After the results of the National Census, 2078 in Nepal, due to the decrease in the population growth rate and fertility rate of the country, the discussion and interest about increasing the population in the future is increasing, expressing concern that the population will be negative in the future. In the new population policy recently prepared by the Ministry of Health and Population, various plans have been made to increase the population in the future by making this issue central.

On the occasion of the launch of the same policy, the Honorable Prime Minister also called for women to give birth to at least 3 children in a period of 20 to 30 years in order to increase the population in Nepal.

After the coming of the population policy and the advice given by the Prime Minister to have three children, there is more discussion on this issue in the formal and informal meetings, meetings, meetings and conferences of various groups and the media is also promoting this issue . However, it is necessary to discuss in depth what the national path should be on this matter. 

In this perspective, as public health workers working in the field of reproductive health and family planning for a long time, we are trying to shed some light on this matter.

vs. According to the 2078 census, the population of Nepal is 291 million 64 thousand 578. V.No. In 2068, the population of Nepal was 264 million 94 thousand 504. During the last 10 years, the population of Nepal has increased by 26 lakh 70 thousand 74. According to this data, an average of 267 thousand 7 population is increasing in Nepal every year. The population growth rate was more than 2 percent from 1971 to 2001 and it decreased to 1.35 percent in 2011 and 0.92 percent in 2021 .

Similarly, the total fertility rate in Nepal has decreased to 1.94 in 2078. In other words, in Nepal, 100 women give birth to 194 children during their reproductive period. In order to keep the population stable, usually one woman should give birth to 2.1 i.e. 210 people per hundred people . This is called the replacement layer in the language of population . In some districts, it has been shown that the population is negative than before. As both the total fertility rate and the population growth rate have decreased and in some districts the population is also negative, there is now a discussion on whether increasing the population is the appropriate solution .

The impact of migration

The constitution of Nepal has given citizens the right to migrate and work from one place to another suitable place for the development of their economic, social and personal abilities and to enjoy comfort and convenience. The rate of migration using this right has increased.

International migration is increasing in Nepal as well as internal migration. Thus, there is a strong possibility that the population count will be affected due to many internal and international migrations. According to the census method used in Nepal, the current place of residence is considered as the main basis for census and if a person is away from their permanent home for more than 6 months, such person is considered as absent population. 

According to the census of Nepal, 2078, 7.5 percent of the total population i.e. 21 lakh 90 thousand 592 people have gone outside the country for various jobs. Only 10.7 percent of them went to India . Both these figures are hard to believe. Because, according to various sources, it is estimated that around five million people are outside the country.

Even though the number of Nepalis who went to India is only 234 thousand 393 shown in the census, the question has been raised whether the data mentioned in the census alone cannot fully reflect the current demographic situation . During the festival, the pressure of Nepalese people seen at the Nepal-India border can be considered as a justification for the concern that the number of people going to work in India is still high.

According to the National Census, 2078, the rate of internal migration in Nepal, i.e. the ratio of people leaving their place of birth and migrating within Nepal, is 29.2 percent. Most of the internal migration was observed in the mountains, from where 32 percent of the people migrated . After this, 28.9 percent has moved from Terai and 13.8 percent from Himalayan region. At present, more than half (53.6 percent) of Nepal's population lives in the Terai region, 23 percent in the Terai region, 40.3 percent in the hills and 6.1 percent in the Himalayan region. About two-thirds of Nepal's population i.e. 66.17 percent live in urban areas (municipalities) and about one-third i.e. 33.83 percent live in rural areas (villages). 

Especially in big cities and in new places, people who migrate may rent, have no fixed address, and stay as guests. Even though the number of such people has been tried to be covered during the census, there is a high possibility that their accurate data will be lost or not recorded. This is also confirmed by the fact that the enumerators did not come to our house during the census.

The decrease in Nepal's population may not be of permanent nature but also of temporary nature . Therefore, without studying the situation of Nepal's population in depth, there may be no need to worry too much that the population has already decreased and had to be increased. In the past there is also evidence that population growth has decreased and then increased. Therefore, it is our opinion and advice that we should reach the conclusion only by studying and discussing this matter in depth.

Total Fertility Rate and Population Growth

Total Fertility Rate has a direct impact on population growth. The total fertility rate in Nepal in 2038 was 6.39. At that time, a woman would give birth to more than six children during her reproductive period . The total fertility rate in Nepal in 2078 has decreased to 1.94 due to the family planning program conducted by the government of Nepal, the expansion of health services, economic conditions and progress in the education sector and other reasons.

Because of the reduction in the total fertility rate, the population will soon decrease, so it is said that the population has to be increased . However, this is partially true but not completely true . The current total fertility rate of 1.94 is average. But it is different according to geography, province, education, economic condition, religious condition . Fertility rate is higher than the average among Madhes (2.85) and Karnalis (2.19), Dalit castes of Terai (3.30), those who have no formal education (3.0) and Muslims (3.98) who have poor economic conditions. Therefore, the population in these groups will continue to increase .

In addition, the share of the population of teenagers and young adults in Nepal is high . As individuals of this group enter reproductive age early and start having children, the population growth continues for many years . This is called population momentum in the language of population . Although the current population growth rate in Nepal continues, it is estimated that the current population will double in 75 years. Although the fertility rate has decreased not only in Nepal but also in the world and is close to the replacement level, the population is currently increasing by 80 million per year in the world. 

The use of contraceptives is important for reducing the total fertility rate. In general, the rate of use of modern contraceptives would have to increase by about 13 percent to reduce the total fertility rate . In addition, for the total fertility rate to reach the replacement level, the use rate of modern contraceptives should be 70 percent or more. In the case of Nepal, both of these estimates are not applicable.

In 1976, when the total fertility rate was 6.3, the rate of modern contraceptive use was only 3 percent. In 2006, the total fertility rate dropped to 3.1 and the use of modern contraceptives increased to 43 percent. But after this, due to various reasons, the rate of use of modern contraceptives has not increased beyond 43 percent, but the total fertility rate has continuously decreased and reached the replacement level. 

Although the use of contraceptives has not increased, according to a study conducted by the Ministry of Health and Population and the American Aid Commission, the main reason for the decrease in the total fertility rate in Nepal is the separation of couples due to migration (28.5 percent). Other causes include contraceptive use, late marriage, infertility and miscarriage.

According to the Nepal Demographic Health Survey 2022, more than one third of the married women aged 15 to 49 years in Nepal, 34 percent of the husbands and 8 percent of the men's wives are not living together or living outside the home . In this way, it is natural for the fertility rate to decrease when couples are separated for a long time . But what should be remembered here is that the decrease in fertility rate due to separation of couples is temporary in nature . They don't stay outside all the time but come to visit their family from time to time. For some reason, if there is an economic problem in the place where they work or if the situation in the country is not good, the people living outside can return to Nepal forever. 

In such a situation, the current fertility rate may increase uncontrollably . Therefore, now that the population has decreased in Nepal, it is not reasonable to say that there is no need for family planning programs. It should be carried out continuously in order to have a baby as per your plan and have a quality sex life . Therefore, this is the main reason why international and national organizations, including the United Nations, continue to operate family planning programs to manage the population instead of increasing it and investing in it.

Incentive program and its effect

Currently, in some villages or municipalities, the population has decreased, so it is necessary to increase the number of various incentive programs. Before holding such programs, it is necessary to find out why the population has decreased in the district or municipality. If in a place there is no facility of health, education, employment, roads, etc., but there is migration, it is necessary to think how wise it is to have a program to increase the population instead of providing facilities as expected by the people in such places. 

It has been explained that in the fundamental right of reproductive health, a person or a couple has the right to decide when to get pregnant, how many children to have or not, etc.

Nepal's constitution has also adopted reproductive health as a fundamental right. From the point of view of science and medicine, if a woman becomes pregnant as a teenager, if she becomes pregnant again within 24 months after giving birth, or if she becomes pregnant after 35 years, the woman may die due to various problems while having a child, even if she survives, she may be ill for a long time due to illness, the child will be born prematurely, the child will be born underweight, the child will still be born, even if the child survives, malnutrition, the child will die due to infectious diseases . Similarly, if premature or elderly women have too many children too soon, the chances of death and morbidity of mother and child are high. 

This has a negative impact on women's education, economic and moral development. Therefore, it is necessary to consider the results of all these health-related studies and the advice given by international organizations before setting up incentive programs to increase the population . We should also remember that these advices and suggestions did not just come, but are the result of years of study in different countries.

It's difficult to tell more or less by numbers only

It is not possible to say that the population has increased or decreased in a country based on numbers alone. For this, the geographical area of ​​that country, the resources available there, food, living space, environment, etc. also have an impact. Looking at the current situation in Nepal, due to population growth, people are forced to live a miserable life by migrating from the mountains and hills to the plains and from villages to cities in search of food and shelter. 

People are making slums by massaging fertile land to live. The current population is having trouble eating and living enough. Due to the destruction of the environment, problems such as heat increase and water scarcity are emerging . Temperature continues to rise not only in the cities, but also in the villages and plains, but also in the hills and mountains. It is becoming difficult to see snow in the mountains. If the population increases in an uncontrolled manner, there may be a situation where Nepal's limited geography cannot support people to live and eat. 

The population can be increased according to the need in a country with a lot of geographical area and resources. However, in a small country like Nepal, when the current population is stagnating, what will be the condition of people when the population doubles in a few decades? Therefore, increasing the population in Nepal more than now does not affect our quality of life more and ? 

Conclusion

In Nepal, population growth and fertility rates are gradually decreasing due to progress in health, education, physical development, employment, economic conditions and family planning programs compared to past rates and this is good. It is contributing greatly to the development of the country and improving the quality of human life. Current population declines are not only due to declining population growth and fertility rates, but also to our internal and international migration, unsafe abortions, infertility and census methods. 

In the name of increasing population, if women have children at a young age, if the interval between one child after another is not suitable, and if they have children after many years, the health of the mother and child may be at risk and the morbidity and mortality rate may increase . In addition, due to having to spend most of the time in pregnant, labor and delivery and taking care of many children, the possibility of hindering women's education, employment, skill learning and skill development is also high.