The Federal Democratic Republic of Nepal is a landlocked country in South Asia bordered by Tibet and India. (Map 1)
Map 1
Population : The population is multi-ethnic, multi-lingual and multicultural with Nepali as the official language. In 2021 it numbered 30 million (UK = 67 million), having been 5.34 million in 1931. (Figure 1)
Figure 1
80% of the population live in rural areas, and it is expected that there will continue to be a slow increase in urban living in future years. (Figure 2)
Figure 2
Geography : Its geography divided into three broad groups –
- the Himal with 8 of the world’s 10 highest mountains,
- the Lower Himalayan Range reaching from subtropical valleys up to alpine climates above
- the lowlands with plains with subtropical and tropical climates.
The seasons are divided into summer, monsoon, autumn, winter and spring. Population density is high in the lowlands and low in the highlands.
Politics : Nepal’s present territory was formed mainly in the 1800s when it was a Hindu kingdom ruled by a royal family. It was not until the late 1940s that the growth in democracy movements lead to the toppling of the regime to establish a parliamentary democracy. Power wrangling continued, however, and the country remained unstable. In 1996 the Maoist Party started a violent bid to replace the royal parliamentary system with a people’s republic and this lead to a civil war that continued until 2006. In 2008 Nepal became a secular state and declared a federal republic divided into seven provinces in 2015 with Kathmandu its capital and largest city.
Civil rights are generally regarded as more progressive compared to some countries - the death penalty has been abolished, there is progress on LGBT and gender equality, it recognises marital rape and supports abortion rights. The country is secular, but four fifths of the population are follow the Hindu religion. The divorce rate is very low and child marriage is common in rural areas. Most marriages are arranged.
It has a long tradition of accepting immigrants and refugees and helping resettlement in other countries.
Wealth : Nepal is defined by the World Bank as a Lower Middle Income Country and its GDP per capita in 2021 was $3,832. The GDP per capita in the UK in 2021 was $44,979. (Figure 3)
Figure 3
The growth rate of its GDP is well below that of its neighbours in South East Asia. There are many different reasons for its low economic performance including its geography, past political instability, poor infrastructure.
A good place to find a summary of this is at https://www.imnepal.com/is-nepal-considered-a-low-income-country/.
Unemployment : Unemployment is at around 5% having increased over recent years. (Figure 4)
Figure 4
Poverty : Although it has experienced only moderate economic growth, there has been a rapid reduction in poverty. Its Gini Coefficient of 58, which is on a part with the USA and China. (Figure 5)
Figure 5
Health
Health Services : Health services are provided by public and private sectors and by NGOs. The total Health Expenditure per person in 2019 was $176.96, which compares to $ 5,087 in the UK.
Life expectancy : Life expectancy in 2021 was 68.4 years compared with 80.4 years in the UK.
Main causes of death : The main causes of death are Cardiovascular and Respiratory Diseases and Cancers. (Figure 6)
Figure 6
Maternal Health
Age at marriage : The average age at marriage in Nepal was 20.6 years in 2014, which compares to a UK figure of 30.8 years in same year. This would seem to contribute to some differences in the birth statistics of the two countries. (Table 1)
Table 1
(Source : Our World in Data www.ourworldindata.org)
Birth rate : The birth rate has been falling since the 1950s when it was around 47/1000. The decline increased in the 1990s and is now to 20.4/1000 in 2021. (Figure 7)
Figure 7
Maternal Mortality : Maternal mortality has fall dramatically since around the year 2000 from a maternal mortality ratio of 553/100,000 live births to 1786/100,000 in 2021. (Figure 8)
Figure 8
Neonatal Mortality : The neonatal mortality rate in Nepal 2021 was 1.6%, while in the UK it was 0,3%. (Figure 9)
Figure 9
Comment : Nepal is a Lower Middle Income Country that has not enjoyed rapid economic growth. However, it has achieved considerable improvements in the health of its population and in ways that reduce inequality. The main causes of death are from non-communicable diseases, but infections of various types are still important contributors. The birth rate has been falling and the maternal mortality has fallen very significantly, though it is not yet low. Being a predominantly rural population, access to services is likely to remain a challenge for some time to come.
Other supporting papers
- Factors contributing to rising ceasarian section rates in South Asian countries : A systematic review (University of Bournemouth)
- Current State of the Maternal Health in Nepal (Maternal Health Taskforce at the Harvard Chan School)
- Who are dying and why? A case series study of maternal deaths in Nepal (BMJ)
- Prevalence and risk factors for maternal mortality at a tertiary care centre in Eastern Nepal- retrospective cross sectional study (Biomed Central)
