– SAHESHA Upadhyay

BACKGROUND

The WHO recommends a minimum of 2.5 health workers per 1,000 population as a general benchmark to ensure adequate access to essential health services. This ratio appears as an unconvincing goal for Nepal given its current ratio of  8.52 per 10,000 (or 0.85 per 1,000 population). This presents a major challenge in terms of healthcare access, particularly in rural areas where mountainous terrain has impeded infrastructure development. The emergence of digital healthcare technology, including telemedicine, tele-visits, remote monitoring, IoT equipment, wearables, and digital healthcare database management, offers a promising solution to bridge this gap. The successful integration of a digital healthcare system requires efficient and dependable energy infrastructure as a foundation. Nepal, therefore, needs to align its healthcare and energy goals if it is to fully realize the potential of digital healthcare technology. 

Snapshot of Digital Healthcare in Nepal  

In recognition of the potential impact of digital health on healthcare accessibility and quality, Nepal’s Digital Framework 2019 has identified health as one of its eight priority sectors and established seven initiatives aimed at leveraging digital tools and technologies that include:

1. National Digital Healthcare Platform
2. Next-Generation Digital Healthcare Facilities
3. Electronic Health Records 2.0
4. Mobile Health Units 
5. e-Maternal Care
6. Drones for delivery of emergency medical supplies
7. Centralized Telemedicine Center

Several online platforms, including Jeeve, Hamro Patro, TeleCareNepal, Tele Upchar, and Hello Health, have successfully been delivering digital healthcare services in Nepal. Their services range from e-consultation and drug prescription to drug delivery to electronic management of healthcare records. Post-COVID-19, Nepal’s telehealth and digital health technology sector has witnessed a significant growth. Despite Nepal’s healthcare system being on the brink of collapse during the pandemic, the need for innovative solutions that could deliver healthcare services to people remotely was amplified. As a result, the utilization of Internet and telephone technologies for consultations skyrocketed in both hospitals and clinics, with numerous new and cutting-edge applications emerging. Furthermore, the country experienced a remarkable transformation in digital payment technologies and services, contributing to the widespread adoption of digital health channels.

Electrification and Healthcare

Despite all the possibilities that digital technologies offer, the challenge is to equip these technologies with the best resources that will keep them running smoothly. Electrical power remains the backbone of hospital operations; we need it not only for powering specific healthcare devices and technologies but also for basic office operations works including lighting, communication, and refrigeration. We cannot emphasize the term “reliability” enough when discussing the availability of electricity in regard to healthcare access. Interruptions in electricity, even for just a few minutes, can have dire consequences, such as life-saving devices failing during medical procedures, or critical medicines becoming spoiled due to loss of refrigeration. Likewise, tele-visits and remote-diagnoses are out of the question, when electricity is simply not dependable. Electricity must be ubiquitous in Nepal for healthcare access to be universal.

We cannot overemphasize the term “reliability” when discussing the availability of electricity in regard to healthcare access. The Energy Progress Report 2020  indicates that 90 percent of Nepal’s population has access to electricity, yet despite this achievement, frequent power cuts in rural areas continue to pose difficulties for the proper functioning of healthcare facilities. According to the Nepal Electricity Authority, several districts, including Ilam, Panchthar, Taplejung, Okhaldhunga, Khotang, Solukhumbu, Bhojpur, Sankhuwasabha, Udayapur, Kavre, Makwanpur, Dhading, Nawalpur, Darchula, and Dolpa have very low electrification;  Dolpa, Mugu, and Humla of Karnali Province have no connection to the national grid at all. The World Health Organization (WHO) also reports that only 65 percent of hospitals and 56 percent of non-hospital healthcare facilities in Nepal have a steady supply of electricity. Likewise, four percent of healthcare facilities in the country do not have access to any electricity supply. The issue of limited access to reliable electricity in healthcare facilities affects nearly one billion people globally, as reported by the United Nations.

For telemedicine and remote-diagnostic technologies to be successful, it is not only crucial for hospitals but also for individual households to have access to reliable electricity. Despite the widespread availability of affordable mobile devices and the expansion of 3G and 4G networks, which have led to a 90 percent coverage of wireless networks in Nepal, there are still significant gaps in coverage, particularly in rural areas. These limitations hinder effective telemedicine visits and remote diagnostics. As such, ensuring access to reliable electricity is essential for both powering devices and providing reliable broadband internet access.

Way Forward

The integration of alternative energy sources such as solar panels holds great promise as a transformative solution that can revolutionize healthcare services in Nepal. In many rural areas, solar power initiatives have already been successful, with 15 percent of the population gaining access to electricity through solar grids as reported by Nepal News news portal. Moreover, the cost of solar panels has decreased significantly in recent years, making it a more viable option for expanding healthcare services. By expanding these programs to rural healthcare facilities, Nepal can significantly improve the digitization of its healthcare technology and make healthcare facilities more reliable.

One way to achieve this is by implementing projects aimed at decentralizing electricity by providing every remote healthcare facility with its own solar panel grid. This not only has the potential to enhance service delivery but also make electricity access more resilient. Catastrophic climate events or any other national emergency will not interrupt the operation of specific healthcare facilities. A great example of this is St. Luke’s Hospital in Ethiopia, where a private renewable energy company provided assistance in implementing a groundbreaking solar hybrid system that delivers 320 KWh of electricity. This resulted in significant cost savings and improved service delivery.

In addition to its impact on healthcare delivery, the electrification of healthcare facilities can also have a profound effect on the distribution of healthcare professionals. A study has shown that access to reliable electricity and digital healthcare technology can serve as a powerful incentive for healthcare professionals, particularly in rural and remote areas. By making healthcare facilities more appealing and attractive, electrification can help attract and retain healthcare professionals in these areas, thereby increasing the availability of healthcare services for communities in need.

To ensure the longevity and effectiveness of these projects, regular maintenance of power plants and medical equipment, as well as personnel training, must be prioritized in the healthcare project design and budgeting process. Effective collaboration between stakeholders from both the healthcare and energy sectors, including public and private entities, can guarantee that healthcare needs are taken into consideration during the design and implementation of electrification projects. Finally, it is also important to draw attention to the fact that the adoption of digital healthcare, particularly telehealth, has far-reaching benefits that go beyond just improving individual health outcomes in rural areas. In addition to providing convenient access to medical services, by eliminating the need for frequent doctor-patient commutes, telehealth significantly reduces the carbon footprint associated with transportation

– SAMJHANA Karki

The opinion piece originally appeared in the April 2023 Issue of New Business Age Magazine. Please read the original article here.

The probability of disasters occurring worldwide is increasing. The Annual Weather, Climate, and Catastrophe Insight Report 2023 revealed that natural catastrophes alone resulted in $313 billion in global economic losses. According to the Global Risks Report 2023, natural disasters and extreme weather events rank second in the top ten risks over the next two years. Whether caused by natural hazards such as earthquakes, landslides, hurricanes, and floods, or non-natural hazards such as industrial accidents, terrorist attacks, civil wars, and pandemics, disasters can have significant social, economic, and political consequences. The impacts of these events can have far-reaching and cascading effects on governance, power dynamics, and public policy.

The recent earthquake in Turkey and Syria has highlighted the impact of disasters on a country’s socio-economic status. According to the Global Rapid Post-Disaster Damage Estimation Report 2023 published by the World Bank, the two major earthquakes on February 6 caused direct physical damages estimated at $34.2 billion for Turkey, which accounts for four percent of the country’s 2021 GDP. Syria also experienced damages worth $5.1 billion.

South Asia has been experiencing a series of disasters that have had a significant impact on the region’s development. Unfortunately, poverty, inadequate infrastructure, and ineffective governance have worsened the consequences of these disasters. One major example of their devastating impact can be seen in Bangladesh, where around 7.2 million people were affected by flooding in June 2022. Similarly, Pakistan experienced historic floods the same year, resulting in damages and economic losses exceeding $30 billion.

Nepal is not immune to the consequences of disasters. It is among the 20 most multi-hazard-prone countries in the world. In 2015, the Gorkha earthquake and subsequent aftershocks caused the deaths of approximately 9,000 people and injured around 22,000. The disaster also resulted in loss and damage estimated at $7 billion, equivalent to one-third of Nepal’s GDP. Additionally, severe flooding in August 2017 affected 1.7 million people and caused loss and damage of $585 million, equivalent to three percent of Nepal’s GDP. Despite having a small population of 30 million, Nepal has faced significant impacts from disasters, resulting in high costs in terms of human life and economic damages.

Disasters have far-reaching consequences, affecting not only the physical environment but also the social and economic fabric of society. The loss of life, injuries, and displacement can cause significant trauma and mental health issues for individuals and communities. Disasters also disrupt businesses, leading to lost revenue and decreased productivity. This can result in reduced economic activity, job losses, and a decline in living standards. Additionally, disasters can have a significant impact on the country’s economy, leading to decreased agricultural output and slowed tourism activities.

The physical damage to infrastructure can also make it difficult for people to access essential services. For example, the floods and landslides of 2021 caused damage to physical infrastructure worth $9.9 million in Nepal, making it challenging for people to access critical services such as water supply and electricity. Furthermore, investment in disaster relief efforts, including search and rescue operations, emergency shelters, and reconstruction and rehabilitation, increases government spending. This can have implications for the country’s budget and development priorities.

Disasters can also worsen existing social inequalities, leading to unequal access to relief and rehabilitation measures. Individuals from so-called higher castes or with political affiliations may be more likely to receive humanitarian aid than the actual needy and affected population. This can lead to a breakdown in social order, and criminal activities may increase.

In addition, disasters disrupt the health sector, causing difficulties in accessing medical care, particularly for individuals with pre-existing health conditions. This leads to a significant impact on health outcomes, resulting in increased morbidity and mortality rates. Moreover, climate-induced disasters often force people to evacuate their homes and seek refuge in evacuation centres or camps. The overpopulation in these camps results in reduced access to safe water and sanitation facilities, increasing the risk of waterborne diseases. Therefore, the socio-economic impacts of disasters make people more vulnerable to future disasters.

Reducing Nepal’s vulnerability to disasters is a complex issue that requires a multi-faceted approach. The government has taken several steps to minimise the impact of disasters, including adopting the National Policy and Strategic Action Plan for Disaster Risk Reduction and Management (2018-2030), enacting the Disaster Risk Reduction and Management Act, establishing various Early Warning Systems, launching the BIPAD portal, creating the National Disaster Risk Reduction and Management Authority (NDRRMA), providing emergency response training to communities, and offering disaster response training. However, the implementation of these initiatives has been challenging due to insufficient coordination, resources, and capacity.

One of the ways forward to reduce the impact of disasters is increasing awareness among students. The Nepali curriculum and textbooks have not been fully disaster sensitive until now. Incorporating disaster risk reduction (DRR) education into the school curriculum is essential to building a more resilient society. DRR education enhances people’s awareness and knowledge about disasters and how to mitigate the hazards and consequences of such disasters. Schools can develop dedicated modules on DRR, Emergency Preparedness, and Crisis Management Plan (EPCMP). Games, simulations, and other activities (use of case studies and real-life disaster examples) can be done to illustrate concepts and principles related to DRR. This could help build our future generation to cope with the risks and impacts of disasters. Nepal can learn from Japan about incorporating DRR into the school curriculum.

Overall, reducing the impact of disasters requires a comprehensive approach that involves developing a disaster preparedness plan, conducting risk assessments, strengthening early warning systems, and establishing emergency response teams. Inclusive policies in DRR can help reduce the impact of disasters and promote inclusive and sustainable development. Collaboration between governments, the private sector, and educational and research institutes is crucial for disaster resilience. Additionally, prioritising community awareness is essential. Moreover, government and local representatives can play a crucial role in reducing disaster risk by promoting preparedness, coordinating responses, and advocating for policies and programs that support resilience.

– SANTOSH Sharma Poudel

The column originally appeared in The Diplomat on 18 April 2023. Please read the original article here.

Kathmandu has been abuzz with discussion about Prime Minister Pushpa Kamal Dahal’s visit to India. Initially planned for April, the visit has been postponed now to early May.

Since his swearing-in as Nepal’s prime minister in late December of last year, Dahal has publicly stated his interest in making New Delhi his first foreign destination. He has repeated this intention time and again.

Nepal’s prime ministers have traditionally chosen New Delhi for their first foreign trip. Dahal was the last prime minister to buck the trend when he assumed the role of prime minister for the first time in 2008. Then, he visited Beijing to attend the Olympics closing ceremony, drawing criticism at home and in New Delhi for flying first to Nepal’s northern neighbor, China.

India is so central in Nepal’s diplomacy and domestic politics that the first visit of a Nepali prime minister to New Delhi is assumed.

While newly appointed Nepali prime ministers often rush to visit India, New Delhi has not always shown similar urgency to meet them. Dahal’s immediate predecessor, former Prime Minister Sher Bahadur Deuba, had to wait nine months before he could visit India. Khadga Prasad Sharma Oli, who preceded Deuba, got to visit the Indian capital within two months after he became the premier. During his last tenure as prime minister (2016-17) Dahal got to visit New Delhi four months after he took over the reins.

India rushed to welcome Oli in 2018 because it wanted to rebuild ties with Kathmandu that had been severely strained by its blockade of landlocked Nepal in 2015. It also saw Oli as a powerful leader, potentially at the helm of the Nepali government for five years. New Delhi was proactive in seeking to ensure that Oli would not lean to Beijing as he did during his previous tenure (2015-16). Besides, the Indian government wanted to project successful diplomacy in its neighborhood.

What explains the delay in Dahal’s visit to New Delhi?

First, since becoming prime minister Dahal has spent his entire energy managing and surviving domestic politics. In the last four months, he has changed coalition partners and is yet to form a government fully. After the Oli-led Communist Party of Nepal-United Marxist Leninist (CPN-UML) withdrew from the government, Dahal was in charge of 16 ministerial portfolios, including foreign affairs. He finally appointed N.P. Saud of the Nepali Congress (NC) as the foreign minister on April 16. It is not a surprise then that without a lieutenant on his side, Dahal’s diplomatic plans suffered. The cabinet expansion is expected to be complete soon, so he can finally glance beyond domestic politics.

Second, Dahal’s grip over power appears tenuous. His party, the Communist Party of Nepal-Maoist Centre (CPN-MC) came in a distant third in the 2022 general elections, winning a mere 11 percent of the votes. While he was able to play on the insecurities of Deuba and Oli to propel himself to the prime minister’s post, his alliance with the Oli-led CPN-UML was a partnership of strange bedfellows, one that was doomed to fail given their past tumultuous relations and the fact that Dahal had a pre-poll alliance with the Deuba-led NC. With the NC actively looking to wedge them apart, the coalition soon fell. New Delhi might have calculated that there was little to gain from the visit of a flailing prime minister. India was therefore not in a hurry to meet Dahal.

Finally, five months after the general elections, Nepali politics look somewhat settled by Nepali standards. Hence, diplomacy, and the trip to New Delhi, is back among the priorities for the Dahal government.

Several outstanding issues in India-Nepal relations require immediate attention.

Among the primary concerns for Nepal is the connectivity: land, air, and power. The detailed project report for the 136-km-long Raxaul-Kathmandu broad-gauge railway is complete. India and Nepal will be holding a meeting of the joint working group on the railway project this week and expect to sign an agreement on the construction and funding modality during Dahal’s upcoming visit.

Nepal has been seeking Indian permission for air routes to efficiently operate the Gautam Buddha International Airport (GBIA) and Pokhara International Airport (both of which, incidentally, were built by Chinese firms). Nepal has requested India to provide three additional entry routes and an agreement on near-border operation for the GBIA to make international flights to the newly built airports economically feasible. Dahal would like to secure agreements for at least two entry points.

The two countries signed a Joint Vision Statement on Power Sector Cooperation during Deuba’s visit to New Delhi in 2022. Cross-border power transmission infrastructure and bi-directional power trade based on market demand are core components of the agreement. Based on it, India has permitted Nepal to export up to 364 MW of hydroelectricity. Nepal seeks to expand the scope and depth of the agreement. It seeks further Indian investment in hydroelectricity, permission for more energy exports to India, and Indian cooperation for exporting hydroelectricity produced in Nepal to Bangladesh via India.

The two neighbors had a fallout over the Agnipath scheme introduced last year. Under the scheme, the Indian Army recruits young soldiers (Agniveers) for four years, after which three in four Agniveers will retire from the Army with a $15,000 severance package. This goes against the 1947 tripartite agreement Nepal signed with India and the United Kingdom, which requires India and the U.K. to provide pensions to the Gurkha soldiers recruited from Nepal. As a result of the spat with India on the matter, India’s recruitment of Gurkhas from Nepal has been postponed since last year. Nepal would seek an amicable solution during the visit.

Besides these concerns, there are other stock issues, such as the territorial dispute along Nepal’s western border with India, border management, and a host of other economic issues to be dealt with. On top of that, the Dahal government will have to allay New Delhi’s apprehensions over Nepal’s increased engagement of Beijing and Washington. It will have to assure New Delhi that these engagements will not come at the cost of legitimate Indian interests in Nepal. These issues make Dahal’s visit to New Delhi in May critical.

Reports say that the visit dates have been finalized but will only be disclosed once some agendas get a concrete shape. Sherpas from both countries are working on the draft of the final agreement to be signed in New Delhi.

Dahal has shown his Machiavellian traits to become the premier. We will find out soon if he is any good at diplomacy.

– NISCHAL DHUNGEL

The opinion piece originally appeared in The Kathmandu Post on 13 April 2023. Please read the original article here.

The recently published Nepal Population and Housing Census 2021 shows an alarming trend: The population of children is decreasing, and the dependent population over 60 is increasing. In 10 years, the population under 14 dropped from 34.91 to 27.83 percent while the population over 60 rose from 8.13 to 10.21 percent. As the average life expectancy of citizens grows, the age imbalance in the population increases the state’s financial responsibility, primarily social protection, in future.

The window of opportunity for Nepal to take advantage of the demographic window is pretty small. To fully realise the demographic dividend, it is necessary to increase the domestic job environment and investment in the skills of Nepali youth. The government has two options with regard to job creation: Making the Prime Minister Employment Guarantee Programme more effective or creating a favourable environment for the private sector to create better jobs.

Job guarantee

On the one hand, Nepal’s share of economically active people working in the agriculture sector is decreasing due to increasing attractiveness in the service and industry sectors (according to the 2021 census, 57.3 percent of the population depends on agriculture). On the other hand, the share of the economically inactive population is found to be students, as well as those engaged in household work and family care, old age people, and persons with disabilities, etc. So the question is: How do we leverage Nepal’s labour force by employing them in productive sectors, striking a balance between the agriculture and non-agriculture sector?

In this regard, job guarantee is one of the structural stabiliser fiscal policies that the government can undertake to promote employment. With a basic wage and benefits package for anyone, especially the economically active population willing to work, a job guarantee should be the mantra of the government. The Nepali labour market has seen high involuntary unemployment rates for several years, and the Covid-19 pandemic has further aggravated it. A targeted job guarantee programme can be an effective and equitable policy for achieving full employment and reducing poverty and income inequality.

The government should work in partnership with companies in the private sector to implement creative employment interventions, such as skill development and job placement, that raise wages for workers and boost productivity at businesses in high-growth industries. While creating jobs, the government must check if employers adhere to employee welfare, labour rights, workplace safety, and social protection regulations. Building a solid base for employment opportunities helps the government generate revenue in the form of taxes.

Nepal is currently working with the World Bank to create an Integrated Social Registry, which can act as a platform to link social protection programmes and information systems and address several other issues, including those related to the front end (service delivery) and back end (information system). Touting social protection programmes looks politically appealing, but it is financially challenging. Promoting job guarantee would reduce the impact on the public budget, and employing the job guarantee workers on projects that encourage domestic production could minimise the trade balance.

Existing laws

Nepal’s social protection system comprises contributory social insurance for formal sector workers, non-contributory social assistance, and employment initiatives. Significant legislative reforms, such as the Contribution-based Social Security Act, Labour Act 2017 and the Civil Service Act (Third Amendment 2014), have been enacted to strengthen the country’s social protection system. The primary contributory social insurance programmes for formal private sector workers are the Social Security Fund (SSF) and the Employees’ Provident Fund (EPF) for public sector employees. The non-contributory side of the system is intended to benefit “the most vulnerable sectors of the population.” The four programmes, namely, medical, health and maternity protection, dependents protection, accident and disability protection, and old age protection, were also introduced. The social protection coverage rate is modest, with pensions having the highest coverage rate. Two recent guidelines, one pertaining to migrant workers and the other to those employed in the informal sector and who are self-employed, on expanding social security safety nets are a step in the right direction.

The gradual expansion of social security programmes over the years is a positive step towards ensuring social security and protection for the people. However, their effectiveness has been hindered by insufficient human resources, planning, and coordination. Human Rights Watch has pointed out that Nepal’s social protection system is inadequate in protecting children from poverty and perpetuates inequalities between formal and informal workers. The targeted programmes are often too narrow in scope, while the selection processes can be expensive, inaccurate, and susceptible to corruption. Additionally, many eligible individuals may face difficulty applying or choose not to apply due to the associated stigma. For example, social institutions and welfare policies may consciously or unconsciously stigmatise impoverished children, reinforcing their sense of failure and shame. This is especially so in cases where poverty is attributed to individual shortcomings rather than structural factors. Universal child benefits are more likely to foster social cohesion. They are cognisance recipients as rights holders entitled to support rather than merely beneficiaries, which can affect their civic engagement and the government’s accountability.

Past experiences

The Karnali Employment Programme (KEP) was designed similarly to the Prime Minister Employment Guarantee Programme currently implemented in Nepal, as it involved the creation of employment through infrastructure projects at the local level, resulting in the construction of physical assets. The KEP was marketed under the slogan “one family, one job” (Ek ghar, ek rojgar) and aimed to provide 100 days of employment to each participating household, specifically targeting households without any employed members. The programme provided a specified number of work days to participating households every year rather than a limited period of employment on a one-time basis.

Although KEP faced budgetary and operational constraints at the local level, which hindered its effectiveness in providing employment to all eligible households and compromised its performance as an employment guarantee scheme, these challenges should not be taken to mean that similar initiatives cannot be developed in Nepal. It is important to note that KEP was designed to address the historical underdevelopment of the Karnali region rather than to serve as a blueprint for a nationwide scheme in the future. Just like in Bangladesh, the government can prioritise certain sectors like the garment industry to create a favourable environment for the private sector or strengthen government-led employment programmes to create more jobs.

Most social protection is linked to formal employment. This social protection system exacerbates inequality since informal sector workers are likely to be poor due to low wages and unpredictable employment. Low minimum wages and good job opportunities in Nepal have led to large-scale out-migration. Hence, creating a favourable environment for the private sector to generate more work opportunities or strengthen government-led employment programmes is important. Domestic employment aids the government’s financial responsibility to support the social security system in Nepal.

Most South Asian countries suffer from political and economic distress. But India and China increase their global footprint. Read the South Asia Bulletin for more.

– SHASTA Kansakar

Almost half of Nepali women of reproductive age use contraceptive measures. Condoms, morning-after pills, and intrauterine devices (IUD) are a commonality for contemporary Nepalis. Having these choices and access to contraceptives is crucial for reproductive healthcare and empowerment. This allows for ease of family planning as well as sexual liberation. It is great that Nepal has reached many milestones with regard to reproductive health, for example meeting MDGs and SDGs. However, it is to be noted that women bear the brunt of using contraceptives over men. 

In 2019, 47 percent of Nepali women aged 15 to 49 reportedly used permanent or temporary contraceptives. These contraceptive methods commonly included female sterilization, birth control pills, IUDs, injectables, implants, and female condoms for women while men used condoms or underwent sterilization. Most of these contraceptives – bar condoms – are either injected or ingested, making them invasive procedures. According to a 2016 study, 28 percent of Nepali women relied on sterilization, 17 percent on injectables, nine percent on birth control pills, six percent on implants, and three percent on IUDs. In contrast, only ten percent of men had undergone sterilization. As per this data, women largely endure invasive procedures over men. Such temporary contraceptives for women largely affect their quality of life due to the side effects. On the other hand, for men, there are no temporary birth control measures aside from condoms in the market. 

Women often report mood changes, weight gain, nausea, migraines, thinning hair, and irregular periods as a few of the side effects of contraceptives. Studies have also concluded that hormonal contraceptives could lead to severe conditions like depression, anxiety, and fatigue. Dr. Heera Tuladhar, head of gynecology and obstetrics at KIST Teaching Hospital, Kathmandu says that these side effects depend on the age and pre-existing conditions of the individuals. For instance, older women tend to experience more side effects. Similarly, while less than ten percent of women may be severely affected by hormonal contraceptives, progestin-only pills like Depo-Provera may lead to bleeding problems. Estrogen and progestin-based contraceptives like pills may lead to heart problems. As further mentioned by Dr. Tuladhar, only a small portion of women may experience severe reactions. Nonetheless, the minor side effects also impact the quality of life of many users and hence should not be ignored. Ironically, there have been many studies speculating whether the negative effects of women’s contraceptives are placebo or not. This is frustrating because not only do women overwhelmingly use contraceptives that intrude on their bodies, but their concerns are also brushed off and understudied by academics. Moreover, holistic research on the physical, mental, and sexual well-being of contraceptive users is acutely lacking. Sex is viewed as a purely biological process instead of a recreational one that intertwines with one’s social or familiar life. So, the sexual functioning or libido and the emotional state and burden of contraceptive-using women should be studied beyond medical side effects. 

The emotional aspect in particular is also gravely undermined. Despite the ubiquity of contraceptives, it is still taboo to speak about them openly. This puts a mental burden on women, especially unmarried ones. There are many instances of gynecologists slut-shaming unmarried women for their sexual choices. It can hence be difficult for women to speak about their experiences with their peers and even medical professionals, isolating them from the support they might need. 

Moving forward, Dr. Tuladhar hopes that newer contraceptives will have low doses and high efficacy. On the other hand, she says that healthcare providers should create a safe space for contraceptive users to express their discomfort. They should also not discriminate against unmarried women and prioritize the needs of the patients instead. In addendum, it is only proper to mention that contraceptives still have not saturated their reach in certain parts of Nepal. That being said, the ones who do have access to contraceptives should receive the care that they deserve. So perhaps it is high time we reflect on the physical and emotional impact it has on women, and the way forward in research and in society to enhance the experience of contraceptive users.

This blog is a part of NIPoRe’s blog series on Women’s History Month 2023

– BIJAY Khadka

In Nepal, the role of women in the economy has undergone a significant transformation in the past four decades. Census data from different years shows that the participation of women in the labor force has increased and the gender gap in labor force participation has decreased.

According to the most recent census of 2021, 72 percent of men over the age of ten are economically active, which means that they were either employed or seeking employment. The figure, on the other hand,  stands at 60.4 percent for women. While the gender gap in economic activity is persistent, results from the previous censuses show that the economic participation of women has undergone a significant increase over time. Between 1971 and 2021, the percentage of the female population over the age of ten who are economically active has increased from 29.2 to 60.4 percent.

One of the major reasons for the increase in women’s economic activity in Nepal is education. Over the years, there has been a significant improvement in women’s education in the country. In 1981, only 9.15 percent of Nepali women were literate, which increased to 34.8 percent in 2001 and further to 48.8 percent in 2011. It now stands at  69.4 percent in 2021. The increase in literacy rates has resulted in more women joining the labor force.

Another reason for the increase in women’s economic activity is the growth of the service sector in Nepal. According to the 2021 Census, the service sector has become the second largest employer for females in the country with approximately 309,944 females employed following agriculture, forestry & fishery.  The service sector includes jobs in fields such as hospitality, tourism, healthcare, education, and information technology. There has hence been the creation of additional employment opportunities across varying skills making them more accessible to women.

There is still a big difference between men and women when it comes to jobs. Only 24.5 percent of employers are female, out of the total employees 36.2 percent of them were females. Females make up less than one-third of government jobs. But in financial corporations, around  44.9 percent of the workers are female. Of those that participated in household work as an economic activity, 51.0 percent were females.

The census has also considered work that is not typically considered economic activities. Female involvement is found to be significantly higher in such activities. For instance, of the population involved in family care, 77.4 percent were females. Likewise, 87.4 percent of females who were not economically active during the 12 months preceding the survey, cited household chores as the main reason.

Despite the increase in women’s economic activity, there are still significant barriers to their participation in the labor force. One of the primary barriers is social norms and cultural expectations. Women in Nepal are still expected to prioritise their household responsibilities and care work over their professional pursuits. This expectation often makes it challenging for women to pursue their careers.

Furthermore, there are still significant barriers to women’s education in Nepal, particularly in rural areas. They are often expected to drop out of school early to help with household chores, and there are inadequate resources to support their education. Out of total “female students” graduates that completed graduation level or equivalent only 41.4 percent were “from rural municipalities, whereas 29.8 percent of females reported having completed postgraduate or equivalent from the rural municipalities.

In conclusion, the census data from the past four decades indicates that women’s economic activity in Nepal has increased significantly. However, the gender gap in labor force participation continues to persist. To achieve gender equality in the workforce, it is crucial to address the barriers to women’s education and employment, including social norms and cultural expectations. Empowering women through education and skills development can result in significant improvements in women’s economic participation and their contribution to the country’s economic growth.

This blog is a part of NIPoRe’s blog series on Women’s History Month 2023

– BINITA Nepali

Despite the remarkable achievements that women have achieved in various fields, women are persistently portrayed as objects, subordinates, or persons who are reliant on others in the Nepali mass media, both in fiction (movies, TV programs, music videos, and advertising) and non-fiction (newspaper, interviews). Such portrayals of women not only downplay women’s overall achievements but also reinforce gender stereotypes and further perpetuate gender inequality in Nepali society.

The commercial market of advertising, music videos, songs, and films in Nepal continue to portray women in conventional gender roles and as mere objects, despite the massive emphasis on women’s empowerment. Women are frequently used as props and shown in sexually suggestive poses to sell products for men (ads for deodorants, and undergarments) or are primarily featured in ads for household products. On reviewing every ad for cooking oils made in Nepal, it is found that ads of nearly all cooking oil brands in Nepal feature women, with only a few ads featuring men, and that too only to demonstrate the impact of cooking oil on having a strong heart, implying that strength is associated with men. Recently, a commercial for  Siddha Baba Cooking Oil went popular on social media for being innovative and promoting the message of not wasting food. While the ad presents a positive social message, it also subtly reinforces the idea that cooking is women’s responsibility, regardless of their social and economic status.

Similarly,  Nepali films often depict women as dependent, subservient, frail, helpless characters that need assistance or lack autonomy, housewives, and mother figures, among other circumscribed roles. The feminist lens applied to review twenty Nepali films between 2017 and 2021, in a study undertaken by Gauthali Entertainment Private Limited in collaboration with Kathmandu University, revealed that the portrayal of women in these films was misogynistic and that they normalized stalking in addition to depicting women in traditional roles. Furthermore, the cheerful, melodic, and funk-influenced item songs in movies and music videos depict women as objects of desire, with their bodies displayed in a manner that appeals to the male gaze. This is especially apparent in dance scenes, in which women are shown dancing provocatively in front of amorous males. Close-up shots and camera angles that emphasize sensitive body parts and revealing outfits accentuate the negative effect of such a depiction.

Similarly, the coverage of women’s concerns in nonfiction media such as news and interviews is equally concerning and leads to the objectification of women. Women are often evaluated based on their physical appearance rather than their accomplishments or ability. When Sobita Gautam was recently elected to the House of Representatives, her physique was featured in news titles to highlight her achievements. After receiving criticism on Twitter, the publication eventually changed its title. In addition, women’s ideas and perspectives on important topics such as politics are often underrepresented, which fosters the notion that their viewpoints are not important on such issues.  I examined the February 2023 Politics sections of two leading English-language daily published in Kathmandu, one private and one public. I found a startling discrepancy. The private media mentioned or quoted just 10 women politicians, party leaders, and political analysts in comparison to 143 men counterparts, and the public media mentioned or quoted 11 women in comparison to 94 men. This disparity underlines the severity of the issue and the necessity for a transformation in the media’s portrayal of women.

Persistence of such depictions in media we consume on a regular basis without any scrutiny enhances the likelihood of emulation and diminishes the significance of gender, sexuality, and instances of abuse as what we see, hear, or read in the media sub-consciously shapes our attitudes, and attitudes shape our behavior.  Hence, it is essential that we recognize the impact the media has on molding our opinions. Since they have the ability and obligation to mold society’s perception of gender, the media must make deliberate attempts to combat these detrimental depictions of women. It is essential that the media presents women as multifaceted, multidimensional beings with multiple roles, experiences, and skills, ranging from those who work outside the house to those who are homemakers, as opposed to restricting them to conventional gender stereotypes and objectification.

This blog is a part of NIPoRe’s blog series on Women’s History Month 2023

– ANUSHA Basnet

The political representation of women in Nepal has improved markedly since the overthrow of the monarchy and the implementation of a federal system. Legal provisions implemented by the Government of Nepal can be largely attributed to this increase in women’s political representation. Article 84 of the Constitution of Nepal states that at least one-third of the total women elected in the federal parliament need to be women. In terms of the local level, Section 17(4) of the Local Level Election Act 2017 states that a political party must field a woman in either the mayor/ chairperson or deputy mayor/ vice-chairperson position. It is also legally mandatory to appoint a female ward member and a Dalit female ward member at the ward level. While all these provisions have ensured the political participation and representation of women, the past two elections have shown that there is still work needed to be done with regard to the proper implementation of these provisions so that meaningful political participation of women can be ascertained. 

In the 2017 local-level elections, 40.95 percent of the total elected representatives were women. There was a slight improvement in 2022 with women being 41.21 percent of the total elected representatives. However, in both elections, the target set to achieve 50 percent representation of women was not met. In addition, to fulfill the legal provisions political parties ended up fielding a large number of women as candidates for Deputy positions in 2017. In contrast, in 2022, due to the political parties forming coalitions, only one candidate was fielded by one political party in mayor/ chief and deputy positions which could be either of the genders. Because of this, the tickets went largely to male candidates while drastically decreasing the number of female candidates. The nominations reflect this – while 3593 women were nominated as deputy chiefs in 2017, 3077 women were nominated as deputy chiefs in 2022 (Data from Election Commission). Furthermore, while it is mandatory for all ward levels to have one Dalit women member, 176 units and 123 units in 2017 and in 2022, respectively, did not field Dalit women candidates.

These incidents show that creating legal provisions is not enough to ensure the participation of women, rather, constant supervision is needed to ensure the correct implementation of the legal provisions. Although the Election Commission has been active in responding to the concerns raised regarding women’s participation in the electoral system, it has still been one step behind with its decisions coming after loopholes have been utilised by the parties. Women’s rights activists and legal experts are the ones who have been raising the alarm on this trend of political parties utilising legal loopholes to shaft women in their nomination and offered positions. Few female cadres and leaders have also raised their voices against their party’s reluctance to give candidacies to women. 

In 2017, the political parties were criticised for giving women candidacies in only deputy/vice-chairperson positions. In 2022, parties were again criticised for using coalitions to give candidacy only to male candidates. In the case of Dalit women representatives, a major criticism remains that parties only look for Dalit women to field as candidates during election time. 

While the public and activists can draw the attention of political parties to the task, the onus remains on political parties to encourage the political participation of women from grassroot level and to fulfill and even exceed the provisions as guaranteed by the constitution. Unless the political parties take lead on this issue, women’s political participation and representation will always be on the margins.

This blog is a part of NIPoRe’s blog series on Women’s History Month 2023

– ANKUR Shrestha

Historically, women’s participation in the tech sector has been remarkably low due to the patriarchal classification of jobs. As a consequence, it led societies to believe that men automatically belong to the fields such as IT while leaving a very narrow space for women. This has caused only a few women to study and subsequently enter the tech sector.

Nevertheless, this is changing, as it rightly should. According to Deloitte Global, the tech industry is making steady progress in shrinking its gender gap. In 2019, overall female representation in large global technology firms was 30.8 percent. Deloitte estimated that women’s share in the overall global tech workforce increased by 6.9 percent from 2019 to 2022. Public commitments by large tech companies to improve gender diversity also aided this increase. Intel, for example, aims to double the number of women and underrepresented minorities in senior leadership roles by 2030. Similarly, HP pledged to reach 50 percent gender equality in roles at the director level and above by 2030.

In Nepal, we see a similar upsurge. According to Nepal’s 2011 census, only 1,117 females studied computing while the number increased to 11,078 in 2021. This shows a monumental increase of about 892 percent in female students in the tech sector during the ten-year period. It also beats the overall increase in students studying computing which amounts to more than 668 percent which is significant by itself as well.

Conversations with women professionals working in Nepal’s tech sector show that one major reason for this uptick is that IT has set itself as an industry better suited for women workers. However, our societal structure has for long had restrictions for women to work (especially after marriage), restricts economic freedom, deems late office working hours as unsafe, treats periods as taboo, considers men as primary breadwinners, and puts less value on women workers. The IT sector provides a workaround for many of these societal issues. Asmita Bajracharya, Product Manager at Innovate Tech says that work in the IT sector can usually be done from home and has flexible work timings, project-based pay, space for freelance work, and a relatively higher pay scale compared to other industries. All these, therefore, she believes make the sector one of the best for working women in Nepal. 

However, the IT sector is also rife with issues depending on which company you analyse or whom you talk to. IT startups are particularly problematic while established companies usually have stringent policies in place. However, we see such discrimination usually persist in smaller and newer companies even within the IT sector. Additionally, smaller companies generally have issues such as longer working hours, and no set leave policies. Nepal’s Labour Act 2017, Chapter 7 Section 33, also requires arrangements for transportation to and from the workplace in employing a female where the working hours begin after sunset or before sunrise. Advocate Sadikshya Maharjan says that this particular section, while well-intentioned, can also cause smaller companies to discriminate in hiring women as they are not able to provide these services.

Another area of the Labor Act, Chapter 2 Section 7, prohibits discrimination in remuneration for equal work. However, unequal pay issues continue to persist in the sector. IT companies are usually structured around payment through projects. Therefore, discrimination while assigning job responsibilities leads to a vicious cycle where companies assign lesser-paying projects to women, leading to lower performances in performance reviews. This subsequently leads to less pay and lower chances of promotion resulting in more incidences of discrimination. Ojaswi Poudel, currently a Software Engineer at Cotiviti, says that she faced such blatant discrimination in one of her previous workplaces. However, she believes having women in senior positions in the company can help break this cycle. She also sees the need for senior women mentors so that younger women have someone to look up to and gain more confidence in this field. She says she does not face such issues in her current company which is more structured, has proper mentorship, and has clear payment policies.

Sadhana Gurung shares similar advantages in her company. Gurung who works at Leapfrog Technology currently as a Software Engineer, QA has proper mentorship models, flexible timings, as well as opportunities for growth in her company. This might also be one of the reasons why it is easier to get more motivation from peers and have women-friendly policies at the office. She also notes how despite fewer women currently working in IT, even clients and senior management are happy to see women workers, are welcoming, and provide proper career guidance.

While it would be a generalisation to say that there is very less discrimination based on only three experiences, trends do point towards more inclusion and provisions of a more equitable working environment for women in tech. With more women choosing the tech sector for their studies and work, and established companies having non-discriminatory policies, the tech sector in Nepal seems to be slightly ahead of the curb than other workplaces in Nepal. A study by McKinsey research showed that the most diverse companies are 48 percent more likely to outperform the least gender-diverse companies. It is then to the benefit of everyone to create a more gender-diverse workplace. There is more to still do to achieve gender parity but the tech sector in Nepal definitely seems to be heading in the right direction.

This blog is a part of NIPoRe’s blog series on Women’s History Month 2023.