NATIONAL 4 - (Spotlight Weekly)

"Nepalis Must Take The Initiative For Their Development"

J. BILL MUSOKE

J. BILL MUSOKE, United Nations Population Fund (UNFPA) Representative to Nepal, has been working to implement various projects in the area of population management. He spoke to SPOTLIGHT on Nepal's population status and the role of UNFPA. Excerpts:

UNFPA recently released its annual report. How do you see the position of Nepal?

First of all, let me thank you and, through you, the people of Nepal, the media and government of Nepal for the continued focus and interest in population and development issues of this country. Unlike several other reports, we do not rank countries based on particular indicators. The statistical tables in our report are directly linked to the goal of the International Conference on Population and Development (ICPD) to which the UNFPA is committed. However, like the other reports before this one, the theme of the State of the World Population focuses on a specific issue. This year it was on Footprints and Milestones: Population and Environmental Change.

What are the main thrust of the report?

The report identifies several footprints and milestones around the globe. Increases in population, particularly in developing countries, and a deteriorating environment are the major focus of the report. The report says that unless population growth is maintained and sustainable development practices are adhered to, the world will witness worsening population and environment dynamics detrimental to people's health and development. One of the key areas of Nepal's development challenge has been deteriorating environment and rapid population growth. Given this, the report has direct bearings on Nepal's population and environment and its policies and programmes in the years to come.

What is the position of demographic transition in Nepal?

You are asking a relatively complex question. Demographic Transition (DT) entails many more things than just transition from high fertility and mortality to low fertility and mortality. Decades of efforts to lower both mortality and fertility have shown encouraging results in Nepal. Demographic and health surveys of the recent past in the country show steadily declining fertility and mortality. In the mid-1960s, a Nepali woman of reproductive age bore about 6.4 children. Today, she is bearing 4.1 children in her lifetime. Knowledge of modern methods of contraceptives has become universal while about one-third of women are current users of contraceptives. Likewise, infant mortality, which is now around 70/1000 live births from around 200/1000 live births in the 1960s, has reduced significantly, contributing to the increased life expectancy of around 60 years (from around 40 during the 1950s) for both sexes in 2001. These are significant achievements and indicative of what one would refer to as the onset of a demographic transition.

How do you evaluate the DT?

However, we have not achieved the implied "Demographic Transition" in your question. Perhaps, the DT you are referring to means a situation that you can compare with that of the West (developed countries), women having two or less than two children during the course of their reproductive life. Let me also hasten to add here that DT is shorter, and swift in countries where the pace of socio-economic development has been rapid (Taiwan, South Korea, Thailand, and the states of Kerala and Tamil Nadu in India. Even Bangladesh, which has almost a similar history of population management programme to Nepal's, is far ahead of us. Almost 69 percent of Nepal's burden of disease is due to disorders related to infectious diseases, maternal and prenatal ailments and nutritional deficiencies). An epidemiological transition from this group of disorder to degenerative and non-communicable diseases) will also hasten the pace of demographic transition in the country. This is still to happen in Nepal. Despite this, even in Nepal, one can say that we are at various levels of demographic transition. In urban areas, and among educated women, total fertility rate is almost half of the national average, indicating educated and urban women are more likely to hasten demographic transition by bearing fewer children and caring more for the survival of their children than their uneducated and rural counterparts.Therefore, the key is the pace of socio-economic development: education, health and women's empowerment. Since the pace of the socio-economic development is rather slow in Nepal, so is the pace of the demographic transition and it may take some more years to complete. However, it may not be too long if the pace of socio-economic development and epidemiological transition is rapid.

How would Nepal's resources be affected by overpopulation in the future?

I wouldn't use the word "over-population". This is a relative term to be taken together with resources and other issues. The population of a country may become "over" only if its resources are constrained, there is continued hunger, disease, unemployment, violence, lack of basic facilities and amenities. People have to judge for themselves whether or not they are "over populated" and take whatever actions they deem necessary. Almost half of Nepal's population is under the poverty line. The poverty level has remained almost stable during last three decades. However, the absolute number of people living below the poverty line has increased significantly. Almost 30 percent of children of school-going age are still not attending school, six out of 10 women can not read and write, 80 percent of households do not have toilet facility and about 30 percent do not have access to drinking water. Frontier land has already been brought into cultivation, which has further added to environmental deterioration. According to the UN Population Projection, Nepal's population is likely to double and reach 44 million by the year 2035. The increased population will require basic services. Now, you tell me, whether you would call Nepal overpopulated or not. It is not too late to take corrective measures that would allow the country to manage the population and strike a balance between the population and the available resources. However, if corrective steps are ignored or delayed more problems lie ahead. Obviously, rapid increases in any given context without commensurate economic development is bound to create resource constraints and Nepal is not an exception.

How do you see the response of the government?

Nepal is one of the countries with "early recognition" of population problem, sometime in the early 1970s. However, until recently, policies and programme to manage the population were not well defined. The government has been sensitive to population issues and has been attempting to formulate a comprehensive population policy especially since the Cairo Conference. We see commitment at the highest level. For example, Nepal is one of the few developing countries that contribute to UNFPA's global activities on a regular basis, which UNFPA is very grateful for. On the other hand, at the local level this commitment is not often translated into practice. For example, the National Population Committee or Board has not met for the last two years. This is the policy-making body at the highest level. If it does not monitor what is happening, who will do it? Population being a cross-cutting issue requires common understanding among the stakeholders. I do not want to sound negative. But I would like to draw a comparison between Nepal and Bangladesh. Both countries had same levels of fertility in the 1970s. But today, the fertility level of Bangladeshi women is almost half that of Nepali women. Why and how could Bangladesh achieve this feat while Nepal lagged behind? There must be reasons. Among other things, it is the leadership in population issues; it is the lack of that commitment to put what we say in practice.

Does Nepal have comprehensive population policy?

Nepal still lacks a comprehensive population policy that addresses spatial and temporal distribution of population, elderly, adolescent and youth, migration (both internal and international), urbanization, ethnic and minority populations, women and gender issues and last but not least the emerging but serious issue of HIV/AIDS. Let me emphasize that formulation of a sound population policy alone is not enough, unless it is accompanied by a coherent and well-articulated operational modality, equally accompanied by sufficient budgetary allocation to translate the sweet words into practice.

What has UNFPA been doing to manage Nepalís population?

Let me make it very clear right from the outset that UNFPA is in Nepal at the request of His Majestyís Government to assist it in identifying and offering solutions to population problems. The onus of managing the population of Nepal lies squarely on the government and people of Nepal. Thus, UNFPA is supporting HMG to manage its population in two ways, namely, technical and financial support. UNFPA started its work in Nepal in the early 1970s. Up to 1996, UNFPA support was directed to family planning, maternal and child health care programmes, population education, expansion of the population database, and development of a national plan of action for women in development and the introduction of an integrated health management information system (HMIS). In the Fourth Country Programme (1997-2001) UNFPA's support focused on improving the coverage, access, quality and continuity of gender-sensitive reproductive health services; and at strengthening the capacity of nodal agencies to integrate, plan; and coordinate gender sensitive population and development issues.

What will be the highlights of the fifth country program?

Under the fifth country programme that is to begin from Jan 2002, we are adopting a two-pronged approach. UNFPA will continue to support some of the nation-wide activities that we have been supporting and also focus on selected districts. This allows us to strengthen the national as well as the district capacity to formulate, implement, coordinate and monitor population, reproductive health (RH) and gender projects. UNFPA is committed to assist HMG towards its commitment for the fulfilment of ICPD goals. Therefore, UNFPA will focus on improving access to quality RH services including family planning and HIV/AIDS prevention, adolescent reproductive health, and safer motherhood.

How do you see the role of government ministries and other local bodies?

UNFPA will further work with HMG to ensure that there is an effective delivery and management system, and improvedmonitoring and evaluation of the programmes and projects. It will therefore, be necessary to continue to work with the nodal ministries/department such as the Ministry of Population and Environment, Ministry of Women, Children and Social Welfare, National Planning Commission, Ministry of Local Development and local bodies (DDCs, VDCs, Municipalities) to improve their capacity to design and implement gender-sensitive population and sustainable development policies and programmes both at the national and local level. I wish to reiterate that UNFPA believes that it is the people of Nepal and their government who have to take the initiative and lead in their own development. Donors are here only for a short time for a specific technical input to speed up the tempo of the development. The process has to be initiated and owned by Nepal and where necessary supported by donors with technical and financial resources. In short, UNFPA and I believe other development partners in Nepal are here to support your own effort and to contribute to the development goals of HMG.