Nepal Population Journal

Global and National Trends of HIV/AIDS

Hikmat Bahadur Raya — Mon, 31 Dec 2018 00:00:00 +0000

HIV/AIDS is one of the worst pandemics, the world has ever known and the entire world has been combating with it. Objective of the study is to analyze the global and national trend of HIV/AIDS regarding the indices PLHIV, New infections and AIDS-related death and coverage of ART. This is a quantitative research completely based on the secondary data. The data is analyzed by simple statistical representations. Regression analysis is used to analyze the trends and to make some predictions. The number of PLHIV is increased by 19.9 percent from 1997 to 2015 and by 69.6 percent from 2000 to 2015 in Nepal. In this same duration, the new HIV infection is reduced by 63.8 percent and 82.6 percent, AIDS related death by 52.2 percent and 411.1 percent respectively in the global and Nepal. The initial coverage of ART in both regions was negligible and by the end of 2015 it reached to 46.4 percent and 30.6 percent in the global and Nepal respectively. Nepal along with the global achieves some positive results in the combating of this health problem. By analyzing the trends, it is not worth to say that we are not far from the achievement of SDGs.

Demographic Window of Opportunity in Nepal

Hom Nath Chalise — Mon, 31 Dec 2018 00:00:00 +0000

The demographic dividend (or window of opportunity) is the period during which a country's population experiences age structures that are highly favourable for development. Greater proportion of population becomes young and working age group. This cuts spending on dependents and spurring economic growth. Demographic dividend has importance in the national development if it is understood well and planned well for the national development. Nepal has already entered in demographic window of opportunity and this dividend phase ends around 2045. Government is lacking to utilize this dividend in the absence of stable government and proper policy requirements.

Mortality patterns of adolescent and youth in SAARC countries: Findings from the global burden of disease

Bhagabati Sedain — Mon, 31 Dec 2018 00:00:00 +0000

Adolescence and youth are the healthiest period of life. Despite being a healthy period of life, the people of this age group also suffer significantly higher deaths and disease conditions. This paper analyzes level, trend of all causes mortality and causes of mortality among population aged 10-24 years. Datasets on population aged 10-24 years; number of deaths and cause-specific mortality were obtained from the Global Health Data Exchange platform (GHDx) of the Institute of Health Metrics and Evaluation. This paper utilized broad causes of mortality and the variables: number and death rates for the years 2000, 2005, 2010 and 2015.

The estimated number of deaths for aged 10-24 years in SAARC countries is 640,000. About 80% of the deaths occurred in Afghanistan and India. Maldives has the lowest mortality rate. In Bangladesh, India, Nepal and Pakistan, the combination of injuries and non-communicable diseases are the major causes of deaths whereas in Afghanistan, Maldives and Sri Lanka, injuries. Majority of female population in all countries died from communicable, maternal, neonatal, causes. In addition to those causes, natural disaster, war also significantly attributed to adolescent and youth mortality in SAARC region. Overall SAARC region data shows that adolescent and youth death rate has declined between 2000 and 2015. There should be regional priorities for the prevention of adolescent and youth deaths recognizing these causes of deaths. Since these findings are based on GBD estimates, there is an urgent need for new evidence based research to examine the validity.

Socio-demographic correlates of age at marriage in Nepal: an empirical analysis

Nepali Sah — Mon, 31 Dec 2018 00:00:00 +0000

Age at marriage of girls is gradually increasing in Nepal, but still there is a lower age at marriage in the Terai. This paper aims to investigate the reasons for early marriage of girls among some families in Nepal with particular focus on the Terai and seeks answer to the research question ‘What are the prominent sociodemographic and cultural factors that influence marriage timing of women in Nepal?’

Findings from empirical data analysis reveal that determination of marriage timing is a complex phenomenon. There are several factors that influence marriage timing of women in Nepal. Although bivariate analysis shows a further elaborative list of factors, multivariate analysis confirms the effect of each variable while controlling the effect of other variables. The prominent factors influencing marriage timing of women are age, place of birth, age at menarche, education of women and their mothers, and caste or ethnicity, and religion.

The significant differences in the risk of marrying early among caste and religion groups, and the significantly higher risk among caste/ethnic groups of Terai origin and Muslims who reside mainly in the Terai, are supported by the distinct sociocultural differences with more strict marriage norms and practices prevalent among these groups. The low educational level of these groups in general and women in particular further increases their risk of marrying at an early age. An education level of some secondary and above seems to be a protective factor against early marriage, but many of the caste and ethnic groups (except Terai highcastes) and Muslims of Terai have substantially low education, particularly among women. Lower age at menarche of girls of Terai origin may also be associated with early marriage as age at menarche and age at marriage of girls were positively associated. The lower age at menarche of girls of Terai caste groups in particular seems to be an important factor creating pressure on parents to arrange marriage of their daughters at an early age.

Demographic and socio-economic factors affecting birth preparation and complication readiness (BPCR) practices in Nepal

Sunil Kumar Acharya — Mon, 31 Dec 2018 00:00:00 +0000

BPCR practices by women in Nepal are still low. Still a relatively high percentage of women do not make BPCR to its fullest extent. Researches in developing countries show that various demographic, social and economic factors influence the BPCR practices by pregnant women. This paper examines the likelihood of BPCR practices based on women’s demographic, social and economic status in Nepal. NDHS 2011 data set has been utilized by applying bivariate logistics regression analysis technique to examine the effects of these variables on BPCR practices in Nepal. The analysis result shows high variations and gaps in BPCR practice based on demographic, social and economic status of women. Against this finding the study recommends implementation of appropriate policy and program measures by the government and other agencies to address the existing variations and gaps in BPCR practices among subgroups of women in Nepal. Further research studies focusing on the existing barriers on BPCR practice need to be conducted in Nepal especially among the women who are disadvantaged and marginalized.

Dynamics of contraceptive use among young women in Nepal

Ramesh Babu Kafle — Mon, 31 Dec 2018 00:00:00 +0000

This paper examines the dynamics of contraceptive use of currently married young women (age 15-24) in Nepal by analyzing the trends and differentials in contraceptive use, the changes in method mix and the determinants of contraceptive use by selected socioeconomic and demographic characteristics. The reasons of non-use of contraception are also assessed. Data from the three rounds of nationally representative Nepal Demographic and Health Survey (NDHS) 2001, 2006 and 2011 are used. Currently married women aged 15-24 are selected and included in analysis. Study sample constitute 2573, 2398 and 2552 eligible women in NDHS 2001, 2006 and 2011 respectively. Use of contraception among young couples is gradually increasing in almost all subgroups of population in Nepal, with narrowing differentials by education and economic condition of household. Tendency of starting contraceptives before having a child is also emerging. There is declining share of sterilization among youth indicating either a probable shifting in age at sterilization or more favour towards temporary methods. Injection has the highest share in all the three surveys. The share of long acting temporary methods (IUD and Implants) is quite small and almost same in all the three surveys. Couples still feel safe to start using contraceptives after having at least one son however, the differences are declining. Reasons for non-use like fear of side effects and opposition to use are sharply declining over time but that due to husband’s absence is emerging as almost a sufficient reason for non-use of contraception among young married women in Nepal. The family planning program should focus on meeting the family planning needs of young couples of all strata of population with special thrust on those women whose husbands are currently in foreign country so that they would be able to avoid unintended pregnancy on their husband’s come back.

Youth empowerment and contraceptive use in Nepal

Bidhya Shrestha — Mon, 31 Dec 2018 00:00:00 +0000

Contraceptive choices have an enormous impact on health, schooling and employment prospects. Access to full range of contraceptive method is vital for ensuring the health of youth. This study examined the association between youth empowerment in the domestic sphere and contraceptive use among currently married female youth in Nepal using the data of Nepal Demographic Health Survey, 2011. A sample of 2,553 currently married women of reproductive age 15-24 were chosen for this study. Bivariate analysis with cross tabulation and chi-square test were used to examine the association between each independent and dependent variables. Logistic regression model was employed for examining the effect of each independent variable as well as control variable on dependent variable. Result showed that the effect of youth empowerment remains statistically significant and has influence on their use of contraceptives, even after adding the control variables into the model. Youth who are empowered they use contraceptive about 2 times higher than those who are not empowered. Influence of some selected socio-economic and demographic variables on contraceptive are also examined. The study shows that the presence of son at home on contraceptive use is strongly associated (OR=4.58). Thus youth empowerment is necessary to increase contraceptive use.

Condom use by Nepalese youth at last sex with most recent partner other than wife or non-live-in partner

Dhanendra Veer Shakya — Mon, 31 Dec 2018 00:00:00 +0000

This study attempts to examine the effects of some selected socio-economic variables like level of education, occupation, current working status, wealth index, place of residence and frequency of exposure to mass media like newspapers/magazines, radio and television; demographic variables like age group, age at first sex, marital status, migration status and travelling away from home in the past 12 months; and cultural variables like religion and caste/ethnicity, and spatial distribution by ecological zones, development regions and provinces on condom use by Nepalese youth males at last sex with most recent partner other than wife or non-live-in partner using multivariate logistic regression analysis. It has used 2016 Nepal Demographic and Health Survey data files with weighted cases. Data are analyzed using percentage and frequency tables and statistical tests are carried out using binomial logistic regression analysis of dependent variable controlling for the independent variables presented in the table of this study.

The significant findings of the study are that youth males with primary level of education are less likely to use condom at last sex with most recent partner other than wife or non-live- in partner than those who have higher than secondary level of education. Not working youth males are more likely to use condom than those engaged agricultural occupation. Likewise, ever married youth males are less likely to use condom than their never married counterparts. Newar youth males are less likely to use condom than youth males of Hill Chhetri. Youth males living in Terai are less likely to use condom than youth males living in Hill. Similarly, youth males living in Far-western region are more likely to use condom compared to their counterparts of Central regions.

Inconsistent use of condom: risky sexual behaviour among the street based sex workers in Kathmandu Valley

Rita Karki — Mon, 31 Dec 2018 00:00:00 +0000

The nature of profession of sex trade is multi partnered which leads the sex partners to unprotected sex. This study aims to explore the knowledge and experiences of STIs, practice and use of condom, reasons of not using it regularly and addiction situations among the street based female sex workers (SFSWs) in Kathmandu Valley. This study is a non-experimental research based on cross-sectional design. Mixed method was used to collect information with 110 SFSWs selected by using snow ball sampling techniques and presented descriptively after arranging in different themes. Among the SFSWs, 64.5 percent experienced STIs and 69 percent of them were unable to use condoms regularly. Most of the sex workers agree to unprotected sex when they are offered extra money and forced for sex by clients without condom, and another reason was lack of skill on SFSWs in using it properly. Knowingly or unknowingly SFSWs, clients and their life-partners are being victimized from practicing of risky sexual behaviour. The study suggests that touchy and broad awareness programs and compulsory rule to use male condom from clients’ side within safer indoor work space could be effective in helping to assure satisfying and safe sex.

Women's autonomy and utilization of maternal health care services in rural Nepal

Kamala Lamichhane — Mon, 31 Dec 2018 00:00:00 +0000

Nepal has one of the highest maternal mortality ratios in South Asia although the situation is improving in recent days. One of the reasons for such a high mortality may be attributed to the under-utilization of modern maternal health services during pregnancy. This study has analyzed the relationship between women’s autonomy and the utilization of maternal health care services in order to explore some possible reasons for the under-utilization of the services. Data from the Nepal demographic and Health Survey, 2011 is used for the study. The analysis is based on 2374 married women aged 15-49 years who had given a live birth during three years preceding the survey. Women's household decision making power, control over use of earning and decision on using contraception have been used to explore the indicators of women's autonomy. Logistic regression is used to assess the net effect of several independent variables on two dependent variables (adequate antenatal care and institutional delivery) of maternal health care. Logistic regression analyses reveal that the utilization of both maternal health care services are related to women's autonomy as indicated by decision making power on own health care, large household purchases and control over earnings because financial sufficiency is must at that period. Women's’ decision-making power appears to be the most powerful predictors for increasing maternal health service utilization. The study results suggest that policy actions that increase women’s autonomy at home could be effective in helping assure good maternal health.

Cross-border migration process of Nepalese people to India

Laxman Singh Kunwar — Mon, 31 Dec 2018 00:00:00 +0000

There is unique historical, socio-economic and political relationship between Nepal and India. Nepal and India has open boarder and there is long history of people’s migration from one country to another by crossing the border. There is no need of any formal document documents (passport, visa) for people of both country in cross border migration process Therefore, this study is confined to analyze the factors associated with cross border migration process of Nepalese people to India. In total, 809 households were randomly selected from studied VDC Daijee of Kanchanpur district. Structured questionnaires were designed to collect the information. In study Daijee VDC of Kanchanpur, out of 809 households, 426 households were cross border migrants households (current and returned). Ancestor’s participation, information provided by friends, self-decision of migrants themselves and moving alone by crossing border were reported as main contributors in cross border migration process.

Nepalese initiatives in poverty research: moving from uni-to-multidimensional concepts and measurements

Keshab Prasad Adhikari — Mon, 31 Dec 2018 00:00:00 +0000

The aged long conventional unidimensional definition and measurement of poverty ‘lack of money’ in most countries is being replaced by the multidimensional approach and methodology. The launching of MPI report in 2018 implied Nepal also officially to adopt this in national poverty measurement policy strategy. This paper is aimed at to sensitize methodological aspects of MPI among academic and policy implications in Nepalese context. Debate on multidimensional poverty research in addressing rampant poverty dates back the advent of basic-needs and the physical quality of life index approaches of 1970s but both failed to establish a valid and reliable deprivation score to divide population as poor and non-poor like in income line approach. Human development index gave basis to rank countries into four groups as very high, high, medium and low level of human development. However it could not offer a precise deprivation score to divide population into-two as in absolute deprivation and non-deprivation as well as population in borderline of deprivation as alternatives of income poverty. It is the Alkire and Foster’s (2007 and 2010) MPI methodology/approach of OPHI and successively adopted in human development reports of UNDP, aggressively being adopted as alternatives of conventional income line methods of poverty measurement and targeting policies. Three dimensional and ten indicators equally weighted MPI based on the same conceptual groundings of ‘capability, wellbeing and functions’ of Sen are taken as reliable alternative to the conventional income approach of poverty measurement. With the official release of national MPI study report in January 2018, Nepal adopted MPI in its policy option in targeting population living in multiple web of poverty and their targeting. The study found poverty and deprivation studied from MPI perspective is vital to attain multiple goals of 2030 SDGs.

Estimation of total fertility rate and birth averted due to contraception: regression approach

Bijaya Mani Devkota — Mon, 31 Dec 2018 00:00:00 +0000

Fertility plays an important role in any demographic transition and total fertility rate (TFR) is one of the basic measurements of fertility. Absences of complete and reliable data, a large number of indirect techniques have been developed to estimate the demographic parameters with incomplete data. Some of these techniques are based on utilizing the data from stable population theory while others are based on the regression technique in which the parameters are estimated through regression equations between the dependent variable which is the TFR and the independent variables which is the socio economic well as demographic variables. The first method is based on the relationship between the Total fertility rate (TFR) and contraceptive prevalence rate for all women. By using this modified estimate of TFR, demographic analysis can easily calculate the birth averted for different regions as well as states also. In fact, provide reasonable estimates of births averted due to contraceptive use by national populations. The variables are CPR that about 51.2 percent variation in TFR can be explained by the first regression approach. The second is based on the relationship between total fertility rate (TFR) and Additive combination of CPR and proportion of currently married females having open birth interval. Using new predictor variable, the improved model explained about 55percent of the variation in TFR. The findings reveal that the values of TFR calculated by the present method are quite close to the observed values of the TFR without involving much computational complexities at different background characteristics. Estimates of births averted and the percent change in births in the absence of contraception, based on the two methods, are fairly consistent.

Prevalence and associated risk factors of prehypertension and hypertension among army personnel

Sapana Gurung, Padma Rai — Mon, 31 Dec 2018 00:00:00 +0000

Hypertension (HTN) is most likely a common disease in the world. In every 3 adult ages over 20 years have this disease. As a consequence, Non-communicable diseases (NCDs), such as hypertension and other cardiovascular diseases are becoming increasingly important as causes of mortality and morbidity in all developing countries. The aim of this study is to determine the prevalence of pre-hypertension and hypertension among the Army personnel in Nepal. This was a cross-sectional descriptive study of 315 respondents, who met eligible criteria. All respondents were enumerated by census method using self-interviewing questionnaire focusing measurement of the blood pressure, weight and height along with the demographic and other socio-economic as well as cultural characteristics. The study shows that overwhelming respondents (77.5%) are normal. And about 13 percent respondents are seemed to be in the pre-hypertension, followed by stage I HTN (6%) and stage II HTN (3.5%). It also shows that there is a significant association between prevalence of hypertension and body mass index of the respondents.

Age structural impact of adolescent and youth on fertility transition in Nepal

Trilochan Pokharel — Mon, 31 Dec 2018 00:00:00 +0000

Nepal is in unique period of demographic situation. The age structure of population is gradually shifting upwards producing a historical large proportion of young population. Given the early age at marriage and childbearing, this population may continue to dominate fertility transition process. Interaction between improvement in the characteristics of this population and recently started declining fertility is expected to push fertility transition at a faster rate until mid of this century before entering to the lowest level marginal decline or stagnation. The young 1population itself are in social, economic, cultural and demographic transition which is sandwiched with generation gap. Demographic analysis should factor their needs and interests to project the future fertility discourse.