Submit your Article

In recent years, population and sustainable development issues are increasing priorities of the governments, political parties, development partners, youth-led civil society, media, private sector and communities at large. Looking back at history, the landmark International Conference on Population and Development (ICPD) was held in Cairo in 1994. This conference enormously transformed the global thinking as well as narratives of population and development with a bold political and development agenda. More importantly, placing people’s dignity and rights are at the heart of sustainable development.

While 179 countries including Nepal adopted the key strategic priorities of the ICPD, there is increasing recognition that inclusive sustainable development demands a clear focus on  human rights, including reproductive rights, empowering women and girls, and addressing inequalities as well as the needs, aspirations and rights of people. Therefore, the national commitments of the ICPD have been highly relevant to adapt to inclusive development policies, strategies, plans and programs, which help promote people-centered development.

Almost 30 years after the ICPD conference, among many others, there has been remarkable progress in the health and population sector. Despite significant health gains, there still are challenges to ensure the rights and choices of women and girls, mitigate the impact of the Covid-19 pandemic and the full realization of the sexual and reproductive health and rights agenda. The ICPD agenda and Sustainable Development Goals (SDGs) are closely aligned to eliminate poverty, achieve gender equality and secure the health and well-being of all people.

Considering the emerging needs of advancing the ICPD agenda in the context of formulating 16th Periodic Plan which is led by the National Planning Commission, the Ministry of Health and Population recently organized a national conference on population and development with support from UNFPA and other partners. The conference provided a unique opportunity for governments, political leaders, development partners, youth-led civil society, media and communities to share the country progress of the ICPD and discuss critical issues, challenges and opportunities for actions.

More importantly, among many others, Nepal’s commitments and progress in the health and population sector were reviewed and discussed at the conference. These include integration of comprehensive sexuality education in school curriculum, legalization of safe abortion, ensuring availability and accessibility of safe abortion services and adolescent-friendly health services. There has been remarkable progress in improving access to sexual and reproductive health services, advancing gender equity and women's empowerment, and integrating population dynamics in development policies, strategies and plans.

While reviewing some health and population indicators, the maternal mortality ratio has come down from 281 per 100,000 live births (2006) to 151 (2021). The births attended by skilled health personnel have gone up from 9 percent (1996) to 80 percent (2022). The total fertility rate has decreased from 4.6 (1996) to 2.1 (2022). The adolescent fertility rate has decreased from 127 (1996) to 71 (2022). The modern contraceptive prevalence rate has gone up from 26.0 percent (1996) to 43.0 percent (2022), whereas the unmet need for family planning has slightly dropped from 24.6 percent (2006) to 20.8 percent (2022).

Nepal has given priority and respect for international human rights treaties and signed political commitments that recognise reproductive rights. The Constitution of Nepal, 2015 guarantees the right to safe motherhood and reproductive health as fundamental rights. Over the years, the government has adopted several policies, strategies and plans to guarantee women’s access to reproductive health services. In 2018, the government enacted the Safe Motherhood and Reproductive Health Rights Act, which defines the right to reproductive health and provides the necessary foundation for safe, accessible and quality reproductive health services.

Despite these significant gains, it is necessary to strengthen health systems so that they can deliver equitable health outcomes on the basis of a comprehensive approach. There are increasing needs for health financing, human resources for health, strengthening procurement and distribution of medicines and vaccines, infrastructure, information systems and service delivery at the local level.

On the other side, governments should focus on universal access to comprehensive and integrated quality sexual and reproductive health services for all women, men and young people to reduce the unmet need for family planning. Particular attention is needed in ensuring access for adolescents and youth for universal access to HIV prevention, treatment, care and support.

More notably, the Nairobi Summit on ICPD+25 took place in Nairobi, Kenya from 12 to 15, November 2019, to mark the 25th anniversary of the International Conference on Population and Development (ICPD+25). During the Nairobi Summit, Nepal made important national commitments to advance the ICPD agenda that largely focuses on universal access to sexual and reproductive health rights, women’s empowerment and their rights in order to achieve sustainable development goals (SDGs).

The commitments largely aim to end violence against women and children, early and forced marriage, ending preventable maternal deaths and ending unmet need for family planning. We need significant investments in young people including their health and well-being by ensuring that they are able to exercise their reproductive rights through upscaling of adolescent-friendly services and comprehensive sexuality education.

There are critical needs to ensure the basic humanitarian needs of affected populations, including sexual and reproductive health care and gender-based violence prevention and response, are addressed in humanitarian contexts. Moreover, health financing policies, instruments and structures are essentially needed to ensure effective implementation of the strategic priorities of the ICPD agenda in the changed context.

In order to accelerate the progress of the ICPD agenda in the federal context, Nepal has prioritized  poverty reduction, health, sexual and reproductive health rights, education, gender equality and women empowerment, adolescence and youth, international migration, urbanization, data and evidence for policy-making.

Population aging is also a matter of concern for development. At the implementation level, there are increasing needs of capacity enhancement of provincial and local governments to mainstream the ICPD priorities in their policies, plans and budget. Meaningful participation of adolescents, youth, people with disability, migrants, sexual and gender minorities, media and civil society representatives from poor and marginalized communities can ensure the inclusive population and development policies at all levels.

Additionally, there are emerging challenges of climate change, pollution, food insecurity, increasing risks of non-communicable diseases, health emergencies, pandemics, disasters and migration for foreign employment. In order to effectively address these issues, multi-sector coordination mechanisms or platforms are needed to harness the partnerships and collaborative actions to create synergies at all levels.

While population and sustainable development are inextricably linked, it is also necessary to consider the population distribution, socio-cultural and political dynamics, ethnic and indigenous diversity, religion and sustainable livelihoods of communities across the country. With a holistic people-centered approach, the essence of ICPD agenda and SDGs can be further harnessed.

The author is Health and Population Consultant at UNFPA

Constitutional experts, legal professionals, and students of constitutional law have consistently emphasized that the Constitution of Nepal 2015 was rushed and lacked the necessary time, thorough deliberation, and extensive discussions during its drafting and promulgation. Consequently, it required subsequent amendments, with the first set of revisions made just four months after its promulgation.

Nevertheless, it’s essential to recognize that a constitution is a living document, subject to modifications as societal needs and circumstances evolve over time. In order to ensure its effective functioning and broader acceptance, amendments become a necessary step.

However, it is crucial to approach any constitutional amendments in a manner that aligns with the fundamental principles of the constitution itself. Deviating from these principles can disrupt the constitutional framework and put the entire system at risk.

It is imperative to understand that no one is exempt from the authority of the constitution, and this responsibility extends to every citizen of Nepal. Safeguarding the constitution is a collective duty that falls upon all shoulders, from laymen to politicians. 

The constitution stipulates that in order for it to operate effectively, existing laws and acts must be regularly reviewed, modified, and supplemented. However, necessary legal revisions have not been undertaken. Take, for example, Part 3 of the constitution, which outlines Fundamental Rights and Duties and comprises 33 articles. It expressly states that the Parliament is responsible for enacting legislation to enforce these fundamental rights, yet no such laws have been enacted. This issue is pervasive throughout various sections of the constitution. Despite the nation celebrating the ninth Constitution Day, it is evident that the constitution has not been adequately put into practice.

The ruling coalition appears to be asserting authority above and beyond the constitution itself. Their decisions during meetings are treated as the final word, regardless of legal stipulations. A clear example of this is when the Supreme Court opened a way for an investigation against former Prime Ministers Madhav Kumar Nepal and Baburam Bhattarai regarding their involvement in the Lalita Niwas land-grab. But the ruling coalition decided that such a probe was unnecessary, contending that the former PMs were not culpable. It is the responsibility of the Central Investigation Bureau (CIB) of Nepal Police to conduct the investigation and the court responsibility to determine guilt or innocence. As a result of the ruling coalition’s decision, despite the apex court’s ruling, no case was filed against them, and even the investigators involved were transferred, in accordance with the coalition’s directives. This demonstrates the governments and political parties’ apparent disregard for established legal procedures.

On Aug 22, President Ram Chandra Paudel called a meeting of representatives from all political parties to address the deadlock in the federal parliament. Has the constitution given the president the right to call an all-party meeting with specific agendas? No. President, being the protector of the constitution, didn’t follow it. Was there any national emergency that the president had to get mobilized for a national consensus? No. Or, the president should have justified his move.

According to Sub-article (2) of Article (1) in Part 1 of the constitution, it is the duty of every person to uphold the constitution. Additionally, Article 48 in Part 3 outlines the duties of citizens. The duties, according to our constitution, are: (a) To safeguard the nationality, sovereignty and integrity of Nepal, while being loyal to the nation; (b) To abide by the Constitution and law; (c) To render compulsory service as and when the state so requires; (d) To protect and preserve public property.

However, it raises concerns as to why the prominent leaders of the government and other political factions are not adhering to these constitutional duties and are seemingly disregarding the constitution. Is the constitution meant solely for citizens to adhere to?

Therefore, if the parliament had enacted laws clearly defining the rights and obligations of citizens, government officials, ministers and political leaders, it could have significantly reduced the issue of not adhering to the constitution.

Isn’t it pathetic that those political parties and leaders who drove the citizens for a new political system and new constitution, are not following it?

The prevailing competition among various parties and individuals in disregarding the constitution has led the public to question its durability. These actions are undermining the longevity of the constitution, prompting people to contemplate alternative options to this constitutional and political system, which definitely is not a good sign for anyone.

On the occasion of Constitution Day, I urge all individuals, organizations, political parties and the government to adhere to the constitution. It’s high time to grasp the significance of upholding the charter.

The author is a member of the Supreme Court Bar and has been practicing corporate law for around three decades

Autism Spectrum Disorder, a neurodivergent condition that impacts social interaction, affects an estimated 250,000-300,000 people in Nepal, with 60,000-90,000 people classified as severely affected. Autism Spectrum Disorder, or ASD, has been thought to predominantly affect males, with a male-female diagnosis ratio of 4:1. However, recent studies have proposed  that this ratio is closer to 3:1, with a considerable population of females being diagnosed late or undiagnosed.

To understand the cause behind poor diagnoses, it is essential to understand the early days of autism research. The term ‘autism’ was coined by the Swiss psychiatrist Eugen Bleuler in 1911 and was used to describe a set of schizophrenia symptoms that involved withdrawal from the external world and increased focus on oneself. 

Later, in the 1940s, researchers Leo Kanner and Hans Asperger used the term to describe a group of children who displayed similar social and communication difficulties but did not fit the profile of schizophrenia. These two  researchers played a crucial role in highlighting autism as a separate developmental disorder. However, these studies were performed with a sample size unrepresentative of autism as a whole. 

The first study (1943) had a sample of 11 children: three girls and eight boys. The  following study was entirely composed of boys. Male-centric research is not just a problem of the past. The current ascertainment bias towards males is 15:1, with males being 15 times more likely to be chosen in a study for autism than females. As most of the existing data focuses on autism in boys, the measures used to define and diagnose autism are also more applicable to male behavior, leaving many girls with late or no diagnosis that can affect them for the rest of their lives.  

To tackle this issue, a recent study analyzed autistic behavior in a sample of both boys and girls. After careful evaluation, they created a list of ASD symptoms that varied from gender to gender. However, there were limitations to the study. Although the focus of the study was to search for symptoms in girls without intellectual disabilities, the ratio of diagnosed boys to girls was an astounding 11:1. They discovered that:  

● Girls were better at adjusting their behavior to fit social contexts.  

● Girls exhibit fewer patterns of similarity concerning restricted, repetitive behavior. 

● Girls were more aware of social conventions and codes of conduct and more influenced by peer pressure. 

● Girls have stronger communication skills. 

● Girls develop significantly fewer routines in specific interests. 

● Girls were less distressed in noisy, crowded places. 

● Girls had fewer non-verbal communication issues compared to boys. 

While this is just the result of one study, it proposes that autism presents itself slightly differently in girls than boys, with girls having fewer social hindrances and lacking the stereotypical repetitive behavior that currently characterizes autistic behavior. These differences are unaccounted for in diagnostic manuals, further hindering a clinician's ability to make a sound diagnosis.  

Diagnosing autism isn’t as easy as putting a patient into an MRI machine. Clinicians must refer to the DSM-5, the diagnosis and statistical manual, to confirm if their patient checks  the boxes for autism. As mentioned earlier, the DSM and most other checklists are based on male-centered studies and are more applicable to men than women. For example, one of the possible requirements for autistic behavior is, as stated: “Stereotyped or repetitive motor  movements, use of objects, or speech (e.g., simple motor stereotypes, lining up toys or flipping objects, echolalia, idiosyncratic phrases).” Some of these behaviors, such as hand wringing, rocking, and restrictive repetitive movements, appear more in boys than girls.

Here’s another example. “Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).” The “restrictive, repetitive patterns of behavior and interest” described often present differently in girls, with girls engaging seemingly ordinary interests like animals, celebrities, or a specific TV show. These interests usually reach a near obsessive level, but they are not “stereotypical” autistic traits, so they often go overlooked. None of these differences are acknowledged by the DSM, as the criteria for ASD show no  variance in gender.  

One final factor in the underdiagnosis of girls is a behavior known as camouflaging. Camouflaging refers to masking social impairment or behaviors to fit society’s standards. Due to gender expectations, women feel more pressure than men to conform to societal norms; therefore, females are more likely to engage in camouflaging behavior. Camouflaging, or masking, can occur in girls as young as 7-8, making it harder for parents to notice and report irregularities in their child’s behavior if they have not already been diagnosed. 

Dr Amit Jha, a doctor at Kanti’s child and adolescent psychiatric unit, observed that family members sometimes normalize symptoms of autism in girls, accounting for a girl’s social withdrawal to being “shy.” Ignoring autism symptoms early on can lead to late diagnosis, which is detrimental to a child’s  health in numerous ways. As mentioned earlier, behaviors like camouflaging can arise and delay  a diagnosis for even longer.  

So what is the importance of an early diagnosis? Younger minds have a higher level of  brain plasticity, or the brain's ability to adapt and change. Therefore, the sooner autism is diagnosed and cared for, the more effective treatment will be. Sita Koirala (name changed) pushed her family to seek a diagnosis for her two-year-old sister after she started developing signs of autism. After much resistance from her family, they booked an appointment, only to be told she was fine. 

As time passed and her symptoms worsened, they booked another consultation and finally got an official autism diagnosis. Now, her sister is receiving treatment and slowly improving her communication and social skills. However, it’s hard not to wonder if further intervention could have occurred if she had been diagnosed correctly the first time around and how a delayed  diagnosis impacted her lifelong development. 

All this new research raises the question of why autism presents differently in females. Dr Supekar and Dr Menon from Stanford School of Medicine sought the answer with a brain  mapping study. His research found discrepancies between the male and female motor cortex, supplementary motor cortex, and a portion of the cerebellum, brain areas responsible for motor function. Dr Supekar hypothesized that these differences could account for the disparity in typical symptoms of autism, such as hand flapping and repetitive behaviors. Another doctor in  the study, Dr Menon, adds: “Girls and boys with autism differ in their clinical and neurobiological characteristics, and their brains are patterned in ways that contribute differently  to behavioral impairments.” 

At the end of the study, Dr Supekar concludes: “The discovery of gender differences in both behavioral and brain measures suggests that clinicians may want to  focus diagnosis and treatments for autistic girls differently than boys.” While this is just a single  study and cannot be used to draw definitive conclusions, it is a promising explanation as to why  autism presents itself differently in male and female brains. 

To put it simply, the existing measures of autism could have a higher validity for boys than girls, resulting in missed and late diagnoses. While part of the ratio between diagnosed  boys and girls with autism is due to biological differences, the global ratio is likely 3:1 rather than the current accepted ratio of 4:1.  The children missed during diagnosis fall into a group that doesn’t show stereotypical autistic traits and risk spending their whole life struggling with an undiagnosed condition.

It should also be noted that while the 4:1 ratio is a global statistic—and there is not  enough data collected in Nepal to create a country-wide metric—it is safe to assume that the ratio of diagnosed girls to boys is even higher due to Nepal’s already gender-biased culture. Mental health is still an emerging field in Nepal. Therefore, if this issue can be addressed sooner  rather than later, the gap can be closed through further research, awareness, and capacity building. To treat our girls and boys equally, their conditions need to be looked at differently. Every stakeholder, from government to clinicians to family members, can help ensure every girl gets the treatment she deserves.

Formal education at school plays a pivotal role in shaping individuals’ perspectives and behaviors. These initial perspectives serve as the foundation upon which subsequent views and actions are constructed throughout one’s life. Consequently, school education leaves a substantial and lasting impact on individuals. Therefore, school actors must remain highly vigilant in overseeing every event and activity within the school environment. This vigilance is essential because each event can have a profound and enduring impact on individuals’ lives.

In July 2002, Transparency International issued a report highlighting that teachers had become primary targets for both the Maoist rebels and the security forces in Nepal. This situation is particularly noteworthy in a society where teachers hold an esteemed status; they, revered as god and goddess, are also equated as parents of the students.  These unique cultural contextual ties naturally prompt us to ponder as to why teachers found themselves specifically singled out during the insurgency period.

Several factors could be behind this targeting, but many education experts now argue that the school education practices during that time, and even now, lack sensitivity toward conflicts that could take root in the formative years of children; the teaching methods and strategies employed were insufficiently attuned to the potential generation of conflicts; students from diverse backgrounds, including differences in learning capacities, cultural heritage, ethnicity, and caste, often did not receive the sensitive treatment they needed within the school environment. Additionally, these students often faced bullying and harassment. Corporal punishment of students was commonly accepted and practiced. As a result, certain binary oppositions were instilled in the young minds of students, such as males versus females, the rich versus the poor, Dalit versus non-Dalits, ethnic versus non-ethnic people, and Pahade versus Madhesi, among others. These binaries left negative imprints on young minds, fostering a readiness to oppose those on binary oppositions. Corporal punishment might have also contributed in building a deep-seated anguish and agony in students toward the teachers, and/or others opposed to their views. When these individuals became embroiled in conflicts, they subconsciously targeted their perceived adversaries as a form of retribution. If one were to endorse this perspective, it is disheartening to observe that no meaningful actions have been taken to date to introduce conflict-sensitive education or implement conflict-sensitive teaching strategies at the school level education.

Certain common school education practices inadvertently contribute to the development of a conflict-prone mindset and behaviors within the school environment. For instance, many schools form separate teams based on gender, creating a division between girls and boys. Some historical events, which are celebrated for their bravery and glory, are often presented in the class, in a way that (that) emphasizes the cast or ethnicity of the individuals involved. In the same strain, some specific qualities are assumed/attributed to the students readily in the class in terms of their ethnic, social and linguistic backgrounds while conducting various teaching-learning activities. But these practices only serve to perpetuate disparities and divisions among students from various backgrounds, including different castes, ethnicities, gender, geographical locations, and socioeconomic and cultural groups providing a fertile ground for the germination of a conflict-prone mindset. 

The competitive teaching approach is usually practiced among students at schools to motivate learning and achievements at the cost of collaboration and teamwork. Instead of learning together, in a competitive teaching approach students may view their peers as rivals, which can hinder a cooperative environment. The fear of failure or falling behind their peers can have detrimental effects on mental health and overall well-being of students. Intense competition can lead to increased stress and anxiety among students. Competitive teaching can exacerbate inequalities among students. Students from privileged backgrounds or with access to additional resources may have an advantage, while others may struggle to keep up. As a result, a highly competitive classroom environment can strain teacher-student relationships, as teachers may be perceived as judges or enforcers of competition rather than facilitators of learning. It, then, unintentionally, results in developing conflict-prone mindsets in students.  

Other prevalent teaching methods often center around competition, fostering a sense of rivalry among students. Competition establishes a hierarchy where excellent performers inhabit a higher pedestal, receiving preferential treatment and higher rankings, while those lagging behind land lower positions. This again unintentionally creates a division between high and low achievers, potentially leading to a conflict-prone atmosphere. There is no universally perfect teaching method that guarantees the creation of an inclusive environment and equal learning outcomes. However, one can exhibit sensitivity in choosing a teaching approach that maximizes learning opportunity for everyone. This, in turn, reduces the likelihood of creating conflicting situations and minimizes the risks associated with a divisive learning environment.

Education is not merely about imparting knowledge; it’s also about shaping attitudes, fostering understanding and equipping individuals with essential life skills. In today’s interconnected and diverse world, the ability to navigate conflicts effectively and with sensitivity is a crucial skill. Teaching methods that promote conflict sensitivity is of paramount importance.  Summing up, selection of conflict-sensitive teaching strategies is essential for nurturing well-rounded individuals, who possess the knowledge, skills, and attitudes needed to thrive in an increasingly diverse and complex world. By promoting empathy, critical thinking, effective communication and conflict resolution skills, these strategies play a pivotal role in shaping a more peaceful, inclusive and just society. Educators, policymakers and institutions have a collective responsibility to prioritize the incorporation of conflict-sensitive teaching strategies into educational curricula to prepare students for the challenges and opportunities of the 21st century. Teachers should also receive training in conflict-sensitive education methods and practices to better understand and address the potential sources of conflict that may grip young minds.