With over one third of the population being young and adolescent girls, Nepal has many challenges to meet their information and service needs related with sexual and reproductive health. Various services in the areas of family planning and reproducti

July 8, 2016, 5:45 p.m. Published in Magazine Issue: Vol.09,No. 24, July 08,2016, Ashad 24,2073)

It was 10:30 pm. A young girl was asking with the anchor of Khulduli.Com, broadcast by Radio Audio Visual, about the change of her physical body. The girl asked all sorts of questions, from basic to complicated. In a traditional society, sex and reproductive health is regarded a taboo subject and no girl can discuss it openly with her parents.

Thus, girls and adolescents find programs like Khulduli.Com a source to know all basic information about reproductive health, safe sex and sexual needs.

Although the population is in the stage of transition of physical and mental changes, what they lack is quality education, access to effective health care, confidential counseling and information services.

To fill the gap, Sunaulo Parivar Nepal, implementing partner of Marie Stopes International Nepal, has been supporting an interactive youth program.

“ has been broadcast between 10 pm - 11 pm every night via 75 different local FM stations of the country along with Radio Audio in Kathmandu valley. The program highlights the major concerns of youth and adolescence; they have limited knowledge and information about sexuality and reproductive health, family planning, safe abortion, a great confusion at the time of making decision about higher education, career development and love, attraction and desires,” said Sunaulo Parivar.

The program has a thematic slogan “Sukhi ra Surakshit yuba” (Happy and Safe Young people). The team has developed this thematic idea in order to make Adolescent and Young people’s life healthier and safer.

Demographic Health Survey reveals 44% of girls get married between the ages of 10 and 19, 16 being the average. Of them 21% become pregnant or give birth to their first child by the age of 19.

As it is very difficult for people in the remote mountain areas to visit the centres, the facilities take the services directly to them via mobile choice camps or outreach services. Through mobile choice camps, they provide voluntary surgical contraception and other FP methods working in close collaboration with the district health offices and local communities.

Shifting Policy

Despite achieving many successes in limiting the population growth, Nepal’s population policy is so unstable that in the last three decades the population division has moved to three different ministries. From high level Population Commission, high profile Ministry of Population and Environment and then Population Division under the Ministry of Health and Population and now again back to Ministry of Population and Environment.

World Population Day

As other countries are doing, Nepal is also celebrating the World Population Day with various programs on July 11. World Population Day has been a day to focus attention on the urgency and importance of population issues and this year's theme for the day is 'Investing in teenage girls.'

According to UNFPA, teenage girls around the world face enormous challenges. Many are considered by their communities or parents to be ready for marriage and motherhood.

Many are forced from school, damaging their future prospects. Even among girls who stay in school, access to basic information about their health, human rights and reproductive rights can be hard to come by, leaving them vulnerable to illness, injury and exploitation. These challenges are exacerbated among marginalized girls, such as members of ethnic minorities or those living in poverty or remote areas.

UNFPA's programs aim to end child marriage, curb adolescent pregnancy, and to empower girls to make informed choices about their health and lives.

"Leaders and communities must focus on and stand up for the human rights of the most marginalized teenage girls, particularly those who are poor, out of school, exploited, or subjected to harmful traditional practices, including child marriage," UNFPA Executive Director Dr. Babatunde Osotimehin said. "Marginalized girls are vulnerable to poor reproductive health and more likely to become mothers while still children themselves. They have a right to understand and control their own bodies and shape their own lives.”

Nepal's context

Adolescents, as a distinct category, remain largely invisible in national policies and programs. Although there are a large number of initiatives promoted by several ministries and agencies that directly or indirectly address adolescent girls’ concerns, there is little proper coordination among them.

Within the broad development context, adolescent girls in Nepal are not progressing to the same extent as boys of the same age. Adolescent girls live at the interface of inequity, vulnerability, disparity and discrimination at all levels, from family to community to the state, curtailing their development opportunities. Owing to a combination of biological, psychological and social factors, adolescent girls are considered vulnerable to various problems such as trafficking, sexual exploitation, child labour, HIV and AIDS, early pregnancy, substance abuse, suicide, accidents and violence.

An overwhelming portion of the population is young, 10-19 adolescent girls. Teenage pregnancy and prevalence of early child marriage are high. There is the need to give priority to the girls.

"Our populations are at risk. The slogan is the most appropriate for a country like Nepal,” said Professor Dr. Ram Sharan Pathak.

According to a report, the adolescent population in Nepal is approximately 6.0 million or 24 percent of the total population; 75 percent of all married women married before they turned 19, and 16 percent before they were 15 years old. The contraceptive prevalence rate for modern methods is 43 percent overall, but only 8.9 percent among women aged 15-19 leading to a high rate of early pregnancy: some 42 percent of married 15–19-year-olds are already mothers.

 “Gender norms are at the root of prevailing inequities between adolescent girls and boys. Gender disparities still persist in literacy and that adolescent girls face multiple obstacles in attaining education in Nepal. Despite the country’s strides in the areas of education and literacy, with near universal enrolment in primary education, gender disparities persist and are more pronounced among poorer, more vulnerable sections of the population,” said UNFPA report.

Girls are undervalued and live in a social environment where resources are distributed unequally between boys and girls. Studies indicate that girls are more likely to be enrolled in public schools than their brothers, who are more likely to be enrolled in private schools.

Girls are often taken out of school when they reach secondary level to engage in economic activities. Girls are expected to contribute substantially to household work and farming. At the same time, their economic contribution is undervalued and discounted, while there is an overemphasis on their reproductive role.

Despite advances in recent years, adolescent girls continue to suffer severe disadvantages, discrimination and exclusion, merely for being young and being female. For many girls, puberty marks an accelerating trajectory into inequality. It also represents a critical window for preventive and protective investments that we must make if we are serious about achieving full gender equality.

Ensuring that girls are able to exercise their rights, can pursue their education and have the skills and opportunities to join the workforce is essential for their own well-being, and a critical foundation for the health and prosperity of families, communities and nations. These rights include choosing when and whom to marry, when or whether to have children, and being free of violence, abuse and exploitation.

When girls are free to define their lives and enjoy their rights, they not only enjoy better health and healthier children; they are also better able to contribute to national development as economic actors and entrepreneurs, helping their countries reap a demographic dividend and driving economic growth.

When girls are free to define their lives and enjoy their rights, they not only enjoy better health and healthier children; they are also better able to contribute to national development as economic actors and entrepreneurs, helping their countries reap a demographic dividend and driving economic growth.

The UN Population Fund (UNFPA) argues that addressing these key issues is fundamental to slowing population growth. “Population dynamics are not destiny,” the UNFPA’s population matters report says. “Change is possible through a set of policies which respect human rights and freedoms and contribute to a reduction in fertility, notably access to sexual and reproductive healthcare, education beyond the primary level, and the empowerment of women.”

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