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COVER STORY |
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COVER STORY |
The Rise Of Birth rates are falling in urban areas of all regions of Nepal.
Growing up with fewer siblings has become the norm in many cities and towns. This is good
news for a country where the population growth rate is still high at 2.24 percent. As
health survey reports and census results indicate a decline in the fertility rate and
family size, the country's population will grow at a slower rate. However, it is too early
to predict demographic patterns, especially at a time when the country is passing through
a very crucial phase of nation building By KESHAB POUDEL On school days, elderly women in Koteswor bring their children to the
playground of the local school. Kamala Subedi watches warily as her 4-year-old grandson
Sujit tussles with a playmate over a ball. "He does not have any brothers or sisters
or cousins," she laments. "Unfortunately, I did not have second child. I keep
telling my son to have another child." But Kamala's son and daughter-in-law seem less
inclined to heed that plea. "Families in Kathmandu used to have lots of children
until two decades ago," she says. "Now that more and more mothers have office
jobs, they don't have time for many children." If one considers the emerging trends in urban
society, it does not make much difference to senior citizens whether they have half a
dozen children or a single child. The elderly largely have to take care of themselves.
Former prime minister Girija Prasad Koirala is a prime example. He does not live with his
single child, daughter Sujata. Instead, the Nepali Congress president has taken refuge at
his nephew's house. Koirala represents a segment of the population who
find themselves alone in old age. Newly married couples in cities and towns are leaving
the extended family in large numbers. Elderly parents have to live alone as families are
disintegrating and getting smaller. It seems that a small family is the choice of males
and females alike. Declining fertility over the last two and half decades indicate this
trend. In 1976, the first fertility survey showed that Nepal had an average 6.3 fertility
rate, with less than three percent of the population using contraceptives. Two new
national surveys indicate that the fertility rate has gone down to 4.1. Prime Minister Sher Bahadur Deuba and Dr. Arju Rana
Deuba have one child. Nobody knows whether Deuba, who grew up with half a dozen brothers,
is satisfied with one child. As both people are busy in their respective profession, it
seems to be difficult for them to plan a second child. The worries of grandmothers like Subedi are
understandable. With an average household size of 4.5 people and 1.9 children per woman,
Kathmandu has the lowest birth rate in Nepal. That means there are fewer births than
deaths each year, resulting in what demographers call reverse fertility. At that rate,
massive migration is the only way to maintain the total population. The recent census
counted 2,273,6934 Nepalis, which is still too large a population for everyone to get
opportunities and facilities. The three districts of Kathmandu valley alone have 1.6
million people. Choice of Small Family The Central Bureau of Statistics' head count and
the results of the Nepal Demographic Health Survey 2001 provide clear indications of
future trends. The study on married female population underscores the choice for fewer
offspring. According to the CBS, the married female population belonging to the 15-49
years bracket is 450,3064. Among them, 85,8467 (19.08 percent) have one child; 699,316
(15.53 percent) have two children; 84,5453 (18.78 percent) have three; 781,619 (17.36
percent) have four; 547,692 (12.16 percent) have five; 33,1170 (7.35 percent) have six;
and 409,510 (9.09 percent) have more than six children. The preliminary findings of the Nepal Demographic
Health Survey (NDHS) 2002 reveals that fertility has declined over the last decade from
5.1 children per woman in 1991 to 4.6 in 1996 to 4.1 in 2001. Over the last five years
(1996-2001), fertility in urban areas has declined nearly three times faster than in rural
areas. Urban fertility declined from 2.8 to 2.1 births per woman (a 25 percent decline)
compared to rural fertility, which declined from 4.8 to 4.4 births per woman (an eight
percent decline). According to United Nations projections, Nepal's population is likely to
double to 44 million by the year 2035. In this changing family landscape, no group comes
under more scrutiny than children do. They are routinely accused of being self-centered
and uncompromising. In urban areas, many parents treat their children as deities. "The survey report shows a remarkable increase
in the number of family planning method users and a decline in the infant mortality rate.
This contributes to decline in the fertility rate," said Tek B. Dangi, senior
administrator of the Family Health Division at the Department of Health Services. Whatever the reasons behind the decision to have
one child, many resent the fact that outsiders always comment on the family size. "I
have to listen to many complaints from people who seem to think either I can't get
pregnant and I must be trying, I can't afford another one or I can't physically take
another pregnancy," says Subhadra Shrestha, a mother of a seven-year-old girl child
from Jyatha. "I didn't not enjoy my pregnancy, the birth was a nightmare and I
wouldn't enjoy spending all my time running around after two kids." Decline in Average Fertility Although smaller families have contributed to a
decline in total population growth rate, constant public scrutiny tends to put many
parents of single children on the defensive. They seem to worry far more than parents of
multiple children about their offspring's social and emotional adjustment. "Decades of efforts to lower both mortality
and fertility have shown encouraging results in Nepal. Demographic and health surveys of
the recent past show steadily declining fertility and mortality," said J. Bill
Musoke, United Nations Population Fund (UNFPA) representative to Nepal. (See SPOTLIGHT 30
November-6 December 2001) One of the interesting revelations of the study is
the number of people with knowledge of family planning. Family planning awareness is very
high in Nepal, with nearly all married women and men (more than 99 percent) in the
reproductive age group having heard of a method. Thirty-nine percent of currently married
women in Nepal reported using a family planning method at the time of the survey, with 35
percent reporting the use of a modern method. Urban women are much more likely to use a method of
contraception than rural women are. As expected, current use of family planning increases
markedly with education, with 57 percent of women having an SLC certificate or higher
education reporting use of method, compared with 37 percent of women with no education. According to the NDHS 2001, the majority of women
express a desire to control their future fertility. Nearly two thirds of the women report
that they do not want any more children or that they or their husbands are sterilized. Even today, the big worry is that runaway
population growth would deplete the country's resources. Scientists warn that the country
may soon run out of water, forest and arable land. Because of sustained programs and
policies, the country has witnessed a decline in total fertility. Nevertheless, the
world's population is still growing rapidly, with Nepal's expected to swell to 30 million
within the next 20 years. The rate of growth is gradually slowing down,
though. Better contraception, delayed childbearing, greater participation of women in the
work force and widespread migration from rural to urban areas have played a major role. So
has public awareness: bombarded with doomsday predictions, many countries including Nepal
launched aggressive family planning campaigns back in the 1970s — and they worked. With support from the United States and other
countries, Nepal launched family planning programs back in 1970. According to the book
"Half A Century of Development: The History of US Assistance to Nepal
1951-2001", Nepal recorded 65,000 family planning acceptors in 1972. Lure For Fewer Kids There is another reason for having fewer children.
Today's exhausted, overworked and literate parents may be reluctant to admit that it is
easier to have fewer children with easily available methods. According to sociologists,
the rise in the number of small families is also linked to the growth of individualism.
"One child is not an ideal but a way of resolving a contradiction," said a
sociologist. With one or two children, it is more feasible,
fiscally as well as emotionally, to take care of the family. Although one is perfect, it's
even manageable to live in a cramped big city like Kathmandu with two kids. Beyond that,
things become complicated. As the number of working population increases,
there is very low demand for children in Kathmandu city. Although the preliminary results
of National Population Census 2001 show that the average households size is 5.44 and the
population growth rate is 2.24 per annum, household and family sizes are declining.
Considering this indication a miracle may be an overstatement. But at the very least, it
is the end of the big boisterous family crowded around the kitchen in Nepalese families of
all castes and ethnic groups. Like other parts of the world, the family size is shrinking
in Nepal, particularly in among financially better off and educated families in urban
areas. Global Trend Across Europe, the average fertility rate in 2000
was 1.46, down from 1.72 a decade earlier. Asia's dropped from just over three children
per woman to 2.54 in the same period. In South and Central Asia, the average fertility
rate is 3.25. The big picture is more dramatic: according to the UNFPA, the fertility rate
in the most developed nations is approaching all time low of 1.50 children per woman. In
the least developed countries, the current fertility rate is 5.24 fertility. According to the UNFPA's Annual Report for 2001,
the average fertility rate is expected to be 2.52 in 2000-2005. In the 48 least developed
countries, the current fertility rate of 5.74 is expected to fall sharply to 2.51 by 2050. More and more parents are opting for one child,
whether by necessity or by choice. Precise numbers are impossible to come by: counting
only children requires asking families whether they plan to have more kids, and often they
say they don't. Population expert Dr. Ramhari Aryal says the declining trend of fertility
shows that there is transition of fertility. It takes nearly two decades to reduce
fertility. "Once fertility declines, it will never go up again." Despite the downward trend, Nepal will have to wait
another three decades to see changes in demographic patterns. Even in the current
circumstances of declining fertility, the country's population will double within two
decades. Compared to three decades ago, the number of
two-child families is rising in rural areas as well. The Population Census 2001, too,
shows that one- and two-child families are on the rise. Compared to 1971, the data
indicates that Nepal's dependency ratio has declined dramatically between 1971 and 2001 in
terms of conventional and adjusted age definition. The child dependency ratio of 0.75 in
1971 meant that for every adult aged 15-59 there were 0.75 children or for every four
adults there are three children. In 1971, one working adult had to support 1.21
child and old age dependants, while this ratio has fallen to less than one percent in
2001. This is attributed to an increase in the total number of adults reported to be
economically active in the 2001 census. The child and old dependency ratios have declined. Fertility is low among women aged under 20 years,
but rises at the peak ages between 25 and 29 and gradually declines thereafter, reaching a
low level at ages 45-49. According to studies, a Nepali woman would, on an average, bear
4.3 children during her reproductive span of 15-49 years. The level and trend of fertility in a country can
greatly influence the pattern of social and economic development. The rapid increase in
population, as a result of high fertility and declining mortality, can do much to
exacerbate the development challenge. The control of fertility is thus recognized as one
of the important factors in the acceleration of socio-economic development. Fertility in Nepal is still high because of the
marriage rate remain low. Compared with the hills, the marriage age is gradually
increasing in urban areas. That results in declining population. If we see the census
results of 1981, average fertility rate was 6.0. It was 6.2 in the hills, 5.9 in the
mountains and 5.9 in the terai. In the last 20 years, the rise in literacy level
has helped to reduce fertility, as the two are inversely related. The effect of education
on fertility may be direct as well as indirect. Women who marry later often have reduced
fertility. On the other hand, education is a fertility reducing force by its own right,
because educated couples are aware of the advantages of a small family and are inclined to
accept family planning methods. According to the CBS, 53.7 of Nepalis can read and
write. Among males and females, this figure is 65.08 and 42.49 percent respectively. Of
the total literate population of 10,348,428 who are 6 years and above, 904,430 (8.74) have
some kind of schooling; 4,333,967 (41.88 percent) have completed primary education (Grades
1-5); 1,986,853 (19.2 percent) have finished lower secondary education (Grades 6-7);
1,177,429 (11.38 percent) have completed secondary education (Grades 8-10); 931,585 (9
percent) have passed the School Leaving Certificate examination or equivalent; 532,233
(5.14 percent), have completed certificate level or equivalent; 277,163 (2.68 percent) are
graduates; 75,079 (0.73 percent) are postgraduates; 25,114 (0.24) have completed other
degrees; and 104,574 (1.01 percent) have not stated their level of education. Studies have shown that the mean number of children
born among literate women was lower than that of illiterate women. A literate woman
prefers one child whereas the illiterate woman wants more. Women with literate husbands
also have less mean number of children born than those with illiterate husbands. This indicates that education is the focal point of
declining fertility. The fertility differential by education of women was mainly due to
the age at marriage. Studies have shown that education of women has an indirect effect on
fertility, while education of husbands has direct as well as indirect effect on fertility. Fertility has declined as a result of delayed
marriage (and marital disruption) and the use of contraception. It is not very difficult
to understand why people want children. What is difficult is to analyze are the issues and
factors that lie behind parents' decisions on the number of children they want. It is
equally difficult to understand the behavior of couples in relation to how they go about
achieving their desired number of children. Desires and actual results can be very
different for many parents. The desire for a specific number of children involves social,
cultural, economic and psychological reasons. But in the setting of traditional
agricultural societies, it is often claimed that the economic motivations for having
children are likely to be a dominant factor. Children have economic value in traditional and
agriculture societies. Couple wants children for their labor value, old-age support and
risk insurance and low economic costs. Infant and child mortality is also considered a
demand variable. As such values are gradually vanishing because of increase in literacy
and greater access to health facilities, couples have started planning small families. The
economic cost of children is very high, as parents cannot afford good education. The direct and indirect cost of education, food and
clothing for children in urban areas is higher and many parents prefer only fewer
children. Compared to cities and towns, the economic cost of children for education, food
and clothing are low in rural areas, so the decline is slow. When it comes to education, there is no comparison.
Only children are much more likely than their friends with brothers are and sisters to go
elite private schools. "I wanted one child so I could give him the best education
possible," says Jamuna Shrestha, a resident of Kathmandu. Desire of Children The desired number of children is low but actual
number of children is much higher. There is a growing demand for fewer children. There is
a very big burden on the child. The concept of traditional societies to have more children
for a secure future has changed. The government must develop proper policy and planning to
bring down the actual number of children. The ideal choice is two and no one wants to have
many children. In Australia and the United States, many primary schools have closed down
because of the natural decline in the population growth rate and high overall migration. "The ministry is happy to say that the
country's fertility rate has declined," said Purushotam Tiwari, spokesman of Ministry
of Environment and Population. "According to projections, the population growth will
come down to 2.1 percent within a decade. If the situation remains same, the size will be
smaller in future." With support from the UNFPA, the government is
promoting the idea of a quality and manageable family size. "The ministry is also
launching population awareness programs through a decentralization approach under the
district population management scheme," said Tiwari. The remarkable changes in the fertility rate need
to be supported by greater access to education and health facilities in order to reduce
the population growth rate. At the household level, growing competition for the economic
and social opportunities available can be expected to nudge parents toward having fewer
children. ‘As Career Opportunities Grow, People Have Less Time For Children' — DR. RAMHARI ARYAL DR. RAMHARI ARYAL, a population expert, spoke to SPOTLIGHT on various issues
relating to declining fertility. Excerpts: Twenty-six years ago, the fertility rate was 6.3
and less than three percent of population adopted family planning method. At the time,
Nepal was among the countries with highest fertility rates. The Nepal Demographic and
Health Survey 2001 has shown a decline in fertility and an increase in the use of family
planning methods. The report shows that female fertility is now 4.1 percent and on a
declining trend. Although migration and fertility are two components of population growth,
the decline in the fertility rate will have a significant impact. There is no detailed
study on migration patterns and nobody knows its impact. Why has there been such a drastic reduction
in the fertility rate? In demographic term, there are four factors that
help to reduce the fertility rate. The marriage age, the use of family planning methods,
declining in infant mortality rate and increase in the number of literate population
contributes to the reduction of the fertility rate. What has encouraged couples to have a
smaller family? As career opportunities expand, people have less
time to raise children. A major advantage of a small family is more affordability of
children. As infant mortality has been reduced drastically, one does not worry about other
children. The average marriage age is 17. One cannot see a significant decline in the
fertility rate until the marriage age reaches 21. How do you assess the use of contraception? The use of contraception has increased by several
folds. The recent survey shows that 37 percent of women aged between 15 and 49 use
contraceptives. Very few newly married couple use contraceptives. If the government
provides sufficient contraceptives to newly married couple, the fertility rate would
decline further. Contraception is yet to produce the desired results. The fertility rate
is still 4.1. Nepal: Demographic Facts Population (2001)
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