| Estimated Population | 27.5 million | | Population Growth Rate | 2.25% per annum | | Population Density | 186 people per square km |
Source: UNFPA[i]
[i] United Nations Population Fund (UNFPA). (2009). Asia and the Pacific at a Glance. New York, USA: UNFPA
Nepal has participated in and endorsed International Conferences and Reservations on the International Conference on Population & Development (ICPD) Programme of Action (PoA). These are: ICPD (1994), Beijing Platform for Action (1995) and Millennium Development Goals (MDG) (2000).[i]
In 2005, Nepal registered the highest MMR in all 12 of ARROW’s priority countries, recording 830 per 100 000 live births, which is an increase from both 1995 (826) and 2000 (740), making it impossible for Nepal to meet the MDG5 goal on maternal mortality reduction by 75% between 1990 – 2005.[ii] However national data on MMR varies considerably, showing an MMR of 281 per 100 000 live births.[iii] The MMR can be attributed to a distinct lack of skilled attendants at birth, of accessibility to health care facilities and services which also includes post partum care. In addition to maternal mortality, the lesser considered aspect of maternal morbidity is also an important one.
Women in Nepal are vulnerable because their health and development are affected by early, too frequent, too many, and late pregnancies. Women bear the medical risks and social responsibilities for unwanted and unplanned pregnancies. Population policies are not based on the principle of respect for the sexual and bodily integrity of girls and women. For example they target a woman as a contraceptive ‘acceptor,’ rather than a whole being, which leads to her suffering from untreated infections and diseases. Women bear the brunt of the side effects of contraceptives and contraceptive methods as most of these are targeted towards women. Despite the legalisation of abortion in 2003, unsafe abortion is still a serious and pervasive problem, and is the cause of up to 20-27% of maternal deaths in hospitals. Records maintained by the National Maternity Hospital in Kathmandu for 2002, show that nearly 10% of the 18,000 gynaecological cases admitted to the hospital were abortion-related. Moreover, studies showed that 5% of maternal deaths in villages are caused by unsafe abortion. Regrettably, many women living in isolated, rural areas die before they ever reach a hospital.[iv] ARROW’s partners in Nepal have chosen the prevalence of uterine prolapsed amongst gynecological patients and its socio-cultural determinants as an issue for advocacy.[v]
Early marriage being predominant in Nepal, the situation is also extremely challenging for female adolescents, and once they marry, they are expected to bear children right away. Nearly one-quarter of women give birth before they reach the age of 18, while over half have had a birth by the age of 20.[vi]
Being a patriarchal society, women’s roles are often limited and restricted. Myths and traditional practices related to women’s reproductive health are still practiced, leading to gender discrimination and suppression of women (for example, menstruation is regarded as something that is dirty and shameful, instead of natural, and pregnant women are oftentimes kept hidden away before and after birth).[vii]
Sexuality, sex and reproductive health are taboo subjects in Nepal, like in many Asian countries, and talking about anything related to these topics is considered immoral (for both the young and adults). Sexuality is an extremely sensitive subject in the Nepalese culture and a girl’s chastity is highly valued. If a girl loses her chastity before marriage, her chances of having a formal wedding is drastically reduced although it’s interesting to note that young men are often sexually active before marriage and marry later in life as they are less restricted than young girls.[viii] Sexual abuse, non-consensual sex and sexual violence, including trafficking of girls and women happen more often than not. Large numbers of girls and women are trafficked for sex work to India and other countries. STIs and HIV/AIDS is proving to be prevalent among sex workers; clients of sex workers (and increasingly their spouses); drug users; and migrant workers.[ix]
As Nepal has committed to implementing the ICPD POA, the BPFA and the ICPD+5, national plans outline increased attention to SRHR awareness, services and related laws and policy; positive reforms in health services; increase in the number of village health workers and mother and child workers in each village development committee; and a focus on poverty alleviation.[x]
Unfortunately, these achievements are overshadowed by persistent poverty and a large number of people with unmet basic needs; an increase in STIs and HIV/AIDS; limited mechanisms to effectively provide services in rural areas; continuing gender, ethnic and other forms of discrimination; a lack of transparent policy; and a low priority for programmes targeted at adolescents and youths. The government’s ineffective and weak performance in policy and programme implementation, and gender mainstreaming in the government (i.e. the consideration of gender issues across all sectors, ministries and departments) have also proven to be problems.[xi]
[i] Thanenthiran, S; Racherla S.J. (2009). Annex of Tables. Reclaiming & Redefining Rights – ICPD+15: Status of Sexual and Reproductive Health and Rights in Asia (p.45). Kuala Lumpur, Malaysia: The Asian-Pacific Resource & Research Centre for Women (ARROW). [ii] World Health Organisation (WHO). (2007). Maternal mortality in 2005 : estimates developed by WHO, UNICEF, UNFPA, and the World Bank. Geneva, Switzerland : WHO [iii] Ministry of Health and Population (MOHP) Nepal; New ERA; Macro International Inc. (2007). Adult and Maternal Mortality. In Nepal Demographic and Health Survey 2006 (p. 133). Kathmandu, Nepal: Ministry of Health and Population; New ERA; Macro International Inc. [iv] Women’s Health and Rights Advocacy Partnership (WHRAP) South Asia; The Asian-Pacific Resource & Research Centre for Women (ARROW). (2008). Nepal. In Advocating Accountability: Status Report on Maternal Health and Young People's Sexual and Reproductive Health and Rights in South Asia. Kuala Lumpur, Malaysia: ARROW. [v] Safe Motherhood Network Federation (SMNF); Beyond Beijing Committee (BBC); Tribhnuvan University Teaching Hospital (TUTH). (2009). Prevalence of Uterine Prolapse amongst Gynecology OPD Patients in Tribhuvan University Teaching Hospital in Nepal and its Socio-Cultural Determinants. Kuala Lumpur, Malaysia: The Asian-Pacific Resource & Research Centre for Women (ARROW) [vi] Women’s Health and Rights Advocacy Partnership (WHRAP) South Asia; The Asian-Pacific Resource & Research Centre for Women (ARROW). (2008). Nepal. In Advocating Accountability: Status Report on Maternal Health and Young People's Sexual and Reproductive Health and Rights in South Asia. Kuala Lumpur, Malaysia: ARROW. [vii] Women’s Health and Rights Advocacy Partnership (WHRAP) South Asia; The Asian-Pacific Resource & Research Centre for Women (ARROW). (2008). Nepal. In Advocating Accountability: Status Report on Maternal Health and Young People's Sexual and Reproductive Health and Rights in South Asia. Kuala Lumpur, Malaysia: ARROW. [viii] Women’s Health and Rights Advocacy Partnership (WHRAP) South Asia; The Asian-Pacific Resource & Research Centre for Women (ARROW). (2008). Nepal. In Advocating Accountability: Status Report on Maternal Health and Young People's Sexual and Reproductive Health and Rights in South Asia. Kuala Lumpur, Malaysia: ARROW. [ix] Women’s Health and Rights Advocacy Partnership (WHRAP) South Asia; The Asian-Pacific Resource & Research Centre for Women (ARROW). (2008). Nepal. In Advocating Accountability: Status Report on Maternal Health and Young People's Sexual and Reproductive Health and Rights in South Asia. Kuala Lumpur, Malaysia: ARROW. [x] Thanenthiran, S; Racherla S.J. (2009). Reclaiming & Redefining Rights – ICPD+15: Status of Sexual and Reproductive Health and Rights in Asia. Kuala Lumpur, Malaysia: The Asian-Pacific Resource & Research Centre for Women (ARROW). [xi] Women’s Health and Rights Advocacy Partnership (WHRAP) South Asia; The Asian-Pacific Resource & Research Centre for Women (ARROW). (2008). Nepal. In Advocating Accountability: Status Report on Maternal Health and Young People's Sexual and Reproductive Health and Rights in South Asia. Kuala Lumpur, Malaysia: ARROW. ARROW's critical Cross-Country Indicators on Nepal ARROW's Monitoring Reports on Nepal ARROW's Resources on Nepal
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Last Updated on Thursday, 03 June 2010 17:38 |
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