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Tag: SDGs

The Explainer - NIPoRe Blog

The Burden of Contraceptives on Nepali Women

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

SAB Blog

SAB Blog – Bhutan

Domestic Development

On 23 May 2022, the Office of the Attorney General (OAG) and the Anti-Corruption Commission (ACC) signed a memorandum of understanding (MoU) on strengthening partnership and collaboration in the prevention, investigation, and prosecution of corruption cases. The MoU provides a framework for professional communication and cooperation between the two agencies to work closely in the best national interests of the country.

Inter-agency cooperation in anti-corruption initiatives has been Bhutan’s weak link. OAG claims that the ACC has a mandate for investigation, not prosecution, per the constitution. However, the ACC act of Bhutan provides provisions for prosecution in particular circumstances.

Bhutan’s corruption ranking has slipped one place from 24th last year to 25th this year as per reports by Transparency International in its Corruption Perception Index 2022. However, the country’s score of 68 has remained the same for the past three years since 2018, and Bhutan is the least corrupt country in South Asia.  

Regional Engagement

India agreed, in principle, to provide a third internet gateway to Bhutan. Bhutan’s foreign minister, Tandi Dorji and Indian External Affairs Minister, S. Jaishankar, reached an agreement during the latter’s visit to Thimpu on 6 May. The rate is not yet finalized but is understood to be less than USD five per Mbps (megabits per second). Currently, Bhutan pays USD seven per Mbps for the Internet connection through the Siliguri corridor. The new link will benefit Bhutan’s Eastern districts and remote pockets of the country. It will also ensure continuity in service during emergencies such as internet shutdown caused by cycle Amphan in other gateways. Bhutan also expects the connection to attract foreign direct investment in information technology (IT) and IT-enabled services and employment generation.

Bhutanese Prime Minister Lotay Tshering said the internet is to be free and that the country should push to reduce the data charges and enhance access to the internet. However, he emphasized the need for responsible use of the internet.

Earlier this year, Bangladesh agreed to provide 10 Gbps IPLC (International Private Leased Circuit) to Bhutan at a friendly rate of USD three per Mbps. The decision came during Tsering’s meeting in Dhaka with his counterpart Sheikh Hasina on 24 March 2021.

Global Engagement

Bhutan unveiled its Sustainable Development Goal (SDG) seven roadmap in Thimphu on 31 May. It aims to ensure universal access to affordable, reliable, and modern energy services. The roadmap focuses on efficiency in transport and domestic fuel use. Thimpu has partnered with ESCAP and UNDP for the same. Bhutan stepped onto the international stage as the first country to become carbon negative in 2017. It means the country’s greenhouse gas production is more than offset by its extensive forests and export of renewable energy. The Constitution of Bhutan states that forests should cover more than 60 percent of the country at all times.

Research Commentaries

NRC0007 – Development of Rights : Should human rights be part of Nepal’s economic development strategy?

Development of Rights: Should human rights be part of Nepal’s economic development strategy?

Sabrina Singh


Human rights and economic development are both considered worthy but different aspirations. In today’s Nepal, development is certainly a top priority for leaders and policymakers, but should human rights be part of this conversation? This commentary makes the case that it should. It first introduces the seeming tensions between human rights and economic development, and explains the concerns of skeptics. It then lays out reasons for a marriage between human rights and development on both pragmatic and theoretical grounds.


Reconstruction and development are top priorities in post-conflict Nepal. More recently, the country seems keen on growth that is investment-led and with lower trade deficits. Nepal’s best-case scenario, moving forward, would be graduating into middle-income country status by 2030.

Should human rights be part of this economic conversation? The instinctual reply might be: why? Human rights are a set of basic (supposedly) inalienable, universal rights that attach to every individual on the basis of simply being human. Compared to this aspirational standard, economic growth seems to require a more technical and pragmatic approach. Some may say that human rights can constrain, rather than enhance, economic growth. For example, increasing social spending in fulfilling every individual’s right to food or shelter may take resources away from investing in productive sectors. But this hypothetical scenario is just that – hypothetical. Whether such an irreconcilable difference exists, in practice, between human rights and development is a question for evidence-based and context-dependent decision-making.

Skeptics: “Development First, Then Human Rights”

There are other concerns with including human rights in the development agenda that come from well-meaning skeptics who do not see an irreconcilable difference between the two, but who nevertheless have concerns. The primary concerns boil down to: development first, then human rights. First, consider the dire economic condition of our country – Nepal’s growth rate of per capita income has been the lowest in South Asia, averaging just 2 percent during 1970-2014; thousands of youth feel compelled to migrate abroad to work. The deadly earthquake in 2015 was another major setback in our growth trajectory; the slow implementation of federalism poses yet another challenge. In such a situation, it may be more strategic to focus our time, resources and political will toward increasing productivity, employment and investment at home, rather than on abstract and aspirational notions of human rights and human dignity. Second, investing in human rights is too expensive and impractical, especially for a poor country like Nepal. Realization of all human rights would include unprecedented increase in government spending and unrealistic expectation in the government’s ability to implement laws and policies. Third, the traditional champions of human rights are Western states or the global elite. They not only fail to adhere to such moral standards themselves but are also waning in geopolitical and economic importance. It would be hypocritical and futile to ‘impose’ human rights from the Western world. And, lastly, human rights are often politicized issues and we should keep politicization out of economic development decisions. So, in sum: development first, then human rights.

Intersections of Rights and Development

However, designing economic growth strategies with an eye toward human rights will add value to the economic trajectory of Nepal. At a minimum, when it comes to certain issues, human rights and economic development have clear intersections. Gender equality is an example. Gender equality and non-discrimination not only improve human rights of women and other marginalized gender identities, they also have a net positive outcome for productivity, economic diversification, and GDP growth. An anecdotal example is increasing a woman’s right to own land – it enhances human rights while facilitating small business activity and access to finance.

Second, human rights include socio-economic rights, and a right to development. Socio-economic rights are right to shelter, food, water, and health. Although not the most well-known among human rights, these are the rights that are essential to living and they also increase human capital and productivity. Civil and political rights like freedom of association can also have a positive and significant effect on economic growth. Moreover, Nepal expresses consistent policy commitments to the Sustainable Development Goals (SDGs), most impressively reducing poverty by half in the past 15 years (but with 6 more million individuals still below the poverty line). Many of the pillars of the SDGs are concurrent claims to human rights, for example eradicating hunger or securing decent work. A commitment to human rights is as much of a practical governance challenge to Nepal as a commitment to the SDGs or, say, increasing Foreign Direct Investment (FDI) as part of private sector enhancement.

Commitments From Major Players and Nepal’s Constitution

Third, the biggest players of the global private sector themselves have recognized that human rights have economic consequences and pledged commitments to respect them. Today, many investors and corporations require human rights due diligence before investing in a country. In addition to private investors, major development and aid partners care about human rights, often trying to integrate human rights into their funding policies and programs.

Lastly, today’s Nepal rests on the values of inclusion, participation and equity as enshrined in our Constitution. It proclaims a right to live with dignity, freedom and equality; specific rights include the right to health care, food, and housing. Using the Constitution as a guiding principle, our development trajectory should also focus on these values. This means a marriage between the basic spirit of human rights and that of economic development.

Rights and development are not irreconcilable. Basic human rights can act as a floor, not a ceiling, for economic development. Although a difficult balancing task, I think it is an investment worth making. Human rights, after all, is about adding the ‘human’ back into development.

  1. Danish Institute for Human Rights. (2017, March 7). Human Rights and Economic Growth. Retrieved from https://www.humanrights.dk/publications/human-rights-economic-growth
  2. National Planning Commission, Government of Nepal, & Asian Development Bank. (2016). Envisioning Nepal 2030. Retrieved from https://www.npc.gov.np/images/category/Envisioning_Nepal_2030_Proceeding.pdf
  3. OHCHR. (2019, August 13). Corporate Human Rights Due Diligence – Identifying and Leveraging Emerging Practice. Retrieved from https://www.ohchr.org/EN/Issues/Business/Pages/CorporateHRDueDiligence.aspx
  4. OHCHR. (Undated). Empowerment, Inclusion, Equality: Accelerating Sustainable Development with Human Rights. Retrieved from https://www.ohchr.org/Documents/Issues/MDGs/Post2015/EIEPamphlet.pdf
  5. UN Women. (2019, August 13). Facts and Figures: Economic Empowerment. Retrieved from https://www.unwomen.org/en/what-we-do/economic-empowerment/facts-and-figures#notes
  6. World Bank. (2017, May). Climbing Higher: Towards a Middle-Income Nepal. Retrieved from https://www.worldbank.org/en/region/sar/publication/climbing-higher-toward-a-middle-income-country
  7. World Bank & Organisation for Economic Development and Cooperation. (2013). Integrating Human Rights Into Development. Retrieved from https://openknowledge.worldbank.org/bitstream/handle/10986/12800/9780821396216.pdf