The 2016 Nepal Demographic and Health Survey (NDHS) is the fifth NDHS survey conducted as a periodic update of the demographic and health situation in Nepal. The survey was implemented by New ERA under the aegis of the Ministry of Health (MOH), Government of Nepal. The primary objective of the 2016 NDHS project is to provide up-to-date estimates of basic demographic and health indicators. Information on following health related issues were collected in the NDHS 2016:

  • fertility levels
  • marriage
  • fertility preferences
  • awareness and use of family planning methods
  • breastfeeding practices
  • nutrition
  • maternal and child health and mortality
  • awareness and behavior regarding HIV/AIDS
  • women’s empowerment and domestic violence
  • other sexually transmitted infections (STIs)
  • other health- related issues such as smoking
  • knowledge of tuberculosis
  • prevalence of hypertension

The 2016 NDHS sample is stratified and was selected in two stages in rural areas and in three stages in urban areas. A total of 11,473 households were selected for the sample, of which 11,040 were successfully interviewed, yielding a response rate of 99%.

Five questionnaires that were used for the 2016 NDHS are:

  • the Household Questionnaire
  • the Woman’s Questionnaire
  • the Man’s Questionnaire
  • the Biomarker Questionnaire, and
  • the Verbal Autopsy Questionnaire for neonatal deaths

The 2016 NDHS involved collecting data on three major types of biomarkers, namely; anthropometry, hemoglobin/anemia, and blood pressure.

Key Findings

Sanitation

Three in five Nepalese households (62%) have improved sanitation facilities with 15% having no facilities at all.

Fertility

A woman from Nepal would bear an average of 2.3 children in her lifetime, if the rate remain constant at this level. Fertility is higher among rural women than among urban women; on average, rural women will give birth to about one child more than urban women during their reproductive years (2.9 and 2.0, respectively).

Teenage Pregnancy

Overall, 17% of women age 15-19 had begun childbearing: 13% had had a live birth and 4% were pregnant at the time of the interview. The proportion of teenagers who had begun childbearing rises rapidly with age, from 2% at age 15 to 36% at age 19.

Family Planning

Overall, 53% of currently married women use a method of family planning, with 43% using a modern method and 10% using a traditional method. Women in urban areas are more likely to use a contraceptive method (55%) than women in rural areas (49%).

Unmet Need of Family Planning

Twenty-four percent of currently married women have an unmet need for family planning services. Therefore, the demand for family planning methods for currently married women is 76%.

Early Childhood Mortality

The NDHS 2016 shows a pattern of decreasing childhood mortality.

Though Nepal met its Millennium Development Goal target of reducing under-5 mortality to 54 deaths per 1,000 live births by 2015, it has a long way to go to meet the SDG target for 2017, reducing under-5 mortality to 28 deaths per 1,000 live births

Maternal Care

The 2016 NDHS results show that 84% of women who gave birth received antenatal care from a skilled provider at least once for their last birth. Sixty-nine percent of women had four or more ANC visits and 89% of women received sufficient doses of tetanus toxoid.

Survey data show that in Nepal, 58% of the births were delivered by a skilled provider and 57% were delivered in a health facility. Sixty- eight percent of births to urban mothers were assisted by a skilled provider, and 69% were delivered in a health facility. After child birth, 57% of women reported having received a PNC checkup in the first 2 days after birth.

Child Health and Nutrition

Overall, 78% of children have received all basic vaccinations, and 38% have received all age-appropriate vaccinations. Ninety-eight percent of children have received BCG, 97% have received the first dose of pentavalent, and 98% have received polio 1. Eighty-six percent and 88% of children have received the third doses of the pentavalent and polio vaccines, respectively. Coverage of vaccination against measles rubella is 90%. One percent of children in Nepal have not received any vaccinations.

In Nepal, 36 % of children are stunted (below -2 SD), and 12% are severely stunted (below -3 SD). Stunting increases with age, peaking at 45% among children age 24-35 months. Likewise, 10% of children are wasted and 2% severely wasted and 27% of all children under 5 are underweight, and 5% are severely underweight. Only 1% of children under age 5 are overweight in Nepal.

Overall, 55% of last born children in the 2 years preceding the survey were breastfed within 1 hour of birth. Only 66% of the infants under age 6 months were found to be exclusively breastfed. Nine percent of infants under age 6 months are fed using a bottle with a nipple. Eighty-three percent of children age 6-8 months receive timely complementary foods, and only 10% of children age 18­-23 months have been weaned.

Among children 6-23 months, only 35% are fed in accordance with the criteria for a minimum acceptable diet.

Eighty-six percent of children age 6-59 months received vitamin A supplements in the 6 months preceding the survey.

Overall, 53% of children suffered from some degree of anemia: 26% were classified as mildly anemic, 26% were moderately anemic, and less than 1% were severely anemic.

Nutritional Status of Women

The mean BMI among women age 15-49 is 22 kg/m2. The mean BMI increases with age. Urban women have a slightly higher mean BMI (23 kg/m2) than rural women (21 kg/m2).

Seventeen percent of women of reproductive age are thin or undernourished (BMI <18.5 kg/m2). Seventeen percent of women are overweight (BMI 25-29 kg/m2), and 5% are obese (BMI 30 kg/m2 and above).

Forty-one percent of women age 15-49 are anemic. The majority of these women are mildly anemic (34%); 7% are moderately anemic, and less than 1% are severely anemic. Pregnant women and breastfeeding women (each 46%) are more likely to be anemic than other women (39%).

The prevalence of anemia among women has increased in the past 5 years from 35% in 2011 to 41% in 2016. However, the prevalence of anemia among pregnant women has declined slightly from 48% in 2011 to 46% in 2016. It can be noted that the percentage of pregnant women receiving the recommended dose of iron tablets during their pregnancy has improved over the period, from 38% in 2011 to 42% in 2016.

Excerpt from Key Indicators Report, Nepal Demographic and Health, 2016