Towards a comprehensive population strategy for Nepal

Abstract

The seminar paper discusses, in lieu of an official proposal, the 1983 National Population Strategy, the Basic Principle of the 8th Development Plan (BP/8P), and the new Policy Directives of the Interim Government (PDIG) at the global, sectoral, and specific level in Nepal. Basic information on what defines a development strategy is given. The author states his concern that a 2.5 children/woman total fertility rate (TFR) goal requires massive social change and a 60-65% contraceptive prevalence rate. The social environment is not conducive to such a rapid fertility decline even though 29.6% in 1976 desired limiting or spacing births and 2.3% practiced contraception. Simultaneous to implementing family planning programs by encouragement of breastfeeding, increasing contraceptive usage, and delaying marriage age, must come social and economic change. BP/8P proposes social development including democratization of political and social structures and meeting basic needs in health and education, but the financial contributions target a decline from 18.14 to 17.93 due to insufficient use of past resources. NGO's and the private sector must be involved, and fast development is related to the availability of family planning resources and increasing demand. Reducing regional imbalances, giving priority to less developed regions, and orienting migration are suggested along with spatial integration; i.e., the development of the north-south highway and strengthening ilaka. Settlement plans for rural to rural migration need attention. New forms of land tenure, the implementation of new technology and electrification of rural areas are needed to reduce fertility. The education goals of BP/8P are already achieved in Kerala, so that secondary education for girls must be strengthened in order for fertility to be affected. The integrated health system needs increased resources and strengthening of staff in district hospitals with outreach family planning clinics. Community participation of mothers' groups and community health volunteers are needed. Followups for those using contraception are advised. Population policy must be set at all levels. Population information, education, communication, political commitment and government and community mobilization, including incentives such as increased retirement benefits for those with 2 or less children, are the focus of other topics.