Background Childhood undernutrition is a significant public health issue in low-and middle-income countries, including Nepal. However, there is limited evidence showing the association between the planning of birth (PoB) and childhood undernutrition (stunting and underweight). We aimed to investigate the relationship between PoB and childhood undernutrition in the current study. Methods We used the Nepal Demographic and Health Survey (NDHS) 2016 data, a nationally representative cross-sectional household survey. We used two anthropometric indicators of childhood undernutrition as the outcome of this study. PoB is the main predictor. We used binary logistic regression with sampling weights to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) to examine the association between the PoB and childhood undernutrition. Unless stated, the significant association between the variables is calculated with p < 0.001. Results The overall prevalence of stunting was 35.8%, and underweight was 27.1% in children under 5 years of age in Nepal. We found a higher rate of stunting (52.7%) and underweight (41.1%) in children with birth order > 3 and < 2 years of the interval between birth and subsequent birth (IBBSB). The association between the children’s birth order and the prevalence of undernutrition had strong statistical significance. Mother’s age at marriage (p = 0.001), underweight mother, mother’s education, father’s education, wealth quintile, no exposure to mass media, children’s age, and place of residence(p = 0.001) were significantly associated with childhood undernutrition. The result of the multiple logistic regression showed that children with birth order one and 12–24 months of the interval between marriage and first birth (IBMFB) had significantly decreased odds of stunting than those children with birth order one and < 12 months of IBMFB (OR 0.6, 95% CI 0.4–0.9). Conclusion The findings of the study demonstrate that PoB has a protective effect on childhood undernutrition. Delaying of childbirth until 12–24 months after marriage was found to be associated with reduced childhood stunting odds. To mitigate childhood undernutrition, Nepal’s government needs to promote delayed childbearing after marriage while focusing on uplifting the household economics status and wide coverage of and utilization of mass media.
This paper examines the dynamics of contraceptive use of currently married young women (age 15-24) in Nepal by analyzing the trends and differentials in contraceptive use, the changes in method mix and the determinants of contraceptive use by selected socioeconomic and demographic characteristics. The reasons of non-use of contraception are also assessed. Data from the three rounds of nationally representative Nepal Demographic and Health Survey (NDHS) 2001, 2006 and 2011 are used. Currently married women aged 15-24 are selected and included in analysis. Study sample constitute 2573, 2398 and 2552 eligible women in NDHS 2001, 2006 and 2011 respectively. Use of contraception among young couples is gradually increasing in almost all subgroups of population in Nepal, with narrowing differentials by education and economic condition of household. Tendency of starting contraceptives before having a child is also emerging. There is declining share of sterilization among youth indicating either a probable shifting in age at sterilization or more favour towards temporary methods. Injection has the highest share in all the three surveys. The share of long acting temporary methods (IUD and Implants) is quite small and almost same in all the three surveys. Couples still feel safe to start using contraceptives after having at least one son however, the differences are declining. Reasons for non-use like fear of side effects and opposition to use are sharply declining over time but that due to husband’s absence is emerging as almost a sufficient reason for non-use of contraception among young married women in Nepal. The family planning program should focus on meeting the family planning needs of young couples of all strata of population with special thrust on those women whose husbands are currently in foreign country so that they would be able to avoid unintended pregnancy on their husband’s come back.
This paper examines declining fertility in a low development setting. Specifically, this paper analyzes transitions in age at first birth and of the length of birth intervals, the variations of the length of birth intervals by selected socioeconomic and demographic factors, and the determinants of the risk of higher order birth in Nepal by using the DHS data. There is very little change in the age at start of fertility schedule but the proportion of women progressing to the next higher order birth from the second, third and fourth births has declined over time. Increases in the median length of higher order birth intervals and decline in the ultimate proportions of women attaining higher order births drive declines in the pace of childbearing and overall fertility level. Controlling for other factors, higher order births are more likely among women who had given a previous birth before the survey period or women who had a female birth compared to women who did not have such births. Significantly, lower hazard ratio of the second birth is observed among women who are more educated, working in non-agriculture sector, from well-to-do households, with higher age at first birth, and whose first child survived during infancy.
This paper studies regional differences in currently married women’s employment status, its nature and some of the covariates in Nepal, with special focus to their education and economic status by analysing data from Nepal Demographic and Health Survey, 2011. Women’s employment, with substantial regional variation in the three ecological regions, is predominately unpaid, done mainly for family members, mostly in agriculture sector and women work throughout the year. Women are employed mainly in family farm and their job is unpaid. Higher education of women is positively associated with their involvement in paid jobs. Women of better wealth strata are less likely to be employed but if employed, they are more likely to be in paid jobs. Increasing education of women may have mixed effect in future. Policy measures are desirable to minimize these regional differences and to reallocate the total labour force in general and the female labour force in particular in more productive sectors with secured paid jobs for women for prosperity of the country.
Background: Childhood undernutrition is a significant public health issue in low-and middle-income countries, including Nepal. However, there is limited evidence showing the association between the planning of birth (PoB) and childhood undernutrition (stunting and underweight). We aimed to investigate the relationship between PoB and childhood undernutrition in the current study.Methods: We used the Nepal Demographic and Health Survey 2016 data, which is a nationally representative cross-sectional household survey. We used two common anthropometric indicators of childhood undernutrition as the outcome of this study. PoB is the main predictor of interest. Binary logistic regression with sampling weights was used to estimate adjusted odds ratios (OR) and 95% confidence intervals to examine the association between the PoB and childhood undernutrition.Results: The overall prevalence of stunting was 35.8%, and underweight was 27.1% in under-five children in Nepal. We found a higher rate of stunting (52.7%) and underweight (41.1%) in children with birth order >3 and <2 years of interval between birth and subsequent birth (IBBSB). The association between the birth order of children and the prevalence of undernutrition had strong statistical significance (p<0.001). Mother’s age at marriage (p=0.001), underweight mother (p<0.001), mother’s education (p<0.001), father’s education (p<0.001), wealth quintile (p<0.001), no exposure to mass media (p<0.001), children’s age (p<0.001), and place of residence(p=0.001) were significantly associated with childhood undernutrition. The result of the multiple logistic regression showed that children with birth order one and 12-24 months of interval between marriage and first birth (IBMFB) had significantly decreased odds of stunting as compared to those children with birth order one and <12 months of IBMFB (OR 0.6, 95% CI 0.4-0.9). Conclusion: The findings of the study demonstrate that PoB has a protective effect on childhood undernutrition. Delaying of childbirth until 12-24 months after marriage was found to be associated with reduced odds of childhood stunting. To mitigate childhood undernutrition, Nepal's government needs to promote delayed childbearing after marriage while focusing on uplifting the household economics status and wide coverage of and utilization of mass media.
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