Kathmandu— Nepal has reduced adolescent pregnancy and childbirth rates by 35 percent over two decades, outperforming many countries with similar socio-economic conditions, including India, according to a new report.

The study, “Improvements in Adolescent Sexual and Reproductive Health and Rights in Nepal,” by the Centre for Research on Environment Health and Population Activities (CREHPA), the African Institute for Policy Development (AFIDEP) and Exemplars in Global Health, shows the adolescent fertility rate fell from 110 births per 1,000 women aged 15-19 in 2001 to 71 in 2022. Adolescent pregnancy dropped from 56 percent to 14 percent in the same period.

“Nepal witnessed a decade-long armed conflict, prolonged political instability, a devastating earthquake and the Covid pandemic, among other challenges,” said lead researcher Dr Mahesh Puri. “Despite these challenges, Nepal made remarkable progress in reducing adolescent pregnancy and childbirth.”

Nepal was identified as a positive outlier in South Asia in a multi-country study that also examined Cameroon, Ghana, Rwanda, Malawi and India. Progress, however, has been uneven. Rates remain higher among girls from poorer families, those with little or no education, and Dalit and Muslim communities. The rate among Muslims stayed unchanged at 23 percent between 2016 and 2022. Madhesh and Karnali provinces recorded the highest levels.

Despite the overall decline, unintended births among adolescents rose from 25 percent in 2001 to 31 percent in 2022, reaching about 40 percent among the wealthiest and 32 percent in urban areas. Gandaki province had the highest share at 37 percent. A 2022 UNFPA report noted nearly half of all pregnancies in Nepal are unintended, with close to two-thirds ending in abortion.

Researchers credited the gains to legal and policy reforms, expanded adolescent-friendly health services including family planning and safe abortion, greater investment in girls’ education, and strong collaboration among government, partners, civil society and communities.​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​