found out she is 19 weeks pregnant.Thapa already has three children, and after they were born she lost four sons one after another. After her menstruation stopped, she suspected menopause but now knows she is pregnant for the eighth time.“My husband is away for months at a time, tending cattle in the mountains. Why should I use <a href="https://www.nepalitimes.com/banner/implant-service-providers-take-contraception-to-nepals-poor/" target="_blank" rel="noopener">family planning</a> when we meet so rarely?” asks Thapa, who looks much older than her age.Read also: <a href="https://www.nepalitimes.com/?p=33648&amp;preview_nonce=5c7e9df60a&amp;preview=true" target="_blank" rel="noopener">Born in Nepal</a>, Sewa Bhattarai<a href="https://www.nepalitimes.com/?p=33648&amp;preview_nonce=5c7e9df60a&amp;preview=true" target="_blank" rel="noopener"> </a>Like most women in the remote mountains, Thapa has never used contraceptives. <a style="background-color: #ffffff; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/here-now/migrating-males-and-population-decline/" target="_blank" rel="noopener">Doing so carries a stigma for married women with migrant husbands</a>, and there are misconceptions about the different methods available. The result is that women suffer unwanted pregnancies, <a style="background-color: #ffffff; letter-spacing: 0.01em;" href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/globe-rallies-to-aid-nepals-women,3841" target="_blank" rel="noopener">unsafe abortions</a> and end up with large families they are  unable to take care of.Nepal’s contraceptive prevalence rate is 53%, but in Bajura it is only 34%. Although this is a dramatic improvement from 20 years ago, it is still a long way from the government’s target of 75% contraceptive prevalence by 2030. The fact that the use of modern family planning methods has plateaued since 2006 points to futher deterrences.“The family planning rate is really low in Bajura because a lot of the men migrate to India for work,” says nurse Dhankala Khadka at Bajura District Hospital. “If the husband is away and the wife wants to use birth control, she is often questioned about fidelity and may be ostracised by her community. Even husbands do not support them.”<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108141124/636a58de9c7e80680e054862jpeg.jpg" alt="" width="1400" height="970"/><figcaption>Parvati Thapa went to Bajura district hospital suspecting menopause, but found out it was her eighth pregnancy. Photo: MONIKA DEUPALA</figcaption></figure>Almost every woman who visited nurse Khadka on a busy day last month had the same story: their husbands were away and they did not use birth control.There were 804 abortions in Bajura in the past year, which Rohit Giri of Bajura District Hospital says is very high: “Most who come to us are married women with children, and the abortions are due to the lack of birth control, which leads to unwanted pregnancies.”<a style="background-color: #ffffff; letter-spacing: 0.15px;" href="https://www.nepalitimes.com/banner/this-is-how-to-upgrade-nepals-rural-health/" target="_blank" rel="noopener">In Bayalpata Hospital</a> in neighbouring Achham district, the story is much the same — it performed 660 abortions in the past year. Bhawana Rawal, 33, has had two abortions at the hospital in the past five years and admits she does not used birth control.Read also: <a href="https://www.nepalitimes.com/here-now/migrating-males-and-population-decline/" target="_blank" rel="noopener">Migrating males and population decline</a>, Om Astha Rai“I already have two children, and do not need any more, but I got pregnant twice by accident,” she says. “I still do not want to use contraceptives in future.” Rawal did try a Depo-Provera injection once but says it made her bleed too much. Other women have the same complaint. For those who do not want to use a permanent contraception, many felt pills were a hassle to acquire and take every day, and IUDs hurt.“Unwanted pregnancies often lead to anaemia because women lose so much blood,” says Kalawati Setthi, a nurse at Bayalpata Hospital. Nearly 40% of women in Far-western Nepal were found in a survey to be anaemic — most of them pregnant and <a href="https://www.nepalitimes.com/banner/back-to-the-nipple-in-nepal/" target="_blank" rel="noopener">breastfeeding</a>.The government has put up posters in rural hospitals to encourage contraceptive use but at this rate, it is unlikely that the target of 75% contraceptive use will be reached.<h2>Demand, but no supply</h2>According to the Nepal Demographic and Health Survey (NDHS) 2016, there is a 24% unmet need for family planning in Nepal — a quarter of women who need contraceptives are not using them. A report by Population Services international (PSI) Nepal found that unmarried youth aged 15-24 and married women aged 20-24 are the groups that use contraceptives the least.Married women like Parvati Thapa at a clinic in Bajura last month (left), normally tended to use contraceptives after their first child, and exposure to information about family planning through health workers and current users of family planning, as well as talking about it with husbands or relatives.Unmarried youth were likely to discuss family planning only with their sexual partners and most used condoms over other methods, which were bought and kept by the male partner. In contrast, married women visited health facilities themselves and chose the type of method they wanted.Unmarried youth, especially adolescents, had a higher unmet need and were more vulnerable to stigma associated with family planning. The report argues that the term ‘family planning’ only applies to married women and their plan to have children, whereas there are many contraceptive users who have no intention of having children, or use contraceptives to prevent sexually-transmitted diseases (STDs).Read also: <a href="https://www.nepalitimes.com/banner/child-marriage-in-nepal-eloped-at-13-mother-by-17/" target="_blank" rel="noopener">Child marriage in Nepal, eloped at 13, mother by 17</a>, Sewa BhattaraiWhen a woman goes to a public health facility for contraceptives, a register is filled out, which includes a column for ‘husband’s name’, which is another deterrent for unmarried women. Though the husband’s name is optional, there is no column for the wife’s name when it comes to male contraceptives like condoms or a vasectomy.A report by the UN Population Fund (UNFPA) about sexual and reproductive health says complications in pregnancy and childbirth are the leading cause of death among girls aged 15-19 in low-income countries like Nepal. Unwanted pregnancies also hamper women’s education and economic independence, and impact their family life, fuelling an intergenerational cycle of poverty and poor health.<h2>More choice for family planning</h2><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108141124/636a58e19c7e80680e054863jpeg.jpg" alt="" width="1400" height="1029"><figcaption> </figcaption></figure>Although Nepal’s contraceptive prevalence rate has increased dramatically, from 7% in 1981 to nearly 60% today, social taboos, patriarchy and unavailability mean that many women still do not have access to birth control.It usually falls on women to take the initiative, since many men refuse to use condoms or get a vasectomy. Popular contraceptives used to be the pill or Depo-Provera, an injectable that needs refrigeration and must be taken at a clinic, but the dosage is high and the injection painful.Now, women like Shanti Adhikari, 43, in Chitwan, (pictured, right) who have always used Depo-provera for short-term contraception, have a new choice: Sayana Press.Read also: <a style="background-color: #ffffff; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/implant-service-providers-take-contraception-to-nepals-poor/" target="_blank" rel="noopener">Implant service providers take contraception to Nepal's poor</a>, Rojita Adhikari<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108141124/636a58e49c7e80680e054864jpeg.jpg" alt="" width="524" height="531">Adhikari’s husband, who works as a security guard in India, will be coming home for Dasain, so she is at the health post in Nawalpur for her Depo-Provera progesterone hormone injection, which prevents pregnancy for three months.But auxiliary nurse midwife Sharada Rimal (pictured, left) tells her about Sayana Press. Its advantages over Depo-Provera are that it comes with its own small needle, the dosage is much smaller, it is less painful and can be self-injected.“Everyone in my neighbourhood comes to this health post for contraceptives, but no one told me about this new injection. The needle looks much smaller, I think I will go with this one,” says Adhikari, 43, as Rimal proceeded to inject her in the thigh.Sayana Press, a successor to Depo-Provera, is being launched in Nepal in two districts: Nawalpur and Sindhuli, by the reproductive health agency Ipas Nepal in coordination with the UK’s Department for International Development (DFID) and the Ministry of Health and Population (MoH). The drug has already been tried and approved, and is available for use in 40 European countries.What sets Sayana apart from Depo-Provera is the smaller dosage (104 mg compared to 150), it comes with its own needle, it can be stored at room temperature and is injected sub-cutaneously (just under the skin), rather than in the muscles like <a href="https://archive.nepalitimes.com/article/from-nepali-press/Ftnp-the-curse-of-the-contraceptive,493" target="_blank" rel="noopener">Depo-Provera</a>.Injectable contraceptives are the most popular reversible contraceptive among women, for a variety of reasons. Adhikari says she does not like pills because she has to remember to take them every day, and, because of her age, she wants to be discreet about using them.While most other methods, like IUCDs, implants, condoms and pills, are visible and can be discovered by others, an injection leaves no traces. 52% married couples use contraceptives in Nepal: 8.9% use injectables, 4.6% are on pills, 4.2% use condoms, 1.4% use IUDs and only 3.3% use implants. 9.8% use other traditional methods. Some have gone for permanent contraception, with 14.7% preferring female Sterilization and 5.5% male Sterilization.“Depo-Provera has been in use for 50 years, but it was so popular and effective not much further research was done on it,” explains Lhamo Yangchen Sherpa of Ipas. “But WHO studies found that a much lower dosage was enough.”<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108141124/636a58e69c7e80680e054865jpeg.jpg" alt="" width="478" height="531">Health workers like Rimal confirm that Sayana Press is much easier to inject, more portable and less painful. Though it is self-injectable in some countries, in Nepal, where it has been undergoing trials in 14 health facilities of Nawalpur and Sindhuli since 5 September, it will only be administered by health professionals.Bhim Singh Tinkari of the MoH Family Welfare Division says that since 7% of pregnant women still die from unsafe abortions, making contraceptives easily accessible can save lives. Binod Bindu Sharma of the MoH links contraceptives to women’s choice and empowerment. “The availability of contraceptives is important for women’s rights, since it lets women choose when and how many children to have,” says Sharma, adding that the ministry is making Sayana Press available for free in health facilities.Lisa Honan, head of DFID Nepal, links contraceptives with women’s economic potential, adding that the country can make better use of women in the workforce if they have better choices of contraceptives. “DFID is committed to providing Sayana in any volume in Nepal until 2022 through UNFPA (the UN Population Fund), and would help Nepal scale it up all over the country if the results of the feasibility study are positive.”

Nepal far from hitting contraceptive target

Nepal’s fertility rate is going down even though contraceptive use has not increased<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221104141140/636517189c7e80680e02c252jpeg.jpg" alt="" width="1400" height="933"/><figcaption>THE RIGHT SHOT: Health worker Januka Dhakal injects Depo-Provera on a woman at Rayale Health Post of Kavre district on Tuesday. With their husbands away, fewer women now want to use contraceptives. Sonia Awale</figcaption></figure>Sita Yonjan, 21, has a two-year-old daughter, and recently stopped using <a href="http://archive.nepalitimes.com/article/from-nepali-press/Ftnp-the-curse-of-the-contraceptive,493">contraceptives</a> even though she is not planning to have another child. She says she doesn’t need her birth control implant anymore because her husband went away to work in Qatar two months ago.Yonjan visited a health post in Rayale village of Kavre to remove the birth control implant that she had inserted last year. The tiny device prevents births for five years, and does not need to be removed even when users abstain from intercourse. But many Nepali men want their wives to stop using contraceptives when they leave for overseas work."My husband thinks I could sleep with anyone if I use contraceptives in his absence," Yonjan frankly admits.An estimated four million Nepali men of reproductive age <a href="http://archive.nepalitimes.com/article/nation/The-cycle-of-migration,3230">work abroad</a>, and their wives back home generally see no need for contraceptive implants, preferring to use short-term methods like condoms, pills and injectables when their husbands come home on leave. Like Yonjan, those using IUDs and implants remove them as soon as their husbands go away again.https://www.youtube.com/watch?v=8lXkqrDtUOUDemographers say this explains the riddle about why Nepal's fertility rate has been going down despite contraceptive prevalence rate remaining low.When Nepal conducted its first-ever nationwide health survey in 1996, only 26% women were using modern contraceptives. Within ten years, it had nearly doubled to 44%, but has leveled off since. The contraceptive prevalence rate actually declined to 43% in 2016, when the last National Demographic Health Survey (NDHS) was conducted. Even so, the fertility rate that measures the average number of children per couple has been going down -- from 4.6 in 1996 to 3.1 in 2006 and 2.3 in 2016 (see graphs, overleaf).Demographers were initially puzzled by the drop in the fertility rate despite contraceptive use rate flatlining. But an analysis in 2013 suggested a correlation between male outmigration and contraceptive use. Another analysis is now underway, which will probably confirm the impact out-migration of men may be having on contraceptive use and fertility rate."If we consider only women who are married and living with husbands, we find a high contraceptive prevalence rate," explains Sharad Pathak, a demographer at the government’s Family Health Division. "This rate is low only because lots of women generally do not need contraceptives when their husbands are away."<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221104141140/6365171c9c7e80680e02c253jpeg.jpg" alt="" width="900" height="826">However, experts warn that Nepal’s declining fertility rate may not mean that population growth will reach replacement level -- one in every four married women still have an unmet need for family planning. A third of young married women aged 15-19 do not use contraceptives, making them more vulnerable to unintended pregnancies and unsafe abortion.Kristine Blokhus at the UN Population Fund (UNFPA) says Nepali women are aware of the benefits of having fewer babies, but face barriers in accessing contraceptives: "Health facilities often run out of contraceptive stocks, and there are not enough trained health workers to provide long-term contraceptives like implants and IUD."A 2016 UNFPA assessment showed most health posts provide only condoms, pills and injectables because of the lack of trained staff. Only one third of the facilities provide all five types of modern contraceptives including implants and IUDS. In most villages, women have to choose between oral pills or Depo-Provera, which they cannot use if there are side effects. Male or female sterilisation is available occasionally, and most women complain their husbands do not want to use condoms.With rising female literacy, the number of women opting for traditional family planning like withdrawal and the rhythm method instead of modern contraceptives is also going up. In 1996, only 3% of married women used such natural methods, now it is 10%. However, the NDHS 2016 showed that 62% women using the rhythm method to avoid pregnancy did not have an accurate knowledge about the ovulation cycle.Nepal’s target is to increase its contraceptive prevalence rate to 52% by 2020, but it may not meet that goal because of male migration, the preference for natural methods, and family planning programs being scaled back due to a drop in U.S. funding after the <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/globe-rallies-to-aid-nepals-women,3841">gag rule under President Trump</a>. The United States has traditionally been the main supporter of family planning projects in Nepal, through organisations like Marie Stopes International that provide abortion services.Beth Schlachter, Director of Family Planning 2020, who recently visited Kathmandu to take stock of Nepal's progress, says: "The US gag rule might affect Nepal's family planning programs if organisations delivering safe abortion services here do not find other resources to supply contraceptives."Since Nepal is poised to become an 'aging' <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/need-to-prepare-for-ageing-society,3624">society by 2030 and an 'aged one' by 2050</a>, there is an even greater need to scale up family planning. For the country to reduce its dependency ratio and <a href="http://archive.nepalitimes.com/article/editorial/editorial-reaping-demographic-dividend,3621">reap the demographic dividend</a>, many more women must have easier access to a much wider range of contraceptives.The mix mattersWhen Nepal launched its first population control campaign in the late 1960s, its population was only 13 million, it was growing at 3% per year because the fertility rate was nearly 6 children per couple. The only contraceptive choice women had then was to get their partners to use condoms. Most men did not like using them, and women did not have any control over reproductive health. The pill could have given women freedom to limit or space births, but they were scared of its side effects.Later, injectables like Depo-Provera and IUDs were introduced and today the government provides five types of contraceptives for free, and conducts health camps offering permanent family planning methods like male as well female sterilisation. But many other contraceptives like emergency pills and female condoms are available only in private clinics, and most rural women cannot use them even if they want to.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221104141140/6365171e9c7e80680e02c254jpeg.jpg" alt="" width="900" height="609">Beth Schlachter, Director of Family Planning 2020, says Nepal needs to provide a much wider mix of contraceptives in order to protect women from unintended pregnancies, unsafe abortions and maternal deaths: "What a 15-year-old girl needs might be different from what a 24-year-old mother of two children needs," she says. "If we try to address all of them with just one or two methods, we will not be very successful."Marie Stopes International is preparing a pilot program to test the acceptability of a new type of Depo-Provera called Sayana Press which can be injected at home and would suit women who do not like to visit health posts every three months for their Depo-Provera.Read also:<a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/globe-rallies-to-aid-nepals-women,3841">Cutting the lifeline</a>,  Kate Ryan<a href="http://archive.nepalitimes.com/article/editorial/editorial-reaping-demographic-dividend,3621">Reaping the demographic dividend</a>, Editorial

Migrating males and population decline

Fenerbahçe Beko won the Turkish Airlines EuroLeague finals in Abu Dhabi, held 23-25 May, defeating Monaco 81-70 in the final. Olympiacos, who defeated Panathinaikos 97-93, finished the series in third place. The Most Valuable Player (MVP) of the final match, Nigel Hayes-Davis from Fenerbahçe Beko, received a prize of 1,000,000 Miles&amp;Smiles from Turkish Airlines’ Chief Commercial Officer Ahmet Olmuştur. The carrier has been the title sponsor of the Turkish Airlines EuroLeague, a top tier tournament, since 2010.

Turkish Basketball

Thousands of Nepali students dreaming of an American education have been forced to look elsewhere as the Trump administration’s visa restrictions make their future uncertain.
The US was long considered a top destination for higher studies, making Nepal the 10th biggest country of origin for international students in America.&nbsp;
However, that number has seen a significant decline with the total for Nepali students now at 16,482. Some 8,000 Nepali students obtained no-objection certificates to study in the US from the Ministry of Education in the past year.&nbsp;
India, Australia, Canada, South Korea, United Kingdom and Japan are the other popular destinations for Nepali students. There are no clear numbers for Nepalis going to India, but a slight decline was noted this year after the deaths of two female students.
The US State Department has issued a circular to its embassies not to issue new visas to applicants until further notice. US Secretary of State Marco Rubio in the directive stated that the department planned to expand the screening of applicants' social media.&nbsp;
While new applicants are barred including those applying for visitor visas, students with scheduled interviews are allowed to proceed.
“Many of our students are affected by the new restrictions, but those who had applied for student visas earlier have got interview dates,” one Kathmandu-based college counsellor told us.
Meanwhile, even foreign students with spotless records already in the US have not been spared, as visa scrutiny intensifies under the new policy. In a move that underscores the growing sense of insecurity, many US colleges advised international students to carry their passports and documents at all times, even when traveling locally.
“Me and my friends did not go home this summer because we were not sure we would be allowed back, so we just went to Niagara Falls,” said a Nepali undergrad in Ohio, who like many interviewed for this report did not want her name used for fear of repercussion.
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Nepali students have adopted a cautious stance, with many choosing not to return home during summer vacation due to fear of visa revocations as well as travel bans. Meanwhile, over 7,000 Nepalis with Temporary Protected Status (TPS) will have to come back to Nepal by 5 August or face deportation. Thirty-seven were flown back to Kathmandu on Omni Air last week.
“The US is one of the most sought-after destinations for higher education, and the ban will definitely impact bright students,” says Narottam Aryal of the King’s College in Kathmandu.
Indeed, Nepali undergraduates admitted into Ivy League colleges for the 2025 academic year have been asked to look for alternatives. The entire Fulbright Foreign Scholarships Board resigned on Wednesday citing interference from the Trump administration on the selection of this year’s cohort. Some Nepali students already on Fulbright scholarships have noted disruptions, delays and even cancellation of stipends.&nbsp;
The student visa restrictions were initially just for foreign students admitted to Harvard University, but it was later extended to all Chinese students and now to all students. Universities like Columbia which actively recruit foreign students, face sharp enrolment declines, threatening their financial stability and diversity.
An Indian female PhD candidate at Columbia University had her visa revoked by the US State Department, and said she was targeted on the basis of her social media posts on Israeli military attacks in Gaza. Social media vetting of political activism has raised concerns about privacy and freedom of expression in a country where such rights were a given.
Many students have been informed via email that their visas have been revoked for getting speeding or parking tickets, but even others with no criminal record have been affected. The fear of deportation looms large amongst international students, including those from Nepal.&nbsp;
For most Nepalis who migrate to the US for education, the journey is a high-stakes investment. They come largely from middle-class families, often rely on a patchwork of scholarships, work-study programs, loans, or even the sale of family assets to afford fees.
Most Nepali students pursue STEM subjects which offer extended Optional Practical Training (OPT) periods that help fund their education. But with the US backsliding on education and humanitarian matters, countries like the UK and Canada are becoming more attractive despite their own recent stricter controls on student visas.&nbsp;
The UK universities saw a 63% rise in Nepali students’ admissions in 2024. Japan is another popular destination with 64,816 Nepali students enrolled as of 2024.
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Already, China, Hong Kong and Malaysia are poised to benefit from the increased scrutiny of US student visas. Several Hong Kong universities are offering unconditional admission to affected students, while Malaysian institutions are targeting previously US-bound Asian students. China and India have 330,000 and 280,000 students respectively in America, but the numbers for China have seen a sharp drop in the past year.
Elsewhere, branch campuses of American institutions such as NYU in Abu Dhabi, Georgetown in Dubai and Northwestern in Doha are getting more admission applications, and universities in the Gulf region are expanding infrastructure to accommodate those who would otherwise have gone to the US.&nbsp;
Even educational institutions in Nepal are hopeful that the US visa restrictions can be an opportunity to at least keep Nepali undergrads in Nepal, and also attract foreign students from the region.&nbsp;
“Many students might choose to complete their undergraduate degree here in Nepal and then move abroad for their Master’s degree later,” says Aryal of King’s College. “There was a need for quality higher education in Nepal anyway in terms of innovation and opportunities, so this could be the time to reduce our dependence on other countries.”
Nepal’s strategic position between India and China makes it sensitive to US policy shifts. India, a key ally, is also under US scrutiny for potential student travel restrictions. Chinese universities are already offering more scholarships to Nepali talent to capitalise on the US retreat.
American universities have challenged student visa restrictions in the courts. A federal court in Boston revoked the blanket ban on Harvard, and the State Department has ordered the resumption of processing student and exchange visitor visas.&nbsp;
Some are still hoping that President Trump will backtrack on the student visa restrictions, just like he has done with many of his more drastic executive orders.
Even so, the visa see-saw and longer-term uncertainties about living in the United States and its education system means students across the world are making alternative plans.
Says Aryal: “Policies of foreign countries change according to their needs, so excessive dependence was never a good idea. We should work to create different opportunities and choices of higher education within Nepal, so students are retained.” &nbsp;

America no longer prime destination for Nepali students

While Nepal was hosting the Sagarmatha Sambaad international climate conference in Kathmandu this month, on Mt Everest it was pretty much business as usual.&nbsp; The signs of climate breakdown are all there: a river now runs through Base Camp in summer, the Khumbu Icefall is more unstable, and there are more &nbsp;frequent avalanches. When expeditions arrived in March, the mountains were bare: it had not snowed since September, but then blizzards dumped unseasonal snow in May. And despite climate worries, such is the pull of Himalayan mountaineering that the Everest Industry showed no signs of slowdown. More than 600 international climbers and their Nepali guides had made it to the summit of the world’s highest mountain. At one point there were an estimated 2,000 people in the tent city on the Khumbu Glacier. All the ropes and ladders on the Icefall came down on Thursday, marking the official end of the spring climbing season, and just in time to avoid a monsoon cyclone approaching from the Bay of Bengal. It has been an action-packed season. One factor could be that Everest fees will go up from September: each foreign climber needs to pay a $15,000 royalty, up from the present $11,000. The cost for a Nepali climber on the South Col route will also go up: from Rs75,000 to Rs150,000.&nbsp; The fee to climb Everest in autumn is $7,500 (up from $5,500), but most climbers still prefer spring. Winter permit fee (December-February) is only $3,750 per person and the mountain is now also open for monsoon (June-August) climbs, when the fee is ever lower at $2,750. The revised rule also makes it mandatory for every two climbers on an 8,000m peak to hire one Nepali mountain guide.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025053004050_67f856fe52714e4bdcf21ae7d45c6f18c82117b9d0a5f73ed1efa04c96de1046.jpg" data-media-id="editor_0" data-image-id="2025053004050_67f856fe52714e4bdcf21ae7d45c6f18c82117b9d0a5f73ed1efa04c96de1046" data-rendition-name="original" width="931" height="732" loading="lazy" alt="The Everest Industry graph 1"> </figure>  In addition, climbers also have to pay for porters and guides, equipment, Base Camp costs, Ice Fall and fixed rope team fees, so climbing Everest does not come cheap. But such is the draw of climbing the world’s highest peak that some say the increased fees will not diminish the crowds next year. The government has tried to spread expeditions out to other seasons and other 8,000ers, but with not much success. Earlier this year, Nepal unilaterally increased the number of 8,000m peaks to 14 by adding six more sub-summits to broaden the choice for climbers. Added were: Yalung Kang (8,505m), Yalung Kang West (8,077m) &nbsp;Kangchenjunga Central (8,473m), Kangchenjunga South (8,476m), Lhotse Middle (8,410m) and Lhotse Shar (8,400m).&nbsp; The announcement could go against the accepted topographic criteria that a stand alone peak has to be at least 300m higher than an adjoining prominence, and at more than 3km isolation from it. The UIAA (Union Internationale des Associations d'Alpinisme) still recognises only 14 mountains as eight-thousanders, and only eight of those are in Nepal, or on the border with China. Nepal’s revised mountaineering regulations also increased the insurance coverage of high-altitude workers to protect porters and high altitude guides who usually take more risks on the mountains. Rescue teams and clean-up campaigners to collect trash and remove bodies of dead climbers up to Camp IV of Mt Everest do not need permits.&nbsp; The Sagarmatha Pollution Control Committee is now using drones to fly down trash in 20kg sacks. Each climber is also required to bring down at least 6kg of waste and not just their own, but this rule is erratically enforced. With five fatalities on Everest and Lhotse, Spring 2025 had a historically low death toll. Another five climbers died on Annapurna, Kangchenjunga and Makalu.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025053004050_38681de22f0fefb6faa12b01755566d09c5064d0ff84e12ccc7b5d68ea9ba38a.jpg" data-media-id="editor_1" data-image-id="2025053004050_38681de22f0fefb6faa12b01755566d09c5064d0ff84e12ccc7b5d68ea9ba38a" data-rendition-name="original" width="665" height="740" loading="lazy" alt="The Everest industry graph 2"> </figure>  Journalist Ben Ayers who ran the Everest Live social media channel from Everest Base Camp with daily updates credited the low death rate to dramatic rescues of climbers from the ‘Death Zone’ by their Nepali guides and longline helievacs — the visuals all uploaded on YouTube.&nbsp; “Ironically, this perception of safety is bringing more and more inexperienced climbers to the mountain, and they need more rescues,” Ayers said in one of his dispatches.&nbsp; American expedition chronicler and summiteer Alan Arnette suspects there is a lot of under-reporting given that the jet stream and storms were lashing Everest even till late in the season. He told us: “I heard a lot about frostbite and rescues that were not made public. It’s become practically impossible to cover the details on Everest. All the teams report nice news, and they don’t talk about bad stuff to avoid hurting businesses.” Although trash on Nepal’s mountains makes headlines, what does not receive as much attention is the climate impact of so many expeditions. The Sagarmatha Sambaad conference sidestepped this issue, which is ironic given that the impact of climate breakdown is most evident on Himalayan peaks and their glaciers.&nbsp; <h2>Need for Speed</h2> The big stories this year have been about speed-running from their home cities to the top of Everest. Ukrainian entrepreneur Andrew Ushakov flew out of JFK on 15 May at 10:15AM Nepal time, and was on the summit 3 days, 23 hours, and 7 minutes later on 19 May at 9:22AM.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250601080640_1c5cc6fc991307861768f07037ed9d30930fb20f35dbb57dc31c9a92a9e1a885.jpg" data-media-id="editor_2" data-image-id="20250601080640_1c5cc6fc991307861768f07037ed9d30930fb20f35dbb57dc31c9a92a9e1a885" data-rendition-name="original" width="1440" height="1800" loading="lazy" alt="The Everest Industry"> <figcaption>Andrew Ushakov at the summt. Photo: ELITE EXPED</figcaption> </figure>  “I could never find the time for the traditional 40-50 days of acclimatisation,” Ushakov explained matter-of-factly. His ‘Everest Sea-to-Summit’ climb was possible because he spent 400 hours in hypoxic sleep tents over the past four years in New York. However, Ushakov did use ropes already fixed, hired four Nepali guides, helicoptered to Base Camp, and used much more oxygen than an average climber. And after the climb, Ushakov was arrested at Kathmandu airport for being in possession of $20,000 of undeclared cash and spent a night in jail and fined $60,000.&nbsp; The other speedsters were Garth Miller, Alastair Cairns, Anthony Stazicker, and Kev Godlington, all former British Army commandos. They left London and summited five days later on 21 May, and flew right back. They also used hypoxic tents to simulate the thin air high on Everest.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250601080644_90c8dd5cc07b4b43f2989b1dc0c0650ab80f10ebb06680c25a6909c519957bd8.jpg" data-media-id="editor_3" data-image-id="20250601080644_90c8dd5cc07b4b43f2989b1dc0c0650ab80f10ebb06680c25a6909c519957bd8" data-rendition-name="original" width="810" height="668" loading="lazy" alt="The Everest Industry "> <figcaption>All four members of the Furtenbach team at the summit. Photo: Sandro Gromen-Hayes</figcaption> </figure>  But more controversial was their use of xenon gas therapy in a German hospital to ramp up the production of oxygen-carrying haemoglobins in their blood. Xenon is banned by the World Anti-Doping Agency for being performance enhancing in sports. Expedition leader Lukas Furtenbach said this rule does not apply to mountaineering, as it is not a regulated sport like swimming. Nepal has no rules about xenon, but the Department of Tourism said it was launching an ‘investigation’ to decide on future policy since it is difficult to ban xenon, but allow oxygen. The controversy has also divided the mountaineering community, with some climbers saying they just want to maximise their chances of survival. Spending less time on the mountain could make climbing safer by reducing avalanche risk. It would also mean less trash on the mountains, but it would reduce the income of Nepal’s expedition industry. It is also unclear how much of the success was due to xenon therapy and whether the ex-special forces were already in good physical shape.&nbsp; The need for speed hides the fact that climbing in the Himalaya is dangerous business, and climbers cannot sprint to the top just by huffing xenon. But ultra-fast climbs could be charged more, and the revenue generated can be used to establish state-of-the-art rescue operations, and increase pay and insurance for guides. Two other speed chasers this season were Swiss-Ecuadorian Karl Egloff and American Tyler Andrews, both on Everest without oxygen. Andrews choppered to Base Camp to catch a weather window, but turned back from 8,500m due to high winds. Heavy snow and wind also forced Egloff to descend from 7,000m. Slow and steady climbers like Anja Blacha from Germany did make it to the summit without oxygen, while Kami Rita Sherpa broke his own record with his 31st Everest summit as he led a 26-strong Indian Army group. There were 468 permits issued for foreign climbers from 48 expeditions to Everest this spring. Nepal’s other eight-thousanders together had only 17 expeditions. Nepal has more than 1,000 peaks above 6,000m, and has opened only 476 of them for climbing.&nbsp;

The Everest Industry

While Nepal marked <a href="https://nepalitimes.com/news/mt-everest-pvt-ltd">Mt Everest</a> Day on 29 May, on the other side of the planet in the US state of Colorado dozens of Nepalis who have climbed the world’s highest peak multiple times were busy working as chefs and Uber drivers. Among them is Nima Doma Sherpa, who climbed Mt Everest in 2019 after her husband Tshering Wangchu was among 16 crushed by an avalanche on <a href="https://nepalitimes.com/banner/on-thin-ice-in-the-khumbu">the Khumbu Icefall</a> five years earlier. A large serac broke off the West Shoulder of <a href="https://nepalitimes.com/news/the-everest-industry">Mt Everest </a>and fell directly on a group of <a href="https://nepalitimes.com/opinion/more-porters-sick-on-everest-trail">porters and guides</a> making their way up the Icefall at 5,800m. Their bodies were flown by helicopter to Khumjung where Tshering Wangchu was born. He was excited about climbing Mt Everest for the first time.&nbsp; In Khumjung, Nima Doma felt like her own life had also ended. This was the kind of news Sherpa wives, mothers and sisters dreaded every <a href="https://nepalitimes.com/here-now/peak-climbing-season-2025-s4abrxny">mountaineering season</a>. She stayed home for more than two years grieving, but ultimately gathered up all her emotional strength to take care of her 6-year-old son and 3-year-old daughter. Nima had grown up in Khumjung hearing <a href="https://nepalitimes.com/review/stories-of-nepal-s-summiteers">tales of adventure on the mountains </a>from their father, Ang Chubi Sherpa who had climbed Everest in 1993. He used to bring her and her sisters and brother European chocolates after every expedition, and used to tell them that the chocolate bars grew on the mountains. “It was only after we got older did we realise that he told us that chocolates grew in the mountains so we would not worry about him putting himself in harm's way,” Nima Doma recalled with a faraway look at her home in Boulder this week. Nima went to the school that <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/commemorating-edmund-hillary-in-nepal,4145">Edmund Hillary</a> opened in Khumjung till Grade 8, and then dropped out to help in the kitchen and <a href="https://nepalitimes.com/here-now/when-yaks-go-so-does-culture">tend yaks</a>. She was married off to Tshering Wangchu, who was also a high altitude guide. When Tshering went on expeditions, Nima also started working as a porter from Namche to Base Camp. It was perhaps her father’s tales of mountains of chocolates that had always attracted her to <a href="https://nepalitimes.com/here-now/knowing-our-mountains-43v4iyvo">the peaks</a>. After her husband was killed ten years ago this month, being a widow with children was not easy for Nima Doma. But she was not alone: there were at least 200 single mothers in <a href="https://nepalitimes.com/here-now/khumbu-since-1950-jaww4qn0">the Khumbu</a>, and 20 of them just in Khumjung whose husbands had been killed in <a href="https://archive.nepalitimes.com/article/nation/tragic-start-to-himalayan-spring-nepal,3695">mountaineering accidents</a>. Some were not even 20 years old, and had children growing up without fathers. But there were also women in the 50s whose husbands had been killed in the 1980s. Nima found sponsors for her children’s education, and moved to Kathmandu. In the capital, Sherpa widows used to meet to help each other. Some of them had joined the Nepal Mountaineering Association (NMA) training for rock and ice climbing. “I decided that it was no use sitting home and crying anymore, after meeting other single mothers I felt less alone,” remembers Nima, who joined the Juniper Foundation and enrolled in an NMA training camp in Manang. There she climbed Chulu East (6,584m) and met Furadiki Sherpa, whose rope-fixing husband had also been <a href="https://nepalitimes.com/news/on-mt-everest-s-70th-records-and-fatalities">killed on Everest</a> in 2013. They set themselves the goal of climbing Everest one day, and started a fund-raising drive.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250530090544_621be0724b9182c8e3594b2c562a71ec32ac01d985a71d0cf31646de9d51e15a.png" data-media-id="editor_12" data-image-id="20250530090544_621be0724b9182c8e3594b2c562a71ec32ac01d985a71d0cf31646de9d51e15a" data-rendition-name="original" width="2678" height="1274" loading="lazy" alt="Everest summiteers find new life in the US"> </figure>  “We decided we had to overcome society’s stigma of <a href="https://archive.nepalitimes.com/article/nation/widows-personal-happiness-comes-last-in-face-of-social-financial-hardships,1855">widowhood</a> and prove that <a href="https://nepalitimes.com/here-now/remembering-junko-tabei">women could also climb mountains</a>,” Nima said, adding that she was inspired by Nepal’s first woman Everest summiteer Pasang Lhamu Sherpa, who died during her descent in 1993. Nima Doma and Furdiki climbed the technically-difficult Ama Dablam (6,812m) and then arrived at Everest Base Camp in April 2019 as part of their Two Widows Expedition with the motto, ‘So Can We’. While climbing up the Icefall Nima passed the spot where her husband had been killed. It was a jumble of constantly-shifting ice blocks bigger than houses. She closed her eyes and said a prayer. “I remember thinking, this is so difficult and dangerous. This is what my husband had to do to support our family,” Nima Doma said. “I was determined to fulfil my husband’s dream of climbing Chomolungma, and to prove to ourselves that we two women could do it.” It was 23 May 2019 when <a href="https://www.reuters.com/article/world/two-sherpa-widows-scale-everest-and-smash-stigma-idUSKCN1SU0MV/" target="_blank">Nima and Furdiki stepped on the summit</a> and looked over into Tibet, and down at Tengboche Monastery to the south.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250530090544_6b822582b5d88ba5e972db084f184690b40653c6efd9901b2dd082ffba2a263b.png" data-media-id="editor_16" data-image-id="20250530090544_6b822582b5d88ba5e972db084f184690b40653c6efd9901b2dd082ffba2a263b" data-rendition-name="original" width="2700" height="1522" loading="lazy" alt="Everest summiteers find new life in the US"> </figure>  Nima Doma hugged Furdiki, took off her mask and wept. But for the first time in five years, it was not from grief but relief — relief for being free of all the sadness and sacrifices and for fulfilling her husband’s dream. They had found <a href="https://nepalitimes.com/here-now/life-after-death">life after death</a>. “I felt this immense joy to be on top of the world, it was indescribable,” Nima Doma said, “I have wept only twice in my life. Once when my husband died, and once there on top of Everest.” The tears had frozen on Nima Doma’s cheeks, as she and Furdiki headed back down the mountain.

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