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Despite political instability, armed conflict, poor economic status, and difficulty in accessing health services, Nepal has made considerable progress in improving reproductive health over the last two decades. There has been substantial progress in reducing maternal mortality, under-five mortality, and the total fertility rate (TFR). Nepal is on track to meet Millennium Development Goals (MDG) 4 (reducing child mortality rates) and 5 (improving maternal health), and has even received international awards such as the Global Alliance for Vaccines and Immunization (GAVI) award in 2009 for reducing child mortality, the MDG Summit award in 2010 for reducing maternal mortality, and the Resolve award from the Global Leaders Council for Reproductive Health in 2012 for improving maternal and neonatal health (WHO and UNICEF, 2012).
Despite these gains, Nepal’s progress on MDG 5b, universal access to reproductive health, as measured by the contraceptive prevalence rate (CPR) and by the level of unmet need for family planning, appears to have slowed. Such evidence raises the question, why has fertility declined so rapidly in Nepal despite stagnation of contraceptive prevalence?
This paper examines whether patterns in male migration can help account for the surprising decline in fertility in Nepal despite a stall in the uptake of contraceptives between 2006 and 2011. Nepal has a long history of labor migration, both internal and international (Sharma and Sharma, 2011). This trend has been increasing over the years, particularly among males. On average, at least 1,099 Nepali migrant workers leave the country every day.