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May 24, 2007
Nepal experiences big drop in fertility

Calverton, MD - Fertility in Nepal has dropped by one child over the past five years, according to the newly released 2006 Demographic and Health Survey. Currently, women have an average of 3.1 births during their lifetimes. This represents a significant decline in fertility since 2001 when women were having an average of 4.1 births. This decline is due in part to the continued increase in the use of family planning. Almost half (44 percent) of currently married women are now using a modern method of family planning. Use of modern methods has increased dramatically in the past ten years, from 26 percent in 1996 and from 35 percent in 2001. The most popular methods are female sterilization (18 percent) and injectables (10 percent). Use of modern methods varies by region of residence: only about one-quarter of married women living in Far-western Hill use a modern method compared to 65 percent of women in Far-western Terai.

Child survival has also improved significantly in the past five years. Infant and under-five mortality rates have dropped more than 25 percent since 2001. The 2006 infant mortality rate is 48 deaths per 1,000 live births, while the under-five mortality rate is 61 deaths per 1,000 live births. This means that only one in 16 children dies before their fifth birthday compared to one in 11 in 2001. Immunization coverage among children has also improved during this period. Currently, 83 percent of children ages 12-23 months are immunized against the six major childhood diseases. Only two-thirds of children were fully immunized in 2001.

Although children’s survival has improved, Nepalese children continue to face nutritional challenges. Almost half of children under age five are stunted, or too short for their age. This is a sign of chronic malnutrition. Stunting has declined only slightly since 2001.

Women’s health indicators are not improving at the same dramatic rate as children’s. Less than half of pregnant women received antenatal care from a skilled birth attendant in the five years before the survey, and fewer than one in five births was delivered with the assistance of a skilled birth attendant. While these rates do mark a slight improvement over the rates reported in 2001, they are still too low to prevent and treat many pregnancy- and delivery-related health problems.

The Nepal Demographic and Health Survey included interviews with over 10,000 women age 15-49 and 4,000 men age 15-59 in all regions of Nepal. The survey was funded by the United States Agency for International Development (USAID), sponsored by the Ministry of Health and Population, and implemented by New ERA with technical assistance from the USAID-funded MEASURE Demographic and Health Surveys Program. The 2006 NDHS is the third national demographic survey to take place in Nepal.