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.

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Future-proofing Nepal’s population strategy

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101148/63720f509c7e80680e0b796ajpeg.jpg" alt="" width="3000" height="2000"/><figcaption>Photo: NISSI THAPA</figcaption></figure>Over 600,000 <a href="https://www.nepalitimes.com/banner/no-conceivable-reason-for-unwanted-pregnancies/" target="_blank" rel="noopener noreferrer">pregnancies in Nepal in 2017 were unintended</a>, close to two-third of which ended in abortion, reveals a new report released this week by the UNFPA, the United Nations sexual and reproductive health agency aimed at shedding light on the often neglected health crisis affecting women of reproductive age worldwide.The State of World Population 2022 report titled Seeing the Unseen also estimated that nearly half of all global pregnancies, totalling 121 million each year, are unintended and that 'for the women and girls affected, the most life-altering reproductive choice — whether or not to become pregnant — is no choice at all.'“This report is a wakeup call. The staggering number of unintended pregnancies represents a global failure to uphold women and girls’ basic human rights,” says UNFPA Executive Director Natalia Kanem. “Our report reveals that rates of unintended pregnancy strongly correlate with gender inequality, with lower socioeconomic development, and with more restrictions on sexual and reproductive rights.”The report further states that over 60% of unintended pregnancies end in abortion and an estimated 45% of all <a href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/globe-rallies-to-aid-nepals-women,3841" target="_blank" rel="noopener noreferrer">abortions are unsafe</a>, responsible for 5-13% of all maternal deaths. After taking dramatic strides to reduce maternal mortality rate from 539 per 100,000 live births to 239 between 1996 to 2016, Nepal’s progress has since stagnated, further affected by the pandemic in the last two years.Some 44% of Nepali women of reproductive age who want to avoid pregnancy do not use any contraceptive methods. Similarly, use of modern methods of birth control among married women of reproductive age stands at 43%, leading to high rates of unintended pregnancy and unsafe abortion, while 50% of those who do use contraceptives discontinue within a year. Prevalent gender norms that <a href="https://www.nepalitimes.com/here-now/nepal-far-from-hitting-contraceptive-target/" target="_blank" rel="noopener noreferrer">prevent women and girls from accessing reproductive health care</a> including contraceptives have been identified as a key factor.In addition, half of all pregnancies among adolescents are estimated to be unintended, as only 23% in the group are reported to use contraceptives -- much lower compared to the national average of 43%.Read also: <a href="https://www.nepalitimes.com/banner/lets-talk-about-it/" target="_blank" rel="noopener noreferrer">Let’s talk about it</a>, Duksangh SherpaThe report further states that for every additional dollar spent on <a href="https://www.nepalitimes.com/banner/implant-service-providers-take-contraception-to-nepals-poor/" target="_blank" rel="noopener noreferrer">expanding modern contraceptive use</a>, Nepal would save $2 on maternal and newborn care as a result of fewer unintended births, induced abortions and maternal deaths."The perception among some policy makers that investing in family planning is no longer necessary due to the decline is fertility in Nepal is very concerning," says Lubna Baqi, UNFPA Country Representative, "as it does not take into account the high levels of unmet need for family planning, which currently stands at 24%, and the high rates of unintended pregnancies, and unsafe abortions that take place because of the gaps in services.”<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221114101148/63720f549c7e80680e0b796bjpeg.jpg" alt="" width="960" height="1216">Women and girls from minority groups face further challenges and discrimination in accessing services and information. Given that <a href="https://www.nepalitimes.com/nepali-times-search/?q=child+marriage" target="_blank" rel="noopener noreferrer">child marriage is still prevalent</a> in Nepal with nearly 41% of adolescents married before 18, adolescent girls are at a higher risk.Abortion services on the other hand are largely unsafe. Despite being legalised in 2002, majority of abortions continue to be conducted by untrained personnel or induced by pregnant women themselves. On top of this, most women and girls face structural and informal hindrances barring them from safe services.The report urges decision-makers and health systems to improve accessibility, acceptability, quality and variety of contraception methods to reduce unwanted pregnancies by expanding <a href="https://www.nepalitimes.com/latest/sisterhoods-empowering-education-in-nepal/" target="_blank" rel="noopener noreferrer">sexual and reproductive health care </a>and public awareness. Equally crucial is to empower women and girls to make their own decisions in the matters of sex, contraception and motherhood.Says Baqui: “Contraceptives save lives and it is high time the Nepal government allocated the necessary financing to fulfil this fundamental human right."Read also: <a href="https://www.nepalitimes.com/?p=33648&amp;preview_nonce=5c7e9df60a&amp;preview=true" target="_blank" rel="noopener noreferrer">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 noreferrer"> </a>

1 in 2 pregnancies in Nepal unintended

https://youtu.be/FmieAvLuWBoFederalism was supposed to bring the government closer to the people, decentralise medical care and improve <a href="https://www.nepalitimes.com/editorial/poor-health/" target="_blank" rel="noopener">public health</a> at the grassroots. But the new three-tier government structure threatens to undo Nepal’s gains in improving health services.The government’s ‘adjustment policy’ in the medical sector, which lets staff to pick their preferred tier of work, has led many to choose the federal level, leaving provinces and municipalities underserved. The biggest losers are the areas already lacking in services: Province 6 (Karnali) and the Far Western Province.Read also: <a style="background-color: #ffffff; font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/?p=37757&amp;preview=true" target="_blank" rel="noopener">Poor health makes Nepalis poorer</a>, Editorial At the Kolti Primary Health Care Centre in Bajura, there is no doctor, after the one serving here chose to be transferred to Kathmandu. Bajura District Hospital has five doctors but the contracts of three of them will soon expire.“I have not been informed of my new hospital yet, but I am about to be transferred. In two months, there will be a shortage of doctors here,” predicts Chief Medical Officer Rup Chandra BK, adding that all technicians, including a paramedic, a radiographer and health assistants, have been transferred or will be soon.Read also: <a href="https://www.nepalitimes.com/opinion/is-free-health-care-possible-in-nepal/" target="_blank" rel="noopener">Is free health care possible in Nepal?</a>, S P Kalaunee <a href="https://www.nepalitimes.com/banner/this-is-how-to-upgrade-nepals-rural-health/" target="_blank" rel="noopener">This is how to upgrade Nepal's rural health</a>, Sewa Bhattarai<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108151124/636a66a79c7e80680e059998jpeg.jpg" alt="" width="640" height="427"/>With a population of 135,000 people, Bajura has no private hospitals and only one government hospital, a primary health care centre, and 26 health posts. WHO recommends a doctor-patient ratio of 1:1,000, but here it is 1:150,000, while Kathmandu has a ratio of 1:850.This is nothing new: Far Western Province has long faced medical staff shortages. According to the Department of Health Services Report 2018, only 80% of positions in health facilities were filled, and only 56 of the 142 sanctioned doctor positions were staffed. That number will decrease further after adjustment.According to a list of adjustments of 8th level general practitioners (GPs) by the ministry of health, 36 doctors were serving in Far Western Province, but only 9 of them have chosen to remain. Of the 631 doctors at this level, as many as 326 chose the federal level, which means they are concentrated in Province 3. It is the same story in all other provinces. There are only 14 doctors in Province 6.“Far Western Province has always faced a shortage of doctors. We have a lot of nurses, assistants, and technicians, and even if they are transferred there are others to replace them. But specialist doctors earn a lot in the cities and a government hospital cannot offer them as much. No wonder they do not want to stay here if they have a choice,” says Ramesh Kunwar at the ministry of social welfare in the province.Read also:<a href="https://www.nepalitimes.com/editorial/poor-health/" target="_blank" rel="noopener">Poor health</a>, Editorial<a href="https://www.nepalitimes.com/here-now/henry-marsh-returns-to-the-institute-created-by-his-neurosurgeon-colleague-upendra-devkota/" target="_blank" rel="noopener">Henry Marsh returns to the institute created by his neurosurgeon colleague Upendra Devkota</a><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108151124/636a66a99c7e80680e059999jpeg.jpg" alt="" width="1500" height="1000"><figcaption> </figcaption></figure>The Government Doctors’ Association of Nepal (GODAN) is also unhappy. “From the beginning we have said that the medical sector is different from others and adjustment would result in neglect of underserved regions and migration of doctors to the cities, and we were right,” says Dipendra Pandey, president of GODAN. “We proposed that a federal bridge should be created, so that medical professionals working at the federal level can be sent back to their previous working area.”Ironically<a href="https://www.nepalitimes.com/banner/risking-his-life-to-save-lives/" target="_blank" rel="noopener">, physician Govinda KC</a> had to call off his 17th fast unto death in Dadeldhura because the district hospital did not have proper facilities in case his health deteriorated. KC has been protesting the commercialisation of medical education, which forces doctors to work in the cities to recoup their investments.“If the government does not replace those who are leaving the province, there is going to be a great crisis in healthcare in the Far West,” says Gunaraj Awasthi, chief of the Far West Regional Health Directorate in Dipayal. “It should immediately reinstitute those medical professionals on contract service.”<h2>Neglect kills mothers</h2><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108151124/636a66ad9c7e80680e05999ajpeg.jpg" alt="" width="640" height="427"><figcaption> </figcaption></figure>Lalita Bohora, 27, was ten months pregnant when her husband helped her walk for three days from Kolti to Bajura District Hospital to deliver her baby earlier this year. The staff told her it was a complicated pregnancy and there were no doctors to perform a caesariean section.Bohora was lucky — many other mothers are in no position to walk to the district hospital. Although Nepal’s maternal mortality rate (MMR) has come down drastically from 600 per 100,000 live births two decades ago to 239 today, many mothers in remote districts like Bajura continue to <a href="http://archive.nepalitimes.com/article/nation/people-politics-placentas-child-delivery-complications,3922" target="_blank" rel="noopener">lose their lives</a> just because maternity wards are not staffed, or properly equipped.Read also: <a href="http://archive.nepalitimes.com/article/nation/people-politics-placentas-child-delivery-complications,3922" target="_blank" rel="noopener">People, Politics, and Placentas</a>, Bikrash Gauchan<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108151124/636a66b09c7e80680e05999bjpeg.jpg" alt="" width="643" height="376">Since it started in 1997, the government’s safe motherhood program has provided cash to mothers if they do all four antenatal checkups, and mothers, and medical staff, are given cash incentives for institutional delivery. The number of birthing centres staffed by at least one skilled birth attendant has reached 1,755 nationwide.Despite the progress, Nepal is unlikely to bring MMR down to 125 by next year as planned, or meet the Sustainable Development Goal (SDG) target of 70 by 2030. Nepal’s topography and lack of roads are not the only reasons progress in MMR has stalled. According to a recent survey, half of public health facilities in Nepal lack running water and electricity at all times.Bajura District Hospital is constructing a new building, but it still operates out of an old, partly demolished building, where the operation theatre is a tin shed and there is irregular water supply and  electricity.“We hook up machines to the power supply during complicated operations, and the electricity suddenly goes off — we have to improvise a lot here,” says surgeon Durga Maharjan.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108151124/636a66b19c7e80680e05999cjpeg.jpg" alt="" width="640" height="427"></figure>Ward at Bajura District HospitalHaemorrhage during birth used to be the biggest cause of maternal mortality in the 1990s, now it is hospital-borne infections like sepsis. Many older women still think babies should be born at home, and dissuade their daughters-in-law from giving birth at a health facility.“There is still the idea that childbirth is a normal, natural thing, and not something you need to visit a hospital for,” says Latika Maskey at the UN Population Fund (UNFPA).Only 30% of women in Bajura go for all four of the antenatal checkups, while the average for the Far West region is 55%, and nationally it is still a high 44%. Because settlements are scattered in roadless remote Nepal, the government has focused on basic health facilities and birthing centres instead of large well-equipped hospitals, explains Punya Poudel at the safe motherhood program in the ministry of health.“We have a roadmap to reduce MMR to 70 by 2030 by focusing on postnatal checkups, midwives will be trained for delivery and community nurses will visit women at home during ante and postnatal periods,” says Poudel.<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108151124/636a66b49c7e80680e05999djpeg.jpg" alt="" width="640" height="427"><figcaption> </figcaption></figure>However, many of the new birthing centres are near bigger health facilities, which makes them less useful. There is a concern among health professionals that populist agendas have fuelled construction sprees, and that the birthing centres are not always staffed and ready to provide service.“Simply building birthing centres is not the solution. They should be properly mapped and located where they will be most effective. They should be functional so that at least one person is available 24 hours a day to provide simple delivery services,” says Pavan Agarwal at Bayalpata Hospital in nearby Achham district.Neetu Shrestha of UNFPA says reproductive health should not be limited to treatment of birth as an event. She says: “To improve maternal health, we need to focus on sex education, invest in <a href="https://www.nepalitimes.com/here-now/nepal-far-from-hitting-contraceptive-target/" target="_blank" rel="noopener">family planning</a> knowledge and methods, ante and post-natal care, and address cultural barriers.”

Federalism leaves Nepal’s medical sector ailing

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107121148/6368f1049c7e80680e035a06jpeg.jpg" alt="" width="800" height="1199"/><figcaption>Pics: NSI</figcaption></figure>Avinashi Poudel, 30, is a mother of two, including a 10-week baby boy. She only breastfeeds her baby, and has supportive in-laws and a mother friendly environment at her workplace. But seven years ago when she was a first time mother, she was not aware of the benefits of exclusive breastfeeding and her first baby did not get enough of her milk.Rama Thapa, 23, moved to Kathmandu from Tanahu after she got married. She now has a six-month baby boy, and feeds him food supplements because she says her own milk is not enough. Her family and friends told her the baby needs the formula to grow up strong and healthy.Nearly seven out of every ten Nepali mothers still exclusively breastfeed their babies, but some families are turning to supplements because of inroads by baby food manufacturers. Ironically, mothers in western countries where those baby food alternatives were first introduced, have returned to exclusive breastfeeding.Nepal is among the countries that are already above the World Health Organisation (WHO) target to increase the rate of exclusive breastfeeding in babies' first six months to at least 50%, by 2025. However, because of aggressive marketing by baby formula brands, Nepal has set its own national target to increase exclusive breastfeeding to 80%.“Nepal has set a good standard in breastfeeding but we need to sustain it and make further progress, this requires policy implementation and monitoring,” says Pradiumna Dahal, nutrition expert at UNICEF Nepal, who is worried that not all health workers are aware of the benefits of breastfeeding.The use of breast milk substitutes is so widespread that health professionals in the Far-West are prescribing bottled milk in hospitals. Baby food is a burgeoning industry, and salesmen often target hospitals, doctors and nurses with inducements to prescribe babies substitutes for breast milk.After a huge international outcry against Nestle and other baby food supplement manufacturers, the WHO adopted the <a href="http://www.who.int/nutrition/publications/code_english.pdf" target="_blank" rel="noopener noreferrer">International Code of Marketing of Breast-milk Substitutes</a> to promote breastfeeding. Nepal passed the <a href="http://www.nnfsp.gov.np/PublicationFiles/2574d2af-7992-469b-befa-ad939ac96497.pdf" target="_blank" rel="noopener noreferrer">Substitute of Breast Milk Act</a> in 1992 to control the sale and distribution of breast milk substitutes. It penalises health professionals pushing and manufacturers promoting baby food formulas.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107121148/6368f1079c7e80680e035a07jpeg.jpg" alt="" width="500" height="234">But while the $70 billion global baby food industry has seen sales plummet in Western countries, as more mothers embrace breastfeeding, modern lifestyles and higher purchasing power has pushed families in developing countries to use infant formulas.Recently, the <a href="https://www.theguardian.com/us-news/2018/jul/08/trump-administration-opposes-breastfeeding-resolution-report" target="_blank" rel="noopener noreferrer">Trump administration exerted pressure to dilute</a> the clause in a resolution to promote and support breastfeeding at the World Health Assembly in Geneva in order to promote the interests of infant formula manufacturers. The US delegation even threatened Ecuador that it would terminate military aid if it voted for the resolution. Washington could also cut funding for WHO, the UN Population Fund and other agencies involved in promoting breastfeeding, reproductive health, contraceptives, abortion and even vaccination programs in developing countries, including Nepal.Allowing infant formula manufacturers unrestricted access to the domestic market threatens to undo decades of effort in Nepal to reduce the infant mortality rate and promote <a href="http://archive.nepalitimes.com/article/nation/people-politics-placentas-child-delivery-complications,3922" target="_blank" rel="noopener noreferrer">maternal health</a>.“We have been working to promote breast milk and convinced a large proportion of mothers in Nepal to exclusively breastfeed. However, we have not been able to regulate the activities of the manufacturers of breast milk substitutes,” says Bikash Lamichhane at the Department of Health Services.Nutritionist Aruna Uprety says that despite the government’s claim that the rate of exclusive <a href="https://katherinerosman.com/extended-breastfeeding/" target="_blank" rel="noopener noreferrer">breastfeeding</a> has increased, breast milk substitutes are used widely, even in government hospitals. Manufacturers are known to reward clinics and doctors promoting and prescribing their infant formulas.“Breastfeeding is engrained in our culture, we don’t need foreign experts to teach us its significance. We just need to create awareness and provide an enabling environment for women to be able to breastfeed,” Uprety told Nepali Times.<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107121148/6368f1089c7e80680e035a08jpeg.jpg" alt="" width="800" height="1199">Indeed, health officials say any future cuts in American funding for maternal and child health should not make a big dent on efforts to promote exclusive breastfeeding in Nepal.In 2016, the government set up a system to monitor the use of breast milk substitutes in each district. But with new federal and provincial structures in place, and confusion about the role of district health offices, experts are worried that the monitoring system will not be effective.A <a href="http://www.nphss.org.np/archive_2012/52-54.pdf" target="_blank" rel="noopener noreferrer">survey in 2011 by the Institute of Medicine</a> showed that despite the Baby Friendly Hospital Initiative, there had been no action to control and regulate breast milk substitutes and producers and the distributors were found to be violating the Breast Milk Substitute Act. The study also noted that the promotion of breastfeeding was not prioritised and awareness was limited to token functions during World Breastfeeding Week.Studies have shown that counselling, awareness and legislating paid maternity leave increased the rate of exclusive breastfeeding, and had an immediate impact on maternal and infant health as well as the overall economy.Says UNICEF’s Dahal: “We need to encourage more women to breastfeed. That means adding breastfeeding corners in our work places and providing maternal security in the form of sufficient leave.”The Department of Health Services is planning to inaugurate a breastfeeding corner at its own office in Teku to mark World Breastfeeding Week (1-7 August). UNICEF is supporting the government to set up 30 baby friendly hospitals, and train counsellors and other personnel. The Ministry of Health is also preparing to extend the duration of paid maternity leave from two months to six, to improve maternal and child health.<h4>The Trump tremor</h4><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107121148/6368f10b9c7e80680e035a09jpeg.jpg" alt="" width="640" height="354">Nepal has scored dramatic success in reducing maternal and infant mortality rates over the few decades, and USAID has been one of the biggest bilateral backers for family planning, reproductive health, maternal and child health projects.However, funding for these programs has often been affected by successive Republican administrations because of a strong conservative lobby for the <a href="http://archive.nepalitimes.com/article/Nepali-Times-Buzz/globe-rallies-to-aid-nepals-women,3841" target="_blank" rel="noopener noreferrer">Global Gag Rule</a>, which seeks to end American aid for contraceptive promotion and abortion.The <a href="https://pai.org/wp-content/uploads/2016/12/Access-Denied-The-Impact-of-the-Global-Gag-Rule-in-Nepal.pdf" target="_blank" rel="noopener noreferrer">last time it was in effect, during the Bush Administration</a>, mobile clinics providing reproductive services to rural Nepal were discontinued. The Family Planning Association of Nepal (FPAN) lost $400,000 in USAID-funded contraceptives, which represented two-thirds of its total stock, and a further loss of $100,000 per year that supported reproductive health clinics.President Donald Trump has renamed the Gag Rule as ‘Protecting Life in Global Health Assistance’ after restoring it in March 2017. Despite its new name, it is actually stricter, even targeting breastfeeding and vaccines.“The Global Gag Rule is not new, what is new is that it has come back with added force under Trump and can have devastating consequences on Nepal,” explains public health expert Aruna Uprety. “By pulling money out of abortion, they are going to increase unsafe abortions and end up killing more women. It is against human rights.”<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221107121148/6368f10d9c7e80680e035a0ajpeg.jpg" alt="" width="600" height="558">Just a month before the 2015 earthquake, the Nepal Government made a commitment to increase the family planning budget allocation by 7% annually. It partnered with international and private organisations to meet the target, but most of these partners are likely to lose a chunk of their funding.“Our government already lacks resource to meet the commitment. With the US pulling out, the gap is only going to widen,” says an official working in family planning.A US Embassy spokesperson said the United States remained committed to helping the welfare of women and children in developing countries: “The Protecting Life in Global Assistance policy has not reduced funding for women and children’s health by one dollar. USAID works together with the Government of Nepal and other external development partners, including multilateral partners, to coordinate interventions, synergise, and reduce gaps. USAID has strong working relationships with both UNFPA and WHO in Nepal.”Although <a href="https://www.nepalitimes.com/here-now/migrating-males-and-population-decline/" target="_blank" rel="noopener noreferrer">family planning</a> is a small component of the aid budget for maternal health, the cuts are biting. The EU and Nordic countries have stepped in, but their contribution does not meet the shortfall.At the recent World Health Assembly in Geneva, the United States wanted to dilute a routine agreement on breastfeeding, amidst a global outcry.The United States delegation wanted to water down the resolution by removing a call on governments to ‘protect, promote and support breast-feeding’ and another clause calling for restrictions on the promotion of baby foods.“What happened was tantamount to blackmail, with the US holding the world hostage and trying to overturn nearly 40 years of consensus on the best way to protect infant and young child health,” Patti Rundall of the British advocacy group Baby Milk Action was <a href="https://www.nytimes.com/2018/07/08/health/world-health-breastfeeding-ecuador-trump.html" target="_blank" rel="noopener noreferrer">quoted by the New York Times </a>as saying.The uproar set off alarm bells in Nepal, where donor support has been critical in trying to meet the target of getting 80% of mothers to breastfeed by 2022.The US Embassy clarified that improving nutrition among mothers, infants, and young children was still an important public health priority for the United States, and it remained committed to working with WHO and other stakeholders to improve health and nutrition through “cost-effective and evidence-based” measures.But, the spokesperson added: “While the United States recognises that breastfeeding and provision of breast milk is best for all babies, we recognise not all women are able to breastfeed for a variety of reasons. These women should have access to full and accurate information about breastfeeding, the benefits of breastfeeding, and safe alternatives when breastfeeding is not possible.”Some experts contend that cuts in funding would not affect the breastfeeding campaign, and Nepal did not need to be dependent on donors anymore.“Even if the US cuts funding, Nepal is capable of going ahead on its own. Awareness here about breast milk far exceeds any opposition from outside, it’s just that the government has to own it,” says former WHO public health expert Rita Thapa.Aruna Uprety agrees, but adds that the Americans have played cleverly on a woman’s choice not to breastfeed: “This distracts from the fact that mother’s milk is the healthiest for babies.”The conclusion is that Nepal is perfectly capable of maintaining its momentum not just on breastfeeding, but also on protecting maternal and infant health with or without outside help.<h4>Breast is best</h4>Awareness and education can double exclusive breast-feeding rates in societies. Paid maternity leave can increase breastfeeding rates by 50%. This directly helps the national economy, and the health of mothers and babies. Breastfeeding:<ul><li>Prevents breast cancer deaths</li> <li>Reduces infant diarrhoea by half and respiratory infections by one-third</li> <li>Decreases hospital admissions by 57-72%</li> <li>Children's IQ increases by average of 3 points</li> <li>Investing $1 to promote breastfeeding yields $35 in economic returns</li></ul>https://www.youtube.com/watch?v=-PSs2cPsciw

Sonia Awale

Back to the nipple in Nepal

In 2004, Poet Durga Lal Shrestha asked me to translate 223 little poems from Newa into English. They were each written as sestet-- terse in their form but heavy in imagery and sentiment. The novice translator in me struggled to find the best way to convey his poetry in English-- but the process became a tour as I discovered my mother tongue anew. The highlight, however, was Shrestha’s handwriting. His calligraphy is immaculate. He had given me photocopies from the notebook he had written the poems in and each page looked as though they were freshly out of the press. The letters bore a consistency, unswayed by the emotions of his poetry. Sometimes, I would just stare at the handwriting in admiration.&nbsp; Someone else had been similarly besotted by his writing: “I met him 25 years ago in the UK when he was the chief guest at a Mha Puja event organised by Pasa Pucha,” recollects Ojesh Singh, writer and engineer. “We were roommates. I noticed he couldn’t stop writing.”&nbsp; Shrestha, an octogenarian now, was a teacher at Kanya Mandir School for many years, where his writing was admired by colleagues and students. Known as Janakavi or People’s Poet, a title bestowed on him by the Nepal Bhasha Parishad, Shrestha is also the recipient of the Jagadamba Shree Puraskar for his contribution to literature.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251021071052_b109f2ee6dbac911fb8002e8e8bb33a50a8f755d26662f333535d32c8573e782.jpg" data-media-id="editor_0" data-image-id="20251021071052_b109f2ee6dbac911fb8002e8e8bb33a50a8f755d26662f333535d32c8573e782" data-rendition-name="original" width="1600" height="900" loading="lazy" alt="Digitising the savant calligrapher NT"> <figcaption>From left to right: Suman Shrestha, Ananda Kumar Maharjan, Durga Lal Shrestha, Ojesh Singh, and Arbindra Man Singh. Photo: SUCHITA SHRESTHA</figcaption> </figure>  “He would write on anything he could lay his hands on. On tissue paper, envelopes, cigarette boxes. It struck me how neat and tidy his writing was,” says Singh. “The structure and size were perfectly in sync-- and as an aspiring graphic designer then, I fell in love with his writing. Later, whenever I read his books, I thought it would be nice to read them in his writing.” After sitting with the notion of turning Shrestha’s writing into a digital font for years, in 2024, he reached out to a small group of people who he thought might be allies.&nbsp; “It was during Ojesh Ji’s book launch that we met and talked about the possibility of turning Durga Lal Shrestha’s writing into font,” recalls Ananda Kumar Maharjan, who has designed the Durga Lal Shrestha font and is affiliated with Callijatra, an organisation promoting Newa calligraphy.&nbsp; For Singh, the desire to immortalise the poet's handwriting wasn’t only coming from personal admiration, it was also about preserving the writing of a language and literature leader and activist. He offered to fund the font project, which meant paying for Maharjan’s time and dedication. He also drew into the conversation Shrestha’s son Suman, who has been an integral part of the process.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251021071056_372dc34ac3ce3b70445128131a11ade8f321756c6cc7615825c4451e85f56374.jpg" data-media-id="editor_1" data-image-id="20251021071056_372dc34ac3ce3b70445128131a11ade8f321756c6cc7615825c4451e85f56374" data-rendition-name="original" width="616" height="728" loading="lazy" alt="Digitising the savant calligrapher NT"> </figure>  The others involved in the process were journalist Arbindra Man Singh, who had been scanning Shrestha’s writing for the book Hastakshar, a collection of poems printed in the author’s handwriting. Also an enthusiast of converting Shrestha’s writing to a font, Singh provided help in bringing together the scans, based on which Maharjan picked the best letter for each alphabet to create a complete set.&nbsp; “Doing this was different from other font developments I have done in the past,” explains Maharjan, who has also digitised his own handwriting into a font, called Anand. “To create Durga Lal Shrestha’s writing as font, I had to analyse his writing archive and pick the best.”&nbsp; He adds: “There was a book published in his writing, so there were scans and digital archiving done by Arbindra Ji, which became the foundation for my work.” He had to find a prototype for each alphabet based on the scans. He traced the letters on Illustrator and copied them to a MAC software called Glyphs where he had to enter each letter, using a traditional Devanagari keyboard instead of Unicode.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/2025102108100_2f6b8c0f3cf91682707ac356e11ad50b342a4198f56490ab68d041e875b15edb.jpg" data-media-id="editor_2" data-image-id="2025102108100_2f6b8c0f3cf91682707ac356e11ad50b342a4198f56490ab68d041e875b15edb" data-rendition-name="original" width="818" height="766" loading="lazy" alt="Digitising the savant calligrapher NT"> </figure>  “I had to be very careful to keep it accurate. Conjunctions need attention,” Maharjan says. “There are half letters, saint letters, ligatures and open type features to pay attention to, this is more advanced than the fonts I’ve created in the past.” &nbsp; Maharjan has designed this font in three different variations that users can play with. “Writing changes with age. While young, people write better, but with age, it starts to change. Since Durga Lal Shrestha hasn’t been very well lately, his hand shakes when he writes. So, we had to pick the best of his writing from the records,” he adds. “People also tend to write in different styles depending on their mood so we took the best four of every letter and traced and picked one.”&nbsp; Handwriting is deeply intimate and in this day and age of tech, becoming lost.&nbsp; What bothers me about the day of phones is that I no longer know what the writing of those close to me look like. I no longer know how you press the pen between our fingers or how you tilt it against the paper or how you pause to write periods or how the nib makes a perfect tiny orb before you drag it just so, to turn it into a comma. The familiarity of the nuances of someone’s writing is lost on us.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251021071056_2c83ab2c3ed4cfa42e6a6a637d88fd879218fb5b7391e086ab5db1a8ec173654.jpg" data-media-id="editor_3" data-image-id="20251021071056_2c83ab2c3ed4cfa42e6a6a637d88fd879218fb5b7391e086ab5db1a8ec173654" data-rendition-name="original" width="992" height="1280" loading="lazy" alt="Digitising the savant calligrapher NT"> </figure>  Ojesh Singh agrees with me. He says it’s important to keep handwriting alive as people become more and more tech-dependent. People are likely to interact even less with letters on paper, but at least we can have fonts, he says.&nbsp; A set of six books by poet Durga Lal Shrestha is set to be launched on 31October. One of them, entitled, Kawa, is typeset in the Durga Lal Shrestha Font. The font will be made available to the general public after the books have been released. In July, I had visited Shrestha, who I also call Durga Lal Taaba, as many Newa people in my generation do. Seated in the quiet of his home, he conversed about literature and language with my father and my uncle. Coming out of Taaba, Newa, which has a utilitarian function for me to communicate with my parents, sounded more like a lyric.&nbsp; I asked him what he thinks about his handwriting being archived as a font. He replied: “This body is going to be gone eventually, so I thought maybe my handwriting could live on.” Suburban Tales is a monthly column in Nepali Times based on real people in Pratibha’s life.

Digitising the savant calligrapher

The winter air pollution season started early this year with emissions, Diwali firecrackers and crop residue burning making the air unbreathable across north India. Much of the pollution was transboundary, with prevailing winds carrying the suspended particulates from Pakistan, across India to Nepal and beyond. All this pollution and domestic emissions killed 41,300 in Nepal in 2023, and 85% of all deaths were because of noncommunicable diseases such as heart and lung disease, lung cancer, diabetes, and dementia, according to the State of Global Air (SoGA) 2025 report released Thursday. With the onset of winter, Kathmandu Valley’s own emissions are trapped in a surface inversion layer and as in previous years will have some of the worst air quality in the world.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251023131016_7c42a4e8b0dce01dfeeaaf89dbb10dbfa036b41163f3ebada88c7ce17dbded49.png" data-media-id="editor_0" data-image-id="20251023131016_7c42a4e8b0dce01dfeeaaf89dbb10dbfa036b41163f3ebada88c7ce17dbded49" data-rendition-name="original" width="921" height="850" loading="lazy" alt="Air pollution killing season starts early NT"> </figure>  The SoGa report says air pollution has now become the leading risk factor for deaths in Nepal, ahead of tobacco and high blood pressure. Interestingly, while the health impacts due to environmental risk factors such as unsafe water and sanitation have reduced significantly since 2000, the opposite is true for ambient PM2.5 (particles smaller than 2.5 microns). Globally, 7.9 million deaths were attributable to air pollution– about 1 in 8 deaths – in 2023. Of this total, 4.9 million deaths were attributable to PM2.5 exposure, 2.8 million were from household air pollution, and 470,000 were from ozone. Similarly, dementia attributable to air pollution resulted in 626,000 deaths and 40 million healthy years of life lost. And 95% of air pollution attributable deaths in adults over the age of 60 are due to noncommunicable diseases. The burden of noncommunicable diseases in relation to air pollution is rising worldwide and in Nepal. The SoGA report shows that nearly nine of ten global air pollution deaths are from chronic ailments, and half of all respiratory disease deaths are attributable to air pollution.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251023131020_8577f464b4a73007de5dd018b8ac91dae3a9c732dbb81a44b6aa5a0ced7df3df.png" data-media-id="editor_1" data-image-id="20251023131020_8577f464b4a73007de5dd018b8ac91dae3a9c732dbb81a44b6aa5a0ced7df3df" data-rendition-name="original" width="1080" height="1080" loading="lazy" alt="Air pollution killing season starts early NT"> </figure>  In Nepal, air pollution is responsible for three out of four COPD deaths, one out of three heart deaths and one out of five diabetes deaths. More than one third of lower respiratory infection deaths were due to air pollution. “The data presented in the State of Global Air report highlight the significant impacts of poor air quality on the health and well-being of billions of people around the world, especially those living in Asia and Africa,” says Pallavi Pant of the Boston-based Health Effects Institute (HEI) that released the report in collaboration with the Institute for Health Metrics and Evaluation and the NCD Alliance. She adds: “Growing momentum on air quality management across those hard-hit locations, including expansion of air quality monitoring, adoption of air quality regulations, and sector-specific interventions are yielding improvements for those most impacted.” Low- and middle-income countries stand to gain most by reducing air pollution, with particularly strong impacts on children, older populations, and people with pre-existing health conditions. Indeed, of the 41,300 air pollution deaths in 2023 in Nepal, 31,600 were in adults over the age of 60 years and 3,500 in children below five years. Death rate for air pollution in Nepal, which is 178 per 100,000, is more than 10 times higher than high-income countries, which is at 17 per 100,000.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251023131020_604e852aed4ffde0dc7d1df72fcd3e73d904136dfb1bb2407e53b7445f3ef72c.png" data-media-id="editor_2" data-image-id="20251023131020_604e852aed4ffde0dc7d1df72fcd3e73d904136dfb1bb2407e53b7445f3ef72c" data-rendition-name="original" width="1078" height="423" loading="lazy" alt="Air pollution killing season starts early NT"> </figure>  “Win-win solutions for air pollution and NCDs exist, with added benefits for climate, physical activity, nutrition, and many other global development priorities,” says Alison Cox, Policy and Advocacy Director at the Geneva-based NCD Alliance. “These policies are effective and deliver a strong return on investment - for the sake of our people and the planet we need to implement them faster.” Fine particle pollution (ambient PM2.5) is the largest driver of air pollution’s burden of disease worldwide as kit attributed to 4.9 million deaths and 124 million healthy years of life lost in 2023. Vehicles, power plants, factories, and homes, as well as agricultural and industrial activities, waste burning and wildfires are some of the biggest sources of pollutants. South Asia is among the regions of the world with the highest exposures to ambient PM2.5 , while more than 36% of people around the world live in areas where PM2.5 levels do not meet even the least stringent interim target. As per the report, 78% of Nepal’s 30 million population lives in areas where annual PM2.5 exposure exceeds the least stringent WHO Air Quality Interim Target of 35 µg/m3. Meanwhile, exposure to household air pollution due to the use of solid fuels for cooking remains an important driver for the disease burden in the country. “Ongoing efforts to meet global development goals are not achievable without directly addressing air pollution,” says Maria Neira, Commissioner of Our Common Air. “Countries and cities must focus their efforts toward reducing air pollution emissions, including household air pollution, which has particularly severe impacts on young children and older people across Asia and Africa.”

Air pollution killing season starts early

Nepal needs to enact and enforce animal law

This year, the <a href="https://nepalitimes.com/opinion/quo-vadis-un-80-9vthn7mg">United Nations is marking its 80th anniversary</a> and it is being celebrated with special events across the world to commemorate its establishment on 24 October 1945. It has also been 75 years since the first UN adviser, the Swiss geologist Toni Hagen, was sent to Nepal to explore development opportunities. In 1950, there were no roads and Hagen walked on foot across the length and breadth of Nepal’s mountains, valleys and plains. This year also marks the 60th anniversary of the United Nations Development Program (UNDP) in Nepal, and much of Hagen’s work laid the basis for the UN’s involvement in education, health, and connectivity in Nepal’s future development. Despite frequent changes in government and political system, Nepal has made remarkable progress. The poverty rate has gone down by half in the past 30 years to 20.27% of the population. Much of it has to do with remittances from Nepalis working overseas, but it is also a result of the Nepal government’s investment in education, health care and social welfare.&nbsp; There have been special initiatives like the Prime Minister’s Employment Program that have provided jobs to nearly 800,000 people in the country’s 743 municipalities — especially in those areas with lower Human Development Index (HDI) like the far-west and the Tarai.&nbsp; This year’s HDI report by UNDP shows that Nepal’s score had risen to 0.622, whereas it was only 0.404 in 1990. In the past 33 years, the average lifespan of Nepalis has risen by 15.6 years to 70.4 years, whereas it was only 54.8 in 1990. However, the country’s HDI ranking is still 145 among the world’s 193 countries. “Yes, there has been significant improvement in living standards in the past 60 years, road connectivity has improved, the maternal mortality rate has gone down dramatically, almost everyone has phones, there are schools,” says Saru Joshi of the thinktank Nepal Policy Institute. But, she adds: “It is still difficult to get citizenship papers, especially in the name of the mother, and this has excluded many women from banking services, inheritance. After all our progress in physical infrastructure, Nepal now needs to prioritise inclusive social development.”&nbsp; Some of this is also happening. Eighteen years ago, Nabaraj Subedi, 49, of a village in Baglung decided not to join his peers &nbsp;fleeing the Maoist conflict to find work overseas. He invested Rs500,000 to buy a diesel generator and start a small furniture business.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251024071044_eeef308e19a73de507a425b2c6afc47269884549cf4c8fac07ca9a4898c8e031.jpg" data-media-id="editor_1" data-image-id="20251024071044_eeef308e19a73de507a425b2c6afc47269884549cf4c8fac07ca9a4898c8e031" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Nawaraj Subedi"> <figcaption>Nawaraj Subedi, 49, proprietor of Tarakhola Furniture Factory. </figcaption> </figure>  Today, with the installation of the 380 kilowatt small hydroelectric plant, he does not need to depend on his unreliable generator to power his equipment anymore. There is now a road connecting his village, and Subedi has generated local jobs, opened a sales branch in the city, and gets orders from as far away as Pokhara and Chitwan. “My costs have gone down drastically because of the electricity, and sales have gone up because of the road connecting my furniture to markets. My business has expanded,” Subedi says. Back in 1960 in a report he prepared for the Nepal government on behalf of the United Nations, Toni Hagen had emphasised just this: investing in electricity generation and connectivity to uplift the remote rural areas of Nepal.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251024081024_188ab121dc3cf2816ee71a72cb3687493eda37ab99ecc04802d647c8c9b4cd2d.jpg" data-media-id="editor_2" data-image-id="20251024081024_188ab121dc3cf2816ee71a72cb3687493eda37ab99ecc04802d647c8c9b4cd2d" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Tarakhola Furniture Factory"> <figcaption>Subedi's staff at the Tarakhola Furniture Factory.</figcaption> </figure>  Subedi’s furniture factory gets its electricity from the nearby Tarakhola Hydropower, a company set up eight years ago with financial and technical support from UNDP’s Renewable Energy for Rural Livelihood (RERL) project. &nbsp; “The project completely transformed living standards in this village,” says municipality chair Dhan Bahadur BK. “It has helped create jobs locally, there is now money to invest in education and healthcare. Households can pay their electricity fees electronically through smart billing.”&nbsp; After working with the government on rural electrification, UNDP is focussed on using that power for local employment creation. A women’s group, for example, has bought an electric-powered potato processing machine that can produce chips.&nbsp; “We are 12 of us mothers, daughters, daughters-in-law who process, package and market the potato that we grow ourselves, and it has raised our income,” says Sukmaya Roka, 57, who chairs the group.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251024071044_70b22418699178bcdd0abb0aa308796980ecd29634bcda6ff113a7624e709751.jpg" data-media-id="editor_3" data-image-id="20251024071044_70b22418699178bcdd0abb0aa308796980ecd29634bcda6ff113a7624e709751" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Sukamaya Roka"> <figcaption>Sukamaya Roka, 57, chair of Sipa Aalu Chips Utpadan Samuha from Tarakhola Rural Municipality, Baglung. </figcaption> </figure>  Today, 6.1 million households in Nepal (92.2% of total) have electricity in their homes, up from 17.9% 30 years ago. Access to electricity has not just brought lights to homes, but improved everything from productivity, quality of education, healthcare and phone connectivity.&nbsp; “To see what electricity and roads can do, just look at our municipality,” says chair Dhan Bahadur BK, “citizens have become more self-reliant, more aware of the outside world.”&nbsp; NETTLES INTO CASH&nbsp; Just a little bit of training, resource backup and local empowerment can uplift the living standards of Nepalis. The progress made in harvesting abundantly-available allo (nettles) and turning it into household products is an example. When a landslide swept away his home and farm in a flood 40 years ago, Buddhi Purja of Parbat became destitute. But he took part in a government training program supported by UNDP and Australia to harvest the wild nettles that grew on mountain slopes and turn the fabric into bags.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251024071048_56c440c478dffbc13911369b6f4133baf658cc3667773cdb44b7c40e006463ce.jpg" data-media-id="editor_4" data-image-id="20251024071048_56c440c478dffbc13911369b6f4133baf658cc3667773cdb44b7c40e006463ce" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Rhitu Saugat Handicraft"> <figcaption>A worker at Rhitu Saugat Handicraft making a bag out of nettles.</figcaption> </figure>  “After the landslide, we had to go hungry if we did not get a day job,” Purja recalls, “but after this training we have found that we can turn nettles into cash.” His allo bags are now hanging in tourist shops in Pokhara Lakeside and Thamel.&nbsp; The idea that nettles can be processed into useful fabric has not spread across the country, and new ecologically conscious consumers in Europe and elsewhere now import Made in Nepal nettle products.&nbsp; Purja started out with an investment of Rs500,000, and had a Rs20 million business that employed 25 workers. The Covid crisis in 2020 affected the sales, but Purja has recovered from it, sent his daughter off to study abroad, and is thinking of diversifying his product range.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251024071044_ab6d15abcbb9a643e12a384f4bc488b7e210a8c95303fbe1b2f77716d26eede9.jpg" data-media-id="editor_5" data-image-id="20251024071044_ab6d15abcbb9a643e12a384f4bc488b7e210a8c95303fbe1b2f77716d26eede9" data-rendition-name="original" width="1500" height="1000" loading="lazy" alt="Buddi Purja"> <figcaption>Buddi Purja, proprietor of Rhitu Saugat Handicraft in Pokhara.</figcaption> </figure>  While UNDP’s project has made successful businessmen out of people like Purja, nationwide it has created 187,000 jobs in rural medium-scale industries. Much of what has worked in Nepal has been at the community level with decentralised projects like these that use the entrepreneurship of people like Buddhi Purja, Navaraj Subedi, and Sukmaya Roka. It is tantalising to imagine how much more progress Nepal would have made if their work could be replicated nationside and upscaled to the state-level.

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