This week at the National Population Policy launch Prime Minister K P Oli exhorted Nepalis to get married by age 20 and have three babies by the time they are 30. This was the first indication that the highest office in the land has understood the need to address Nepal’s dramatically <a href="https://nepalitimes.com/news/nepals-demographic-window-is-closing">falling birth rate</a>, but Oli’s statement was greeted with ridicule on<a href="https://nepalitimes.com/banner/avoiding-the-quicksand-of-social-media"> social media</a> — especially by women. Most urban young are already grappling with economic pressures and shifting life priorities. Even with a university degree,<a href="https://nepalitimes.com/here-now/workers-return-to-jobless-nepal?%2F"> many cannot find jobs</a>, and are taking the first flight out for overseas employment. Having a child is now a fraught decision shaped by income, individual autonomy, and family pressure. The <a href="https://www.unfpa.org/swp2025">UNFPA’s State of the World Population report </a>released last month, highlighted a significant <a href="https://nepalitimes.com/here-now/migrating-males-and-population-decline">decline in fertility rates </a>around the world. The global average fertility rate is 2.25 children per woman, and 18% of the reproductive adults said they will not be able to have the number of children they desire. The total fertility rate in Nepal has plummeted to 2.1 births per woman — down from 5 just 30 years ago. This is considered replacement level, meaning the newborns will replace their parents.&nbsp; However, birth rates are not declining as rapidly everywhere. The Tarai in has a total fertility rate of 2.20, and northwestern mountains is still 2.24.&nbsp; There are multiple factors in play, and the report broadly divides them into four categories: health issues, economic concerns, fears about the future, and lack of a supportive partner or their absence. More than half of the respondents said finance, which includes unemployment and increased cost of housing, as well as parenthood, was a barrier to having children. “More and more people prefer one or two children at maximum. Many women also decide to have children at a much later age,” says Kamala Devi Lamichhane of Tribhuvan University. “The opportunity cost is far higher for women.” But there is also a cost for the country, as the National Population Policy notes. At the rate the total fertility rate is falling it will soon be below replacement level — meaning that in the next three decades Nepal will be confronted with an <a href="https://nepalitimes.com/opinion/the-future-is-older">ageing population</a>.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250714140740_bac3e5a284b69a77d97b3b99daf2e7fd3019bc48f1a399fb2771381c751d8291.png" data-media-id="editor_6" data-image-id="20250714140740_bac3e5a284b69a77d97b3b99daf2e7fd3019bc48f1a399fb2771381c751d8291" data-rendition-name="original" width="1302" height="501" loading="lazy" alt="Nepalis having fewer babies. Why?"> </figure>   <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250714140740_251115b0a88d4e82be70245c43cb74477f3be18042ef1aa3b904c597d815f13b.png" data-media-id="editor_7" data-image-id="20250714140740_251115b0a88d4e82be70245c43cb74477f3be18042ef1aa3b904c597d815f13b" data-rendition-name="original" width="1125" height="500" loading="lazy" alt="Nepalis having fewer babies. Why?"> </figure>  Besides income, there are also cultural factors at play in women having fewer babies — they are expected to do all the childcare duties, even putting their careers on hold. In general, there is little help from spouses, and with more nuclear families there is less support from relatives. “Women today are well educated, career-oriented, and economically independent, allowing them to delay marriage as well as being conscious about their body and <a href="https://nepalitimes.com/multimedia/nepal-far-from-hitting-contraceptive-target?%2F">reproductive rights</a>,” says Laxmi Tamang of the International Confederation of Midwives (ICM). Also present at the policy launch was demographer Yagya Bahadur Karki, who said that women are more educated and hence, empowered to take their own informed decisions regarding having children.&nbsp; He adds, “But the fertility rates have reached replacement rate, and that stands as a warning for the future.”&nbsp; Fertility rates have fallen in inverse proportion to the rise in female literacy. The regions of Nepal where couples have more babies is where women are less educated. Couples in Madhes and Sudur Paschim provinces, where child marriage, gender-based discrimination, menstrual huts and dowry are still widespread are where the fertility rate is still high.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250717120740_ababfd31ed5ff79ded427e1f1adfff02e6af2384bd541e51dfe05e52fbbccb39.jpg" data-media-id="editor_9" data-image-id="20250717120740_ababfd31ed5ff79ded427e1f1adfff02e6af2384bd541e51dfe05e52fbbccb39" data-rendition-name="original" width="994" height="682" loading="lazy" alt="TFR Map"> </figure>  And because female literacy also has a direct correlation with <a href="https://nepalitimes.com/news/fatal-discrimination">infant and child mortality</a>, couples in those regions tend to have more babies so some of them survive.&nbsp; But it is Nepal’s urban centres among the educated where the increased choices in reproductive health, including alternative methods of conception like IVF and treatment for infertility, as well as <a href="https://nepalitimes.com/banner/implant-service-providers-take-contraception-to-nepals-poor">contraceptives</a> offer more options for family planning. “There are more choices regarding reproductive health, and there is more awareness as well, which is why people decide carefully on whether or not to bear a child,” says population expert Yogendra Gurung. <a href="https://nepalitimes.com/here-now/migrants-returning-from-the-gulf-with-infertility">Migration is another factor</a> adding to the decline in fertility rates. Many young Nepalis of reproductive age leave every day in pursuit of better jobs overseas. Spousal separation means fewer children.&nbsp; “Once away, even if not educated, they realise that child-rearing costs are high, and try to have fewer and even no children in some cases,” Gurung adds. Recent studies have also shown that men returning after their stint in the Gulf and Malaysia, where they are <a href="https://nepalitimes.com/news/gulf-workers-need-protection-from-heat">exposed to extreme heat </a>for extended periods as well as various chemicals and toxins in their work environment &nbsp;have a range of health problems, including infertility. To increase the birth rate, Nepal will have to reverse its family planning strategy of the past 40 years. Complicating this is that some regions of Nepal will need measures to control the birth rate, while urban areas will need a strategy to help parents have more babies. One way to help families have more children is to develop more <a href="https://nepalitimes.com/here-now/future-proofing-nepal-s-population-strategy?s=04&amp;fbclid=IwY2xjawFQf-NleHRuA2FlbQIxMQABHRxSwwGPfm7_2cBhDVAowPxEmFXP0Os-KRs1DXqIW_84wDhciExtZuNi1g_aem_jzRqN2cEVAppfwr5qedxRg">family-friendly policies</a> that favour women and youth as the Nordic countries, which also have falling birth rates, have done. They have introduced flexible parental leaves for both parents, including financial and health incentives. China, also concerned about its declining birth rate and an ageing population, now has a three-child policy as well as tax deductions, expanded childcare services, and leave policies to encourage couples to have more children. “We must work towards childbirth and childcare policies and plans that are suitable for Nepal, so that couples planning for children do not have to think twice about it because of finances or other reasons,” adds Gurung. Tamang of the International Confederation of Midwives says a gender transformative approach is needed to address the issues of the gender gap which is adding to the decline in childbirth. Husbands need to play a more important role in child-rearing. Instead of increasing fertility for the sake of it, the objective should be to assist young people to start the families they desire, at a point and time of their choice. Respect for everyone’s rights and dignity lays a foundation for a more balanced demographic trend. Lamichhane sums it up: “If fertility rates are to be sustained, it requires changes in the gender roles and behaviour, keeping the youth’s aspirations in mind.”

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Nepalis are having fewer babies. Why?

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>

Shristi Karki

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

The monsoon has got bad press because Nepal’s tourism operators actively told visitors to avoid <a href="https://nepalitimes.com/opinion/managing-the-monsoon?%2F">the rainy season</a>. It is time to change that. The reason can be found right here in the vast alpine meadows of Central Nepal where this time of year you can walk on velvet grass of pastures abloom with delicate pink, red and yellow flowers as the mist rolls up the valley. There is no sound except the hum of bumble bees. &nbsp;&nbsp; There are dozens of places across high Nepal called Chaurikharka, which means yak pasture. But this particular Chaurikharka in Rukum East located at an altitude of 4,000m stands out for its serene beauty, rustic charm and bucolic setting. There is just the occasional chime of <a href="https://nepalitimes.com/here-now/when-yaks-go-so-does-culture">yak bells</a> in the distance, and the sharp whistle of herders corralling sheep. &nbsp;&nbsp; The grass shoots are so fragile that one hesitates to step on them, the rounded ridges appear and quickly vanish in waves of mist. With the<a href="https://nepalitimes.com/here-now/before-the-next-monsoon"> arrival of monsoon</a>, these meadows are a soothing shade of green dotted with millions of <a href="https://nepalitimes.com/review/the-anatomy-of-a-flower?%2F=">multi-coloured flowers</a>. Until very recently, it took a week or so to hike up to places like Chaurikharka, but with the expansion of the road network even to these far-flung mountains in the lap of Dhaulagiri, they are much more accessible. It is just a three-hour uphill from the Mid-Hill Highway on the border between Baglung and Rukum East.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250802130828_a0b06b494d751b2144ffbbf10894ea64b29e8aed844bc8c66171783abfaf4e16.jpg" data-media-id="editor_4" data-image-id="20250802130828_a0b06b494d751b2144ffbbf10894ea64b29e8aed844bc8c66171783abfaf4e16" data-rendition-name="original" width="2048" height="1365" loading="lazy" alt="Visit Nepal in the monsoon"> </figure>  Purists would say that such easy access devalues the sanctity of these remote high meadows, but it also means more people will be moved to treasure the experience, appreciate <a href="https://nepalitimes.com/banner/natures-fragile-gift-to-nepal">the value of nature </a>so they can take steps to protect it.&nbsp; To be sure, the <a href="https://nepalitimes.com/here-now/deadly-monsoon-in-nepal-turns-deadlier">monsoon season can be challenging for road travel</a>. The roads are rough even at the best of times, and in the monsoon they become muddy and treacherous, often blocked by<a href="https://nepalitimes.com/news/monsoon-deluge-in-nepal"> landslides</a>. But that could be precisely the kind of adventure that the more intrepid visitors crave. Improved road connectivity has already made Chaurikharka and places like Badimallika &nbsp;and other sacred lakes in the mountains of western Nepal popular with domestic tourists. What is driving this traffic is the urge to go to exotic new places and share videos and selfies on social media. Several of Nepal’s travel vloggers have visited Chaurikharka and popularised the place, enticing followers on TikTok or YouTube to retrace their footsteps. But even as they become more popular, these fragile and once-remote places should be protected from over-tourism.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250731110736_f97110b7cdc3e7f80d5877690948fc9f4c95a09c583deb23b07355491e6c5446.jpg" data-media-id="editor_8" data-image-id="20250731110736_f97110b7cdc3e7f80d5877690948fc9f4c95a09c583deb23b07355491e6c5446" data-rendition-name="original" width="1083" height="699" loading="lazy" alt="Visit Nepal in the monsoon NT"> </figure>  <h2>INCREASING FOOTFALL</h2> Chaurikharka is located in Bhume Rural Municipality of East Rukum, near the scenic valley of Dhorpatan in Baglung district. Even in the <a href="https://nepalitimes.com/banner/monsoon-culture">middle of the monsoon</a>, there is a steady stream of Nepali hikers trooping to these high pastures – especially during festival days like Saune Sankranti which this year was on 17 July and actually marks the auspicious beginning of the monsoon here. “This year the rains have not been as heavy and there have been some clear mornings when we could see everything from Dhaulagiri to Machapuchre,” says Khageswar Bhandari, who trekked up here from the road. “The flowers, the greenery and the snowy mountain views make this an incredibly unique place.”&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250802130824_1b9e26f2e9853fdfe69154bb42a7c9ea6da4bf4940efc1da99b304dcfbd7d3d9.jpg" data-media-id="editor_10" data-image-id="20250802130824_1b9e26f2e9853fdfe69154bb42a7c9ea6da4bf4940efc1da99b304dcfbd7d3d9" data-rendition-name="original" width="2048" height="1152" loading="lazy" alt="Visit Nepal in the monsoon"> </figure>  Chaurikharka is worthwhile to get to in any season, but it has a different charm during the monsoon. Word has spread and because it is now easy to get to from Baglung or even Pokhara, people have been flocking here.&nbsp; “Holidays and Saturdays see the largest crowds, with up to 500 visitors every day,” says ward chair Mankaji Pun of Bhume.&nbsp; There was a time not too long ago when local herders brought sheep, goats, cows, buffaloes, horses, and mules to graze here during the monsoon. Although there are still livestock around, animals have been replaced by visitors taking selfies. Read also: <a href="https://nepalitimes.com/here-now/the-monsoon-and-nature-s-arithmetic">The monsoon, and nature’s arithmetic</a>, Tom Robertson Ward Chair Pun says infrastructure development is his main priority. A foot trail to Chaurikharka was built last year by the Tourism Division Office in Kohalpur, but access via the Raniwas-Koipa road section still remains challenging.&nbsp; “If we get more budget, we can improve the road and facilities to make Chaurikharka the main tourist attraction of this region,” says Bhume Municipality Chair Hom Prakash Shrestha. “After that, we hope to promote Chaurikharka as a top tourist spot.”&nbsp; Economic activity is also picking up with the arrival of visitors, but there seems to be a need to manage the makeshift sheds made of corrugated sheets that spoil the beauty of the place. Tea shops and lodges are also available but facilities are basic. Kuldeep Neupane took a three-day trip from Ghorahi in Dang to visit Chaurikharka recently, and says: “This is an ideal trip to make a quick getaway and let nature recharge your mind and body. And it is much more fun with a tent, to watch the sunrise over the Himalaya or the mist blowing in.”

Visit Nepal in the monsoon

Two weeks ago, Prime Minister KP Sharma Oli announced jubilantly on social media that Nepal had achieved a historic annual growth of 81.8% in exports. He was right. Nepal’s trade did take a great leap forward compared to last year. But the dramatic rise was mainly due to processed soya bean oil.&nbsp; However, Nepal does not produce the edible oil it exports. In fact, the soya and palm oil that make up 44% of total exports are imported from Southeast Asia and South America, and simply re-exported, mostly to India.&nbsp; Under the SAFTA (South Asian Free Trade Area) Agreement, Nepal can export products to India duty-free if it has at least 30% value-added. Nepal’s traders have taken advantage of SAFTA even though the edible oils they export do not reach that value addition threshold. “The 30% value addition requirement is often only on paper,” says former commerce secretary Purushottam Ojha. “It is clear that simply packaging edible oils in Nepal does not fulfil the terms of the trade agreement.” Prime Minister Oli is aware of this, and even called Nepal’s export figures “fake” at an earlier event. The government is relying on other iffy figures to suggest that Nepal’s economy is strong and getting stronger. For example, the value of imports rose by 13.25% in 2024-25 compared to the previous fiscal year.&nbsp; Some of it was due to a jump in electric vehicle imports worth Rs 31.76 billion, but mostly it was because more wholesale soya oil was imported to be re-packaged and sold in India. The very fact that the government boasts about increased imports is an indication of how much it relies on taxing them for revenue. Touting such trade figures cannot be the basis to claim an economic rebound.&nbsp; “A jump in the value of imports can be interpreted as an increase in purchasing power, but it is not evidence of a stronger economy,” says economist Keshav Acharya. “Even though imports have increased, Nepal's domestic production and productive capacity have not improved.” Nepal Rastra Bank's semi-annual economic activity study report shows that industrial production was down in the first six months of the last fiscal year. This despite an increase in the number of new industries registered and investment commitments. Out of the Rs70.2 billion proposed foreign investment, Nepal received only Rs17.9 billion last year.&nbsp; Meanwhile, the rate of capital formation was limited to 24% last year, which is lower than the year before, suggesting that new investment, job creation and economic expansion all declined. If domestic production does not improve in relation to this year’s inflated trade figures, the outflow will put pressure on foreign exchange reserves like it did three years ago. At that time, Nepal borrowed from the IMF under its Extended Credit Facility Program to kickstart the economy.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025080710084_2cdaaa5795828c4a7de93a0604ba884ef0a8b8f24cccd939f6c24e279ab6058f.jpg" data-media-id="editor_0" data-image-id="2025080710084_2cdaaa5795828c4a7de93a0604ba884ef0a8b8f24cccd939f6c24e279ab6058f" data-rendition-name="original" width="1633" height="723" loading="lazy" alt="Nepal's bubble economy NT"> <figcaption>Source: NEPAL RASTRA BANK</figcaption> </figure>  The macroeconomy is on firm footing with foreign exchange reserves at a comfortable Rs2,520 billion in May, up 23% from last year. This was largely due to remittances, and partly due to a falling NPR exchange rate. Real estate transactions and the stock market index have also been climbing as a result of government policies to revive the sector.&nbsp; However, former executive director of Nepal Rastra Bank Nar Bahadur Thapa cautions: “This is not organic growth, it is the result of deliberate policy decisions to relax rules on real estate and stock markets transactions.” In reality, the sharp rise in land prices have increased the cost of production, and excessive monetisation of the real estate has become the main source of Nepal’s economic woes. The central bank has announced a slew of new policies, shifting the terms of loan repayment for industrialists and entrepreneurs, reducing interest rates, and injecting more working capital — all designed to inject adrenaline into the real estate and stock market sectors.&nbsp; When he was governor, Mahaprasad Adhikari made several financial reforms during the latter half of his tenure to stimulate the economy, including tightening credit flow.&nbsp; By the last fiscal year, additional financial reforms had resulted in a credit expansion rate of around 8%. As the pace of credit expansion slows, real estate prices have started to fall. This is actually beneficial to the economy, because it lays the foundation for improvements in land-related entrepreneurship, production, and the construction sector. Just because real estate and the stock market transactions increase, it does not indicate an economic turnaround — especially when manufacturing and productive sector continues to languish.&nbsp; “It is foolish to believe that real estate and the stock market have magically revived our economy. Agriculture employs more than half of the population, but it is in decline. Investment in the productive sector has not increased, and job creation has not increased.” Two years ago, Nepal’s industrialists, business leaders, and political leadership predicted a recession amidst a sluggish business, declining market demand, large-scale job loss, and a shrinking real estate and share market.&nbsp; Still, the economy grew by 3.36% in fiscal year 2023/24. In fact, Nepal’s economy has grown nominally over the last two decades even when all sectors of the economy are in decline.&nbsp; Says Keshav Acharya: “The growth in trade, real estate, and the stock market are bubbles. The real economy remains stagnant.”

Nepal’s bubble economy

The final investigation report on the crash of a Saurya Airlines jet on 24 July 2024 at Kathmandu airport has revealed flaws in the carrier’s technical operation procedures, poor monitoring by the Civil Aviation Authority of Nepal (CAAN) and gaps in the airport’s emergency response. Eighteen people including a child were killed, and only the captain survived as the plane plunged seconds after takeoff, crashing within the airport perimeter. This was the latest in a series of aircraft accidents in previous years, and further tarnished Nepal’s already poor aviation safety record and contributed to the country being retained in the EU’s air safety list. &nbsp;&nbsp;&nbsp; The circumstances in the Saurya crash were different from the Yeti Airlines crash in Pokhara in January 2022 that killed all 72 on board, and two Tara Air crashes in February 2016 and May 2022 on approach to Jomsom that together claimed 45 lives. However, all four tragedies were a result of negligence of carriers and crew, failure to follow procedures, regulatory slackness, and overconfidence. The Saurya crash, especially, was a glaring example of how an ailing airline broke its own rules to allow passengers, including non-employees, a joy ride to Pokhara on a maintenance ferry flight. CRASH REPORT The Final Investigation Report prepared by the Aircraft Accident Investigation Commission and released on the first anniversary of the crash last week carried a long list of rules that were ignored or broken, and of regulatory failure. The first mistake was to cram spares, tools and inflammable chemicals needed for the aircraft’s C-Check in Pokhara into the cargo hold flouting its own ground handling procedures.&nbsp; There was no check-in of passengers, some of whom were not even employees – even though regulations say only flight and maintenance crew should be on board a maintenance positioning flight. Many brought their own luggage into the plane and stored it unsecured in the cabin. There was no flight attendant to give a safety briefing to passengers. The load and trim charts given to the flight crew were rough estimates, and the total takeoff weight of the plane was 18,300kg plus or minus 200 kg. That would still have been all right, but there was a glaring mistake in the speedchart Saurya pilots were using to calculate the minimum takeoff speed (known as VR), and it had been wrong ever since the 21-year-old aircraft entered service with the airline in 2017. FAULTY DATA&nbsp; The Commission probed Flight Data Recorder inputs from previous takeoffs of the Canadian-built CRJ200-LR in 2023-2024 and found that the undetected error in the speedchart had caused the plane to pitch up at an abnormal rotation rate at least 18 times on previous takeoffs.&nbsp; Any rotation rate more than 3°/sec is regarded as unusual. But on at least two occasions, this aircraft with tail number 9N-AME had rotation rates of 5.8°/sec and 5.5°/sec, the second one was when the pilot who survived was flying in March 2024.&nbsp; On this particular day, the plane’s rotation rate was 6.5°/sec, causing it to go into a deep stall soon after takeoff, the Commission report said. Essentially, the plane was not flying fast enough down the runway to take off safely.&nbsp; It is not yet clear whether excess weight, unsecured luggage, wrong centre of gravity were also factors, but relying on a faulty speedchart for the given takeoff weight, the captain flying pulled back on the yoke before the plane had reached takeoff speed and at a pitch angle that was too steep. The investigation report says the plane then went into a deep stall and started banking right with the stick shaking. At this point, the flight officer on the right hand seat is heard on the cockpit voice recorder saying: “Whoa, whoa, whoa. Sir, Sir, Sir…” It then banked left before the pilot flying turned the plane sharply to the right again in an evasive action to avoid the parking aprons of the international and domestic terminals. Had he not done so, there would have been a disaster of a much greater magnitude at Kathmandu airport that day. The plane scraped the runway with its right wingtip, collided with a container having helicopter spare parts, and plunged into a gully east of the runway, exploding in a fireball. The investigation also noted that the impact forces seemed to be survivable for some occupants. The fire trucks took unnecessarily long to reach the site even though it was inside the airport perimeter. The absence of an ICAO-standard runway strip, inadequate rescue drills, lack of training, and a blocked emergency service gate leading to the crash site were cited as other factors. &nbsp;&nbsp; <h2>Timestamp of a Disaster</h2>  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250731110724_39cdd04693994ce6e55a5b302905c0fa4884fe85bed21ff0779bb1439f3a5725.jpg" data-media-id="editor_0" data-image-id="20250731110724_39cdd04693994ce6e55a5b302905c0fa4884fe85bed21ff0779bb1439f3a5725" data-rendition-name="original" width="778" height="826" loading="lazy" alt="Flouting rules caused Saurya tragedy NT"> </figure>  11:10:34 - The Saurya Airlines CRJ200 on the takeoff roll from runway 02. It had a takeoff weight of about 18,300kg, but the pilot’s speedcard had a previously undetected mistake about the minimum takeoff speed. 11:10:55 -The plane with tail number 9N-AME goes into deep stall soon after takeoff because it does not have enough speed to lift its weight. The plane also has an abnormally steep nose-up attitude.&nbsp; 11:11:03 - Without enough speed to generate lift, the plane banks right, then left and right again in CCTV photos taken from the domestic apron (below). If it had not banked right, it could have hit the aprons and terminal buildings. Seen parked is Saurya’s other CRJ200 with tail number 9N-ANM.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20250731110732_608132f7225c649125cca2691dd6a6bf930984c5b359e888d7ad9e5eacce3afd.jpg" data-media-id="editor_1" data-image-id="20250731110732_608132f7225c649125cca2691dd6a6bf930984c5b359e888d7ad9e5eacce3afd" data-rendition-name="original" width="770" height="555" loading="lazy" alt="Flouting rules caused Saurya tragedy NT"> </figure>  11:11:08 - The plane scrapes the runway with its right wingtip, and falls into the gully. The captain is thrown off the left side of the cockpit and survives. 11:11:15: Plane explodes in a fireball inside the airport perimeter. Firefighters take time to reach the site because of lack of access road and a blocked gate. Read the full investigation report <a href="https://www.tourism.gov.np/files/9N-AME%20AIC%20Final%20Report.pdf">here</a>.

Flouting rules caused Saurya tragedy

French citizen Louis arrived in Nepal for the first time earlier this year, planning to <a href="https://nepalitimes.com/banner/the-abcs-of-a-winter-trek-in-nepal">trek the Annapurna Circuit </a>before heading down to Bardia to hopefully catch a glimpse of some<a href="https://nepalitimes.com/news/nepal-counting-its-tigers"> tigers</a>. Before he began his journey from Besisahar, Louis (who only revealed his first name) had imagined breathing crisp mountain air, and following the melodious gurgle of the Marsyangdi.&nbsp; Instead, he had to breathe fumes and dust all the way to Chame. Louis says he masked his face with a handkerchief: “It was not what I expected, this is not right.”  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025080304080_f03fce1527cf8a63178e4e82589a1a7096c8cfa28893ca4a5f7fe82d91a6e38a.jpg" data-media-id="editor_2" data-image-id="2025080304080_f03fce1527cf8a63178e4e82589a1a7096c8cfa28893ca4a5f7fe82d91a6e38a" data-rendition-name="original" width="2419" height="1814" loading="lazy" alt="Manang trails NT 1"> </figure>  Many other trekkers are similarly disappointed as roads have been built along what used to be <a href="https://nepalitimes.com/banner/a-walk-back-in-time-chandragiri-hatiban">walking trails</a>. Manang and Humla are the last remote regions in the Himalaya to be connected to the national road network. &nbsp;Construction of the 87km Besisahar-Manang road began in 1994, but was stalled during <a href="https://nepalitimes.com/news/14-years-after-conflict-no-closure-in-nepal">the Maoist conflic</a>t, and finally finished in 2012.&nbsp; Most of it has not yet been blacktopped, and sections have been carved out of vertical cliff faces, making them treacherous. But it has allowed road access to Manang, a journey that previously took a week on foot.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025080304084_32b3ca875a0df9f1dd42dbe915e6f6a2cd4f2e53f1cf2d3ee5cbdb3435905000.jpg" data-media-id="editor_5" data-image-id="2025080304084_32b3ca875a0df9f1dd42dbe915e6f6a2cd4f2e53f1cf2d3ee5cbdb3435905000" data-rendition-name="original" width="2400" height="1505" loading="lazy" alt="Manang trails NT 1"> </figure>  While the <a href="https://nepalitimes.com/opinion/the-road-out-of-nepal">road has improved access</a>, it has impacted on<a href="https://nepalitimes.com/here-now/trekking-in-the-time-of-climate-change"> trekking tourism </a>— the mainstay of Manang’s economy. The number of tourists visiting the scenic valley behind the Annapurnas grew from 21,245 in 2023 to 30,866 in 2024. The Annapurna Circuit is known for unique sights like <a href="https://archive.nepalitimes.com/news.php?id=9194">Tilicho</a>, one of the highest lakes in the world, the Thorong La pass that connects Manang to Mustang, and the valley’s own rich cultural heritage. Thorong La at 5,416m is the highest hiking pass in the world, and was used by locals for trade with Mustang before it became a <a href="https://nepalitimes.com/opinion/comment/lift-restrictions-on-upper-mustang">popular trekking route</a>. &nbsp; “For guests, the excitement of reaching Thorong La is now overshadowed by their disappointment of having to journey through dusty roads to get there,” says Manang lodge-owner Ongma Gurung. “That is the complaint we get the most.” <a href="https://nepalitimes.com/banner/tourism-that-treads-lightly-on-the-land">Local tourism </a>operators are trying to get the government to build alternative foot trails. But there have been delays due to a lack of budget.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025080304084_c5f76e398182785bb17846a148e3ca89de5687b4623580f8e2d725a7a287edfa.jpg" data-media-id="editor_11" data-image-id="2025080304084_c5f76e398182785bb17846a148e3ca89de5687b4623580f8e2d725a7a287edfa" data-rendition-name="original" width="2419" height="1762" loading="lazy" alt="Manang trails"> </figure>  The Naso Rural Municipality has identified other routes along the Annapurna Circuit in Chyamche, Tal, and Khotro so trekkers can bypass heavy vehicles involved in the construction of the Manang-Marsyangdi Hydropower Project. “But the local government cannot do everything,” admits the chair Dhan Bahadur Gurung. “And for leaders in Kathmandu, Manang is out of sight and out of mind.” Munindra Jung Gurung represents Manang in the Gandaki Provincial Assembly, and says he has raised the issue in <a href="https://nepalitimes.com/news/pokhara-s-tourism-woes">Pokhara</a>. He is hopeful there will be a hearing. To be sure, the road is not all bad news. Locals benefit, the number of visitors has grown, and trekkers can now also save time and use it to explore <a href="https://archive.nepalitimes.com/news.php?id=5960">side valleys in Manang</a>, visiting the villages like Nar and Phu. Annapurna Conservation Area (ACA) chief Rabin Kadariya concedes that the road to Upper Manang was crucial to connect the remote region with the rest of Nepal, but adds: “We have built an alternative trail connecting Talgaun, and we will consult local communities about their priorities on other hiking trails.”&nbsp;

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