13-19 February 2015 #745

Nepalis are living longer

Santa Gaha Magar and Ramesh Kumar in Himal Khabarpatrika, 8-14 February

Latest research shows that Nepal has made dramatic progress in increasing the average life-expectancy of its citizens – mainly due to a sharp drop in maternal and child mortality.

Nepal has now overtaken other South Asian countries and has the second highest life expectancy after Sri Lanka, according to a paper published in a recent issue of the British medical journal, Lancet.

The average lifespan of a Nepali is now 71, while Sri Lankans live longer to be 76. Bhutanese at 69, Indians and Pakistanis are both at 66 and Afghanis have the lowest life expectancy at 56.

What is remarkable is how quickly the average lifespan of Nepalis has increased – going up by 12.3 years between 1991 and 2011. Back in 1954, due to high infant mortality, an average Nepali lived to be 27.8 years. Out of 188 countries studied by the Lancet, Nepal is among the top ten countries to have dramatically improved life expectancy.

Life expectancy grows if the mortality rate decreases in proportion with birth rate, which is what has been happening in Nepal. Other factors include better access to health care, education, nutrition and immunisation. “The rise in life expectancy of Nepalis is a result of decreasing child and maternal mortality,” explains statistician Bhim Prasad Subedi.

Subedi says improved public health services and women literacy has contributed to higher life expectancy of women than men. “The government now needs to have plans for our rapidly aging population,” says Subedi.

Nepal has achieved two key Millennium Development Goals (MDGs) by lowering maternal and under-five mortality rates. Today, 170 in every 100,000 mothers die while delivering babies – down from 880 per 100,000 compared to 20 years ago. Similarly, 54 in every 1,000 children die before they reach five years of age whereas this figure was 150 only two decades ago. Nepal has achieved these targets two years before the 2015 MDG deadline.

Swarnim Wagle of the National Planning Commission (NPC) says curbing preventable deaths is effective for developing countries like Nepal to increase their average life expectancy. “Growth in life expectancy is an outcome of investment made by the government in health and education sectors over the last two decades,” he explains.

After 1990, Nepal allocated just 19.2 and 7.21 per cent of its budget for education and health respectively. Today, the figures have risen to 25.5 and 13 per cent respectively. The increase in the health budget has allowed the country to decrease the number of deaths caused by diseases like diarrhea, tuberculosis and pneumonia.

The growth in life expectancy is also a result of Nepal’s dramatically decreasing fertility rate, which is now at just 2.5 – down from nearly 6 in 1990. Yogendra Gurung of Tribhuvan University says people tend to have fewer children when they see higher prospect of their children’s survival, and fewer births mean fewer deaths.

In the last two decades, due to the increase in per capita income, Nepalis can buy healthier food and afford medical care. All this means the proportion of elderly people in the country has gone up.

According to the Central Bureau of Statistics, 295,459 Nepalis were more than 75 years old in 2001 and it went up to 437,981 in 2011.

Economist Keshav Acharya says the state now needs to spend more on pension and medical care of the elderly population. Better management of the aging population will also have a positive impact on the country’s economy. Anthropologist Suresh Dakhal says: “The elderly are a big source of knowledge, we must encourage them to share what they know with the new generation,” Dakhal says, adding that the state and the health sector have been lagging behind in geriatric care.

Kashi Raj Dahal of the Administration Reforms Suggestion Committee argues the government now needs to increase the retirement age of civil servants. “If it is increased from 58 to 60, experienced civil servants will have two more years to serve the country.”

Read also:

Nepal's Three Curses, Bihari K Shrestha

The generation gap, Trishna Rana