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Family Planning Needs and Costs: Nepal, 1985-2000


Thapa, Shyam & Tsui, Amy Ong (1990). Family Planning Needs and Costs: Nepal, 1985-2000. Asia-Pacific Population Journal, 5(2), 17-30.


Achievement of the Government of Nepal's goal of a total fertility rate of 2.5 by the year 2000 requires careful consideration of the levels of contraceptive prevalence required to meet this target, the optimal contraceptive method mix, and program costs. The scenario envisioned by government planners is for the fertility rate to fall from 5.8 in 1985 to 4.0 by 1990 and finally to 2.5 by the end of the century. The 2.5 target is 54% lower than what the United Nations regards as a plausible course of fertility decline and will require a 4-fold increase in contraceptive prevalence, form 15% in 1985 to 62% in 2000, given no change in method mix and high discontinuation rates, and a rise in the number of contraceptive users form a half-million to 2.8-2.9 million over a 15-year period. If no change of method mix occurs, the 2.5 fertility rate target requires that sterilization use increase from 13% to 53%. An alternative contraceptive mix for the year 2000 is pill use, 13%; IUD use, 19%; and sterilization, 13%. In terms of cost, achievement of the government's target will require a 5-fold increase in annual spending for contraception, from US$2.74 million in 1985 to US$16.39 million in 2000, and a 24-fold increase, to US$67.76 million, in total family planning expenditures. These projections suggest that the government may need to reassess its target; the United Nations has suggested that a fertility rate of 4.6 by the year 2000 is more realistic. Such a goal would require a contraceptive prevalence rate of 34%, 1.6 million users, and annual family planning costs of US$38.54 million. Regardless of the scenario selected, there is a need for the government to examine carefully the cost-benefit ratios for contraceptives such as improved IUD's and subdermal implants.


Reference Type

Journal Article

Year Published


Journal Title

Asia-Pacific Population Journal


Thapa, Shyam
Tsui, Amy Ong