Nepal Demographic and Health survey 2022

The key findings of the Nepal Demographic and health survey are summarized below

Drinking Water and Sanitation:

• Nearly all households in Nepal (98%) have access to at least basic drinking water services, with slight variations between urban and rural areas.
• The main sources of drinking water are piped water into the household and tube wells or boreholes.
• Approximately 73% of the household population has at least basic sanitation services, with similar access in both urban and rural areas.
• Sanitation access varies by ecological zone, with the terai zone having lower access compared to mountain and hill zones.
• Open defecation is practiced by 7% of the population.

Fertility and Pregnancy:

• The total fertility rate in Nepal has declined significantly over the years, reaching an average of 2.1 children per woman in 2022.
• Fertility rates are higher in rural areas, with variations by ecological zone and province.
• Education and household wealth influence fertility rates, with higher education and wealth associated with lower fertility.
• Teenage pregnancy exists, with 14% of adolescent women age 15-19 having ever been pregnant. It is more common among less educated and poorer young women.

Family Planning:

• Approximately 57% of married women age 15-49 in Nepal use some form of family planning, while 43% use modern methods.
• The most popular modern methods include female sterilization, injectables, and implants.
• The use of modern family planning methods increased from 26% in 1996 to 44% in 2006 but has since stagnated.
• Family planning clients in Nepal are encouraged to make informed choices, although there is room for improvement in providing information about side effects and alternative methods.
• About 78% of married women in Nepal have a demand for family planning, with 43% using modern methods and 15% using traditional methods.
• The total demand for family planning includes both met and unmet needs, with 21% of married women having unmet needs.
• Approximately 55% of the demand for family planning is satisfied by modern methods, with variations by province.

Maternal and Newborn Health Care:

• In Nepal, 94% of women with a live birth received antenatal care from a skilled provider, with 73% having their first antenatal visit in the first trimester.
• About 79% of live births are delivered in health facilities, while 19% are delivered at home.
• Cesarean sections account for 18% of live births, with higher rates among women with more education, wealth, and in urban areas.
• Postnatal care is common, with 70% of women receiving checkups within two days of delivery.
• Among newborns, 70% received postnatal checkups within two days of birth.
• Men's involvement in maternal health care is notable, with 72% of fathers present at some prenatal visits.

Infant and Child Mortality:

• Infant and under-5 mortality rates in Nepal are 28 and 33 deaths per 1,000 live births, respectively, with a neonatal mortality rate of 21 deaths per 1,000 live births.
• Mortality rates have shown a significant decline since 1996, reflecting improvements in child survival.
• Birth spacing plays a crucial role in child mortality, with children born within two years of a previous birth having higher mortality rates.
• Mortality rates vary by rural/urban residence, maternal education, household wealth, and ecological zones.

Vaccination Coverage (Basic Antigens):

• Approximately 80% of children aged 12-23 months in Nepal are fully vaccinated against basic antigens, which include BCG, measles-rubella, polio, and DPT-containing vaccines.
• Vaccination coverage peaked at 87% in 2011, declined to 78% in 2016, and has since increased slightly.
• About 4% of children aged 12-23 months have received no vaccinations.

Vaccination Coverage (National Schedule):

• To be fully vaccinated according to the Nepali national schedule, children aged 12-23 months must receive a range of vaccines.
• In Nepal, 52% of children aged 12-23 months are fully vaccinated according to the national schedule.
• Coverage varies by ecological zone, with higher rates in the hill and mountain zones compared to the terai zone.
• Vaccination coverage according to the national schedule generally increases with mother's education, and it varies by province.

Childhood Illnesses:

• About 1% of children under the age of 5 in Nepal had symptoms of acute respiratory infection (ARI) in the two weeks before the survey.
• 75% of children with symptoms of ARI received care from a health facility or provider.
• Approximately 23% of children under the age of 5 had a fever in the two weeks before the survey, and most of them received care.
• 10% of children under the age of 5 had diarrhea in the two weeks before the survey, with higher rates among children aged 6-11 months.
• Among children with diarrhea, 57% received care from a health facility or provider.
• However, only 45% of children with diarrhea received oral rehydration therapy (ORT), while 28% received no treatment.

Nutrition of Children and Adults:

• Stunting, an indicator of chronic undernutrition, affects 25% of children under the age of 5, with higher rates in rural areas and mountain zones.
• Wasting, an indicator of acute malnutrition, affects 8% of children under the age of 5.
• Underweight status affects 19% of children under the age of 5, but only 1% are overweight.
• Overweight/obesity among women aged 20-49 is higher in urban areas and among wealthier households.
• Anemia affects 43% of children aged 6-59 months and 34% of women aged 15-49.
• Iron and vitamin A supplementation programs are in place, with varying coverage rates.
• Salt iodization is widespread, with 98% of households having iodized salt.

Feeding Practices and Supplementation:

• Nearly all children under age 2 were ever breastfed.
• Exclusive breastfeeding for the first two days after birth is common, and early initiation of breastfeeding within the first hour of life is practiced in 55% of cases.
• However, only 56% of children under six months are exclusively breastfed.
• Complementary foods are introduced to 85% of children aged 6-8 months.
• About 43% of children aged 6-23 months receive a minimum acceptable diet.
• Unhealthy feeding practices, such as sweet beverage consumption and the consumption of unhealthy foods, are prevalent.
• Vitamin A and iron supplementation programs are operational.
• The majority of households use iodized salt.

Disability:

• Approximately 6% of the household population aged five and above in Nepal have a lot of difficulty or cannot function in at least one domain of disability.
• Difficulty walking or climbing steps is the most common difficulty, followed by seeing and hearing impairments.
• Disability is more common among individuals with no education and those in the poorest households.
• Difficulty in at least one domain is observed in 8% of women and 7% of men aged 15 and above.
• These findings provide insights into vaccination coverage, childhood illnesses, nutritional status, feeding practices, supplementation, and disability status among children and adults in Nepal, which can inform public health policies and interventions to improve child health and well-being in the country.

Knowledge of HIV Prevention Methods:

• 80% of women and 96% of men have heard of HIV or AIDS.
• 26% of women and 37% of men are aware that antiretroviral medicines (ARVs) treat HIV.
• 65% of young women and 88% of young men know that using condoms every time they have sex can reduce the risk of HIV.
• 69% of young women and 85% of young men know that limiting sex to one uninfected partner who has no other partners can reduce the risk of HIV.
• Knowledge of Prevention of Mother-to-Child Transmission (MTCT) of HIV:
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• 80% of women and 78% of men know that HIV can be transmitted from mother to child during pregnancy.
• 75% of women and 73% of men know that HIV can be transmitted from mother to child during delivery.
• 53% of women and 43% of men know that HIV can be transmitted during breastfeeding.
• 37% of women and 33% of men know that the risk of MTCT can be reduced by the mother taking special drugs during pregnancy.

Multiple Sexual Partners and Higher-Risk Sexual Intercourse among Men:

• 3% of men had two or more sexual partners in the past 12 months.
• 29% of those who had multiple partners used a condom during their last sexual intercourse.
• 9% of men had sexual intercourse with a person who was neither their spouse nor lived with them in the past 12 months.
• 70% of those who had sex with a non-cohabiting partner used a condom during their last sexual intercourse.

HIV Testing:

• 10% of women and 13% of men have ever been tested for HIV and received the results.
• 3% of women and 2% of men were tested for HIV and received the results in the 12 months before the survey.
• Recent HIV testing among men has declined since 2016.

Women’s Empowerment:

• Employment rates are higher among married men (98%) than married women (76%).
• A higher percentage of women (46%) than men (10%) were not paid for their work.
• Women who earned cash were more likely to make decisions about how to spend their earnings (93%).
• Ownership of assets like houses and land is relatively low among both women and men.

Participation in Household Decisions:

• 72% of married women have sole or joint decision-making power in their own health care.
• 60% make decisions about major household purchases.
• 68% make decisions about visits to their family or relatives.

Attitudes toward Wife Beating:

• 19% of women and 17% of men believe that a husband is justified in hitting or beating his wife/partner under certain circumstances.

Use of Banks or Mobile Phones for Financial Transactions:

• About half of women (49%) and men (53%) have and use a bank account.
• Half of women (50%) and 55% of men have and use a bank account or used a mobile phone for financial transactions in the last 12 months.

Birth Registration:

• 73% of children's births were registered with civil authorities.
• Birth registration rates vary by province.

Access to Education:

• 72% of children who were age 4 at the beginning of the school year participated in organized learning.
• Attendance in schools decreases with age, and gender parity index varies by educational level.

Blood Pressure Measurement:

• 13% of women and 15% of men have ever been told they have high blood pressure or hypertension.
• 18% of women and 23% of men have hypertension.
• Hypertension prevalence varies by region and increases with age.

Accidents and Injuries:

• Deaths and injuries due to road traffic accidents are more common in urban areas and the terai zone.
• Motorcycle accidents are the most common type of road traffic accidents.
• Falls are the leading cause of non-road traffic accidents.

Mental Health:

• 22% of women and 11% of men experienced symptoms of anxiety.
• 5% of women and 2% of men experienced symptoms of depression.
• A smaller percentage of those with symptoms sought help for mental health issues.