National 6 (Spotlight Weekly)

Unmet Needs

As the number of adolescent population increases, more programs on reproductive health are on demand

By A CORRESSPONDENT

On July 11 when global communities celebrated the World Population Day urging to increase access to sexual and reproductive health needs of the adolescent groups, many young people in Nepal suffer from unwanted pregnancies as most of them are unaware about their reproductive health even after marriage.

Women at family health clinic : Growing access

Despite the vigorous efforts of government and non-governmental organizations to increase access to health facilities to younger people, large number of rural and urban population is yet to have access to reproductive health and sexual education.

Over the last decade, Nepal has made significant progress in reducing its fertility and mortality rate, but the threat of population outburst is still looming large since the volume of young population continues to increase.

When Nepal is facing challenges to provide basic services to adolescent population, the World Population Day celebrated with the message: One Billion Adolescent; the right to health information and services. This year's slogan could not have been more suitable to Nepalese concerns.

"Since one third of our population is adolescent, we need to direct our population related program to fulfill the need of younger generation," said Dr. Ram Hari Aryal, demographer and joint secretary at the National Planning Commission (NPC). "Most of the adolescent are at the age of regeneration so they need all kinds of access to sexual and reproductive health."

Nepal's Reproductive Health Initiative (RHI) has aimed to contribute to improving the reproductive health of women, men and adolescents in under-served rural areas of the country and among marginalized, vulnerable urban population.

With the support from the United Nations Population Fund and other donor countries, the government has been launching various programs targeting the adolescent population.

"Ministry of Population and Environment has celebrated the world population day stressing the need to provide access to the adolescent population," said Purushottam Tiwari, under secretary at the Ministry of Population and Environment.

National Population Census 2001 shows that over 25 percent of the population are adolescent and many of them are unaware of reproductive health issues due to lack of educational opportunities and also due to cultural inhibitions. The studies reveal that nearly half of the 15-19 year-old adolescent girls are already married and 24 percent of them are already mothers or pregnant with their first child.

Many are unprepared for pregnancy and motherhood. Being under-nourished and under-fed, they face higher chance of death or morbidity as a result of their pregnancy.

One fifth of maternal deaths occur among adolescent girls. Interestingly, relatively fewer people have been using the existing services, which have weak links to the communities, and inadequate supplies, equipment, and personnel.

The studies have shown that the lack of opportunities for literacy and education limits the access of many people to information on reproductive health. The studies conducted by Department of Health Service reveal that three in four women and two in five men have never attended school.

Overall more than 50 percent of mothers did not receive any antenatal care during their last pregnancy and a doctor or a nurse attended only one in ten births.