Nepal has done well in recent years in the areas of child survival, family planning and fertility, said USAID director Rebecca Rohrer at the launch of the 2001 Nepal Demographic and Health Survey. The survey reveals a marked reduction in the average number of children born to a Nepali woman. The decrease, 0.9 less than the five 15 years ago, represents a nearly 20 percent drop in fertility. The main factor contributing to the decline is a doubling in contraceptive use among non-pregnant women between the ages of 15-49, up to 39 percent from just 15 percent in the late 1980s.

Infant mortality rate has also come down significantly?from 103 to 64 deaths per 1,000 live births. This goes together with advances in health care. Five years ago, just over one in three children were fully immunised, today 60 percent are. Vitamin A supplementation now covers 81 percent of the under five children.
But it is still probably too early for celebrations. There are other problems in our health sector that could easily drag us back?87 percent of deliveries take place in the absence of trained birth attendants, and less than half of all women are immunised against tetanus. Over half of all Nepali children are shorter than the normal height-for-age, and a fifth are severely malnourished, says the survey carried out by New ERA for the Family Health Division of the Ministry of Health.

At the same gathering Health Minister Sharat Singh Bhandary said the figures would be taken seriously and promised the following: a gender sensitive approach to health care delivery, decentralisation of public health service facilities, and increased participation of communities, local governments and private sector to improve the overall health scenario in Nepal. If only it were that easy.