Oasis Health, Population & Environment Education Book 10

Approved by the Government of Nepal, Ministry of Education, Curriculum Development Centre, Sanothimi, Bhaktapur as an additional material. Health, Population & Environment Education 10 Author: Dheejan Babu Kaphle M.Ed. (Health), MBS, LLB (TU) Health, Population and Environment - 10 1

Health, Population & Environment Education 10 First edition : 2073 Second edition : 2074 Third edition : 2075 (Revised) Fourth edition : 2078 Copyright : Publisher Layout : Oasis Desktop Group (Ramesh Bhattarai) Printed in Nepal 2 Health, Population and Environment - 10

It has been a matter of pleasure to bring this textbook “Health, Population and Environment Education” for class X with the contents according to the syllabus prescribed by the Curriculum Development Center, Ministry of Education, Nepal. This book covers recently updated data related to the contents. A new scheme for evaluation of practical portion is also included in the annex with necessary forms required for the students. Besides, the book is written in simple graspable language and profusely illustrated with colorful pictures to assist them in understanding the texts easily. During the preparation of the manuscript, a continuous vision remained persistent on the psychological and physical potency of children in learning. They are intended to lead the student on a journey of a healthier lifestyle with scientific bases and reasoning in the context of contemporary population and environmental situations in Nepal. I am grateful to them for their company in the classrooms that has made me familiar to their interests, capacities and level of recognition. I would like to express my deep sense of gratitude to Oasis Publication Pvt. Ltd. for the encouragement to prepare this book. I would also like to express my gratitude and indebtedness to Mr. Ramesh Lamsal and Mr. Bijayalal Shrestha for editing the texts. My sincere thanks go to Mrs. Durga Dahal, Mr. Dhiraj Kafle, Mrs. Sumuda Pokhrel, Mrs. Nisha Adhikari, Mr. Nirjang Pratap Malla Thakuri, Bishwas Babu Pokharel, Sandesh Kafle, Abiraj Kafle, Aamod Kafle, Naju Adhikari, Suraj Adhikari, Surata Pokhrel, Shriyuta Subedi, Aaryabrat Bhandari, Abhinav Parajuli, and Slok Adhikari for their kind support. I am indebted to Mr. Ram Chandra Chaudhary and Oasis Desktop Group for replication of the raw manuscript into an attractive book for the students. I look forward to valuable feedback and healthy comments from the readers so that the subsequent edition will be more fruitful. 2021 Dheejan Babu Kaphle Author [email protected] Health, Population and Environment - 10 3

Health, Population and Environment: Specification Grid, 2074 Unit Contents Teach- Knowledge Comprehension Application Higher Efficiency ing 26 30.66% 21.33% 21.33% Hours VS S L VS S L VS S L VS S L 1. Concept of Health, Population 16 1 1 and Environment Education 2. Demography, Population Change 17 11 and Management 1 3. Population, Environment and 14 11 Development 4. Demographic and Environmental 18 1 1 Status of Nepal 18 1 5. Family Life Education and 11 Quality of Life 6. Natural Resource and 18 1 1 Biodiversity 18 1 1 7. Environmental Health and 1 Diseases 8. Adolescence, Sexual and 17 11 Reproductive Health Education 9. Consumers’ Health and 18 11 1 Community Health 10. Primary Health Care, Risk 16 1 1 Awareness and Safety Education Total 170 5 2 1 4 3 1 1 2 1 1 2 1 Organization of Questions Types of Questions Number of Number of Marks for Time Allocation Full Marks Questions Questions to Each 11 Questions for Very Short An- 36 swers Asked Answer Question 11 11 @1 22 mins. (@2 min. for each) Questions for Short Answers 9 9 @4 63 mins. (@7 min. for each) Questions for Long Answers 4 4 @7 50 mins. (@12.5 min. for each) 28 Total 24 24 135 minutes (2 hr. 15 min.) 75 Notes: a. There will be alternative questions separated by ‘or’ in the short questions from units 2, 6, and 9 b. Four areas and three categories of questions according to the specification grid should be included in each terminal examination. c. There will be four long questions, one from of each of the areas (knowledge, comprehension, application and higher efficiency). 4 Health, Population and Environment - 10

1. Concept of Health, Population and Environment Education 7-18 1.1 Aspects of Health, Population and Environment.......................................... 7 1.2 Interrelationships among Different Aspects of Health, Population and Environment................................................................................................ 11 2. Demography, Population Change and Population Management 19-67 2.1 Demographic Components, Processes and Measures ................................. 19 2.2 Effects of Rapid Population Growth............................................................... 39 2.3 Population Management................................................................................... 48 3. Population, Environment and Development 68-84 3.1 Activities Related to Population, Environment and Development.............. 69 3.2 Regional Balance in Development ................................................................. 74 3.3 Sustainable Development ................................................................................. 77 4. Demographic Situation of Nepal and Environment 85-110 4.1. Population Distribution of Nepal according to Geographical Regions....... 85 4.2 Ecosystem of Nepal according to Geographical Regions.............................. 88 4.3 Effects of Population Distribution on Ecosystem of Nepal according to Geographical Regions.......................................................................................... 99 4.4 Environmental Conservation and Management ........................................... 104 5. Family Life Education and Quality of Life 111-128 5.1 Introduction to Quality of Life....................................................................... 112 5.2 Elements of Quality of Life............................................................................. 115 5.3 Bases of Quality of Life................................................................................... 118 5.4 Indicators of Quality of Life .......................................................................... 119 5.5 Human Development Index........................................................................... 121 5.6 Interrelationship between Quality of Life and Low Quality of Life......... 224 Health, Population and Environment - 10 5

6. Natural Resources and Biodiversity 129-158 6.1 Concept of Biodiversity...................................................................................... 130 6.2 Importance of Biodiversity and Rare Living Things.................................... 133 6.3 Conservation Measures of Biodiversity.......................................................... 137 6.4 Biodiversity of Nepal according to the Geographical Regions of Nepal.............. 138 6.5 Rare Living Things ............................................................................................ 139 6.6 Adverse Effects on Biodiversity and Their Mitigating Measures.................. 153 7. Environmental Health and Diseases 159-188 7.1 Concept of Communicable and Non-communicable Diseases................ 159 7.2 Some of the Major Communicable Diseases................................................... 163 7.3 Non-communicable Diseases........................................................................... 175 8. Adolescence, Sexual and Reproductive Health Education 180-210 8.1 Sexually Transmitted Diseases ........................................................................ 190 8.2 Safe Motherhood................................................................................................. 196 8.3. Risky Conditions of Pregnancy........................................................................ 199 8.4 Maternal and Child Health (MCH) Care and Its Measures......................... 200 9. Consumers’ Health and Community Health 211-247 9.1 Concept of Community Health ....................................................................... 212 9.2 Health Service Providing Agencies and Their Functions.............................. 216 9.3 Provisions of Health Services in Nepal............................................................ 218 9.4 Voluntary Health Agencies in Nepal.............................................................. 223 9.5 Major Policies and Programmes of Health Sector in Nepal ....................... 227 9.6 Bad Habits, Its Effects and Measures for Prevention.................................... 237 9.7 Tobacco, Smoking and Drugs (Effects and Measures for Prevention)....... 240 10. Primary Health Care, Risk Awareness and Safety Education 248-268 10.1 Methods and Procedures of First Aid ............................................................. 249 10.2 First Aid in Certain Cases................................................................................. 253 10.3 Human Health..................................................................................................... 261 Model Questions................................................................................................................ 269 6 Health, Population and Environment - 10

Concept of Health, 1 Population and Environment Education Contents 1.1 Aspects of Health, Population and Environment 1.2 Interrelationships among Different Aspects of Health, Population and Environment 1.1 Aspects of Health, Population and Environment Health is related to our mind, body and behavior. It is dynamic and affected by our surrounding. Population is never static in nature. There are uninterrupted changes in population due to demographic components like birth, death and migration. Population is affected by both human health and environment. Environment has three major aspects. They are biotic, abiotic and abstract factors. People's health, population characteristics and environment interact with each other continuously with their mutual inter- influence. Such interaction unites these three factors on the basis of the following common aspects: Health, Population and Environment - 10 7

Political Psychological Aspects Aspects Economic Environment Health Physical Aspects Aspects Population Socio-cultural Science and Aspects Technological Aspects Biological Aspects Aspects of health, population and environment a) Physical aspect Things around us may be living or non-living. The non-living things present in the environment constitute the physical aspect. It is directly related to human health, population and environment. This aspect includes natural resources like air, water, soil, etc. Manmade components like development works, constructions, etc. have physical existence. The physical aspects constitute the environment and affect the health status of human being. Polluted environment containing harmful components causes various communicable and non-communicable diseases. Disease germs live in the dirty and polluted environment. If they get opportunity to enter into the human body, they reproduce in our body significantly and become able to cause diseases. Physical aspects also include food materials, construction works, natural structures and abiotic components on the earth. b) Biological aspect Biological aspect includes the living components around us. Human beings themselves are biological components of the environment. They survive in the ecosystem with their predefined roles and positions. They make 8 Health, Population and Environment - 10

certain relationships with other living components of the environment. The domestic animals like cow, buffalo, sheep, yak, pig, duck, etc. are raised for obtaining food from them. Human population size directly or indirectly affects other domestic and wild animals in the environment. Flora and fauna, including micro-organisms, are also the components of the biological aspect. Biological aspect Domestic and wild animals, herbs, crops, trees, birds, reptiles and all components which are biotic members of existing ecosystem are the components of the biological aspect. Biological components are different in the Mountain, Hilly and Terai regions. They are indispensable aspects of human life. Fertility of soil and vividness of biotic components make human residence more convenient for survival. Biodiversity is one of the essential requisites of appropriate residential place for human beings on the earth. c) Economic aspect Economic aspect includes income, expenditure, employment, entrepreneurship, financial plans, budget and the factors related to economic activities. It is essential for the fulfilment of human needs. People are engaged in various forms of income-generating activities like teaching, lawyering, farming, business, marketing, production of goods etc. These are also the components of the economic aspect. d) Socio-cultural aspect Socio-cultural aspect includes social norms, values, social systems, traditions and practices. Such factors are developed by people themselves for convenient livelihood and social cooperation. A human is a social animal because he/she lives in society with common life-practices. Health, Population and Environment - 10 9

e) Psychological aspect Psychological aspect is the key determinant of human behavior. It is related to the mental state of a human being. A positive attitude and behavior help in maintaining harmonious relationship among people. People who grow up in an uncivilized family and poor culture usually have a negative attitude. It is always harmful for them. The psychological state cannot be described and understood just as an abstract aspect; rather it is determined by the mental health and healthy mental activities. f) Political aspect Political aspect determines the guidelines for almost all sectors of a nation. The government plays the central and key role in the formulation and implementation of national plans and policies. A government is made by political activities like election, activities of the political parties and other political movements. In this way, the political aspect of a nation determines the state of health, population and environment. g) Science and technological aspect This is the age of information and technology. Besides, people's new scientific achievements in the communication sector have brought miraculous changes in human life. The science and technological aspect includes scientific inventions, development of transportation vehicles and spaceships, new medical technologies like organ transplantation, genetic engineering, etc. It can save people's life at difficulties and protect the environment with its natural balance. Advancement of communication and information technologies with email and internet has become an eminent boom that can be used in health, population and environment fields for their promotion, conservation, education and public awareness related to them. 10 Health, Population and Environment - 10

1.2 Interrelationships among Different Aspects of Health, Population and Environment Political Psychological Aspects Aspects Economic Environment Health Physical Aspects Aspects Population Socio-cultural Science and Aspects Technological Aspects Biological Aspects Interrelationship between health, population and environment a) Relationship of physical aspect with other aspects of health, population and environment Components of physical aspect create the basis for the total environment around us. Air, water, soil, land, rocks and such several abiotic things provide support for living things. Human health is directly determined by components of the physical aspect. A polluted environment deteriorates our health. Existence of all living things including human being is fully supported by the physical things around us. We can remain healthy in the clean surrounding. Population distribution depends on the availability of the physical components. Population density is higher at those places, where physical components needed for life are abundant, and it is low in those places, where there is a lack of these components. People want to live in areas with good facilities. Health, Population and Environment - 10 11

b) Relationship of biological aspect with the other aspects of health, population, and environment Living things, including plants, animals and micro-organisms, constitute the biological aspect of the environment. There are many kinds of biological components that have created wide diversity among the biotic components. Biodiversity is an important determinant of population distribution and density. Human life itself is one of the components of biodiversity. It depends upon several other biotic factors, including plants and animals. Human survival is possible only with the consumption of biotic resources of the environment. Food, clothes, furniture, fresh air, availability of water, etc. are influenced by the living things around them. On the other hand, human health obviously determines the population size of its own. The population size, directly or indirectly, influences the environment. In this way, health, population and environment are interrelated on the basis of biological aspect. c) Relationship of economic aspect with other aspects of health, population and environment Economic aspect is related to employment, financial investment, income and expenditure. Rapid growth of population results in increased problems of employment. Lack of employment opportunities increases social problems. It increases poverty. When there is very high population density, environmental pollution increases. A polluted environment further deteriorates the human health. Health, population and environment promotional programs require financial support and proper mobilisation of funds. Availability and acceptability of health services and facilities depend directly upon economic resources. Population programmes and environmental conservation programmes also need economic funds to run properly. Income generating activities like jobs, occupation, entrepreneurship, business etc. come under economic aspect. 12 Health, Population and Environment - 10

d) Relationship of socio-cultural aspect with other aspects of health, population and environment The elements of socio-cultural aspect like social norms, values, social systems, traditions, and practices directly affect human life. They were developed during the social evolution of human beings at different places. There are many cultural systems affecting the health of people. Some ethnic groups have a system of taking alcohol during religious occasions. Such a system affects their health adversely. Some religious days are celebrated with compulsory bath in the morning. Such Conservation of Peepal Tree cultural traits are helpful to promote healthier behaviour of people. System of preserving natural resources like rivers and trees (For example: Peepal, Tulsi, etc.) contribute effectively in the conservation of natural resources. The socio-cultural practices are influenced by the environmental factors around us and their utilisation. They are mostly associated with locally available plants, animals, rivers and other natural resources. Similarly, the environment is also affected by these practices. In some cultural days, we have a trend of overeating and in some we remain hungry without taking even a drop of water. Both practices harm our health because we need food in limited amount at regular intervals. e) Relationship of psychological aspect with other aspects of health, population and environment Health, population and environment are directly influenced by the psychological aspect of the people. It is related with the attitude and behavior of the people. Human health is positively affected by a healthier lifestyle. The attitude of the people towards the natural and environmental situation determines their behavior towards natural conservation. Furthermore, human health and mental state are influenced by the environmental surroundings. People must have sound health, which can be obtained with controlled population in their living area and a clean environment. If people have positive attitude towards the environment, they participate in the environmental conservation programs and conserve the environmental resources. They maintain healthy environment and achieve good health. Health, Population and Environment - 10 13

f) Relationship of political aspect with other aspects of health, population, and environment Political system of a country has a determining role to make the plans and policies of that country. It makes all health, population and environment related policies and programs. National health strategies are made and implemented with commitment at the political level. It determines the guidelines for various activities in a nation. Health, population and environmental strategies are formulated by the government, which is formed by a political system of the nation. In Nepal, some important health strategies are included in the current developmental plan. Such strategies are developed according to the commitment of Nepal at various international forums. The National health programs run according to these strategies. The Health and Population Ministry works for conservation of the environment and population management activities. The government is made by political activities like elections, activities of the political parties and other political movements. In this way, political aspect of a nation determines the state of the health, population and environment. g) Relationship of science and technological aspect with other aspects of health, population and environment Human health, population and environment are interrelated on the basis of science and technological aspects developed by human beings. Health is broadly studied in medical science, and many scientific achievements affect human health in positive as well as negative ways. Some inventions like x-ray, ultrasonography, computerized tomography (CT) scan, and various Discuss the following conditions and circumstances with respect to their impact on surrounding environment. i. Dolma’s villagers rapidly cut down trees of the forest near her home. ii. Prakash and his friends put fire on grassland near their field. iii. Ram Narayan’s father established a brick industry in the middle of his village. iv. Dr. Shreeya established a clinic in a town in Terai. ***** Write a paragraph with your conclusion on each conditions and show it to your subject teacher. 14 Health, Population and Environment - 10

other scientific technologies are widely used in the diagnosis and treatment of different diseases. These new technologies are useful in tackling human diseases and health hazards. But the use of some technologies is harmful to human health and the environment as well. Experimentation of nuclear power, development of different weapons, production of pollutants, etc. can be taken as some of the adverse effects of science and technology on health and the environment. ct-scan x-ray Some of scientific technologies are useful in the conservation of the environment. Identification of environmental problems and evaluation of the environmental status have been easier due to the development of technologies. In this way, health, population and environment are interrelated on the basis of science and technological aspect. Invention and experimentation of some science and technological objects sometimes cause massive destruction of people and environment. Nuclear bomb explosion by USA at Hiroshima (on 6th August 1945) and Nagasaki (on 9th August 1945) in Japan are eminent examples of brutal destructive effects caused by technological development on human and the earth. The radioactive effects of the explosion are still inhibiting natural development of life at the affected areas even after several decades. Science and technological aspects have both positive and negative impacts on human health, population and environment. Hence, they are closely related with each other. Health, Population and Environment - 10 15

Find any three components of physical aspects around your community. Ask your guardians and neighbors the components of each of the aspects prevailing in your community. ***** Select three determinant components of each of the aspects and show your task to your teacher. ***** Conduct a symposium in your class under the supervision of the subject teacher. Notes • People's health, population characteristics and environment interact with each other continuously with their mutual inter-influence. • Physical aspects of the environment include food materials, construction works, natural structures and abiotic components on the earth. • Biological aspects of the environment include the living components around us. • Disease germs live in the dirty and polluted environment. If they get opportunity to enter into the human body, they reproduce in our body significantly and become able to cause diseases. • Economic aspect includes income, expenditure, employment, entrepreneurship, financial plans, budget and the factors related to earning and wealth. • Socio-cultural aspect includes social norms, values, social systems, traditions and practices. Such factors are developed by people themselves for a convenient livelihood and social cooperation. A human is a social animal because he/she lives in society with common life-practices. • The psychological state is an abstract aspect and it is determined by the mental health and healthy mental activities. • A government is made by political activities like election, activities of the political parties and other political movements. The political aspect of a nation determines the state of health, population and environment. • Science and technological aspect includes scientific inventions, development of transportation vehicles and spaceships, new medical technologies like organ transplantation, genetic engineering, etc. • Various aspects of health, population and environment are inter-related with each other according to their status and contributions in the existing socio-ecological contexts. 16 Health, Population and Environment - 10

Exercise A. Give very short answers to the following questions. 1. Write one aspect of health education. 2. Write one effect of physical aspect on human health. 3. Give one example of the physical aspect of environment education. 4. Which aspect of health population and environment includes agriculture and forestry? 5. Why are social norms important in determining our h+ealth? 6. What is the role of human psychology in population change? 7. Mention one adverse effect of RPG on the environment. 8. Give any one component studied under socio-cultural aspect. 9. Write any one example of science and technology-based factor affecting the environment. 10. Which aspect is related to the mental state of a human being? B. Give short answers to the following questions. 1. Why are physical components regarded as aspects of health, population and environment? Justify. 2. Explain three aspects of population in brief. 3. Explain the interrelationship of health, population and environment on the basis of socio-cultural and biological aspects. 4. How are physical components of the environment related to human health? Describe with appropriate examples. 5. Show the positive impacts of science and technology on human health. 6. Explain physical and biological aspects of health, population and environment. 7. Give a short introduction to political and psychological aspects of health, population and environment. 8. Describe science and technology and political aspect of health population and environment briefly. Health, Population and Environment - 10 17

9. Explain psychological and physical aspect of health, population and environment. 10. Show interrelation of biological aspect of the environment with its other aspects. C. Give long answers to the following questions. 1. Illustrate in detail the interrelationship among health, population and environment. 2. Explain in detail the interrelationship among health, population and environment education in terms of their various aspects. 3. What is the role of economic resources in maintaining the environment in good condition? Explain with examples. 4. How are science and technology related to environmental conservation and population management? Explain with appropriate examples. 5. How are physical and biological aspects interrelated with other aspects? 6. How are biological and socio-cultural aspects interrelated with other aspects? 7. How are socio cultural and economic aspect interrelated with other aspects? 8. How are economic and science and technological aspects interrelated with other aspects? Explain with examples. 9. How are political and psychological aspects interrelated with other aspects? Explain with examples. 18 Health, Population and Environment - 10

demography, 2 population change and population management Contents 2.1 Demographic Components, Processes and Measures 2.2 Effects of Rapid Population Growth 2.2.1 Socio-economic Effects 2.2.2 Environmental Effects 2.3 Population Management 2.3.1. Introduction to Population Management 2.3.2. Methods of Population Management 2.1 Demographic Components, Processes and Measures Introduction to Demography Demography is the study of the human population in a scientific and systematic manner. The study of population and its characteristics is the prime content of demography. Population is never static. It is continuously changing. It increases or decreases because of three demographic components: birth, death and migration. There are various characteristics of population. We need a systematic study of these characteristics to know and analyse the present, past and future status of population. In order to Health, Population and Environment - 10 19

make it feasible and easy, we study demography. John Graunt of Great Britain is called the 'Father of Demography' because he studied population data for the first time in the world. He had collected population data from different churches that were related to mortality in England. In 1662 AD, he published a book 'Natural and Political Observation made upon the Bills of Mortality'. People started studying about population trends and their characteristics from the time of Graunt, and an important milestone was made by Achille Guillard in 1855 AD. Guillard was the first person to coin the term 'demography' in population studies. He wrote a book 'Comparative Demography' in 1855 AD that brought a new, scientific and statistical concept in studying population in the modern world. The word ‘demography’ is composed of two Greek terms: ‘demos’ and ‘graphien’. ‘Demos’ means people and ‘graphien’ means scientific study. Thus, demography means the scientific study of human population. Only this etymological1 meaning may not be sufficient to understand the wider scopes of demography. In a broader sense, Demography is defined as the scientific and statistical study of human populations mainly about their distribution, size, composition as well as the causes and consequences of changes in these characteristics. According to the demographic dictionary published by UNO 1 , ‘Demography is the scientific study of human population primarily with respect to their size, structure, and development.’ 20 Health, Population and Environment - 10

Population is affected by some specific factors. They are called demographic components and processes. The effects are statistically analysed with demographic measures. It is very essential to study these aspects of population to understand the population characteristics and also to formulate the plans and policies for people. Demographic components, processes and measures Components Processes Measures Birth Fertility Fertility rates Death Mortality Mortality rates Migration Migration Migration rates Demographic Components Birth, death and migration which are responsible for population change are called demographic components. Population changes are brought by various other factors too, but all these factors bring changes in these components first to do so. Diseases, epidemics, calamities, wars, etc. increase the death component and decrease the population. Illiteracy, superstition, preference to son, etc. increase the birth component and increase population. Fertility of land, better environment, employment opportunities and various services and facilities attract the people from other places and bring changes in migration component, which increase the population of the place of destination and decrease the population of the place of origin. Demographic Processes The processes of fertility, mortality and migration that bring changes in the demographic components and population composition are called demographic processes. It is the process by which there is a change in the demographic components with the influence of factors affecting the population. Fertility and fecundity both are related to the birth component. Fecundity refers to the biological capacity of a female to give birth. Fecundity starts in females after menarche, or the first menstruation, and it lasts up to menopause, or the last menstruation of her life. The fertile period of women is generally considered as the period of 15-49 age grouups. Few women have 1. Etymological: pertaining to the study of the history and origin of the words and their meanings 2. UNO : United Nations Organization Health, Population and Environment - 10 21

defect in their reproductive functions in their body and cannot produce children. Such women are called infecund or sterile. Fertility is defined as the actual reproductive performance of a woman or a group of women. We can list the following differences between fertility and fecundity: Differences between fertility and fecundity Fertility Fecundity It is the observed capacity to produce It is the biological capacity to pro- children duce children. It is modifiable. People can increase It is non-modifiable and directly de- or decrease their fertility as per their termined by heredity. needs and desires. It refers to the actual reproductive per- It refers to potential reproductive formance of an individual or a group. performance of an individual or a group. It is quantitative and expressed with It is qualitative and cannot be ex- numbers. pressed exactly with numbers. Fertility is affected by fecundity. Fecundity is not affected by fertility. It starts from the sexual relations and It starts with the menarche and pu- conception. bescence. It is exhibited by females only. It is exhibited by males and females both Fertility play direct role in population Fecundity has indirect role in popu- growth. lation growth. Demographic Measures Demographic measures are the tools which determine the effect of demographic components and processes in the changes of population characteristics. The changes in demographic components and demographic processes ultimately bring changes in population characteristics. Demographic measures are the mathematical calculation methods for the study of demographic situation of a certain place that causes the population changes over the period of time. There are three main demographic measures. These are fertility rates, mortality rates and migration rates. In order to calculate various types of demographic measures, we need the 22 Health, Population and Environment - 10

mid-year population. Mid-year population is the average population of a year. There is no constant population throughout a year, but mid-year population represents the average population of the whole year. Mid-year population can be taken in two ways. The first way is an easy one, in which the population on the first day of the seventh month, or on July 1st (Kartik 1st for BS year) is taken as the mid-year population. The second method uses the concept of average and is calculated by using the following formula: Population in the beginning of the year + Population at the end of the year 2 Three alternative methods for estimating MYP i. MYP = Population on Kartik 1. ii. MYP = Population on July 1. iii. MYP = Pop. of Jan 1 + Pop. of Dec. 31 2 a) Fertility Rates Fertility is the actual reproductive performance of a woman or a group of women. The demographic statistical tools that measure the fertility behavior and practices of people are called fertility rates. Some of the important fertility rates are Crude Birth Rate, General Fertility Rate, Age-Specific Fertility Rate and Total Fertility Rate. i. Crude Birth Rate (CBR) Crude Birth Rate is the total number of live births per thousand mid-year population of a certain place in a given year. It is the mostly used and simplest way of measuring the fertility rate. It is calculated by using the following formula: Crude Birth Rate (CBR) = B × 1000 P Where, B = Total number of live births in a given year. P = Mid-year population of that year. Example: In 2072 BS, the mid-year population of a country was 2,45,56,822. Among them 9,72,452 were newly born infants. Find out the Crude Birth Rate. Solution: Given, Total number of live births (B) = 9,72,452 Health, Population and Environment - 10 23

Mid-year population (P) = 2, 45, 56,822 Crude Birth Rate (CBR) = ? We know that, Crude Birth Rate (CBR) = B × 1000 P 9,72,452 = 2,45,56,822 × 1000 = 39.6 per thousand Therefore, CBR of the country in the year 2072 BS was 39.6 per thousand. Advantages and disadvantages of measuring the Crude Birth Rate: Advantages • It is the simplest measure of fertility. • It is easy to calculate. • It needs simple data of births and mid-year population only. • It is used in the calculation of the rate of natural increase (RNI) and population growth rate. Disadvantages • It is a rough estimation of the fertility level, as the total population is taken for its calculation. • It is not affected by age and sex composition of the population, while fertility is affected in reality by change in the age and sex composition. • It is not useful to compare with the fertility levels between two populations. ii. General Fertility Rate (GFR) General Fertility Rate is the total number of live births per thousand mid-year population of women in the child bearing age group (15-49 years) at a certain place in a given year. It gives the accurate rate of fertility because it counts only the fertile women, who give birth in reality. But, if we analyse the Crude Birth Rate, it counts the total mid-year population, which includes all males as well as children and elderly people who do not produce children. General Fertility Rate is calculated by using the following formula: General Fertility Rate (GFR) = B × 1000 Pf(15 – 49) Where, B = Total number of births in a year. Pf(15–49) = Female population of child bearing age groups i.e., in the age range of 15 – 49 years. 24 Health, Population and Environment - 10

Example: Total number of women in the age group 15-49 years in a district was 80,000 in a year, and there were altogether 2,100 live births in that year. Find the General Fertility Rate. Solution: Here, Total number of live births (B) = 2100 Total number of women of child bearing age group (15-49 years) Pf(15–49) = 80,000 General Fertility Rate (GFR) = ? We know that, GFR = B × 1000 Pf(15 – 49) = 2100 × 1000 80000 = 26.25 per thousand. Therefore, General Fertility Rate (GFR) = 26.25 per thousand, i.e., there were 35 newly born infants per 1000 women of child bearing age. iii. Age Specific Fertility Rate (ASFR) Age Specific Fertility Rate is the total number of live births given by the women in a certain age group per 1000 mid-year population of the women in the same age group in a year. Age specific fertility rate counts the fertility within a certain age group only. The age group is taken with a certain age interval, generally the interval of five years. ASFR is calculated by using the following formula: ASFR = Ba × 1000 Pfa Where, Ba = Total number of live births given by the women in a certain age group in an area in a given year. Pfa = Total mid-year population of the women in the same age group. Example: In a town, women in the age group 21-25 years gave birth to 300 babies in a year. If their population counted on July 1st of that year was noted to be 1500, find out the Age Specific Fertility Rate for that age group. Solution: Given, Age group = 21 to 25 years. Total number of live births from the women of the given age group, (Ba) = 300. Mid-year population of females in the given age group (Pfa) = 1500. Health, Population and Environment - 10 25

Age Specific Fertility Rate, (ASFR) = ? Ba We know, ASFR = Pfa × 1000 i.e. ASFR = 300 × 1000 = 200 per thousand. 1500 iv. Total Fertility Rate (TFR) Total Fertility Rate is the estimated number of children born throughout the fertile life span from an ideal woman, who represents the average fertility behavior of all women in a place. It gives an estimated fertility power of women in a certain place. It is calculated with the help of the age-specific fertility rate. In reality, it is the total, or sum, of all age-specific fertility rates of each fertile year enumerated per woman unit. Given table shows the situation of Total Fertility Rate in Nepal. Total Fertility Rate, Nepal, 1971– 2020 AD S.N. Source Statistics Year TFR 1 Census, 1971 AD (2028 BS) 1971 6.3 2 Nepal Fertility Survey, 1976 1975-76 6.3 3 Contraceptive Prevalence Survey, 1981 (2038 BS) 1980-81 6.3 4 Nepal Fertility, Family Planning, and Health Sur- 1989-91 4.8 vey, 1991 (2048 BS) 5 Nepal Family Health Survey, 1996 1993-95 4.6 6 Nepal Demography and Health Survey, 2006 2006 3.1 7 Nepal Demography and Health Survey, 2011 2011 2.6 (2068 BS) 8 Nepal in Figures, 2015 2015 2.5 9 United Nations - World Population Prospects 2020 1.88 Source: Health and Population Ministry and Central Bureau of Statistics, Nepal, 2015 AD. TFR is helpful to make and implement plans regarding public health, especially maternal and child health, family planning services and others. TFR is calculated by using the following formula: Total Fertility Rate (TFR) = ∑ ASFR × Age interval of five (5) 1000 Where, ∑ ASFR = Sum of Age Specific Fertility Rates 26 Health, Population and Environment - 10

Example 1: Here is a list of Total Fertility Rates observed in different age groups of fertile females living in a village in a year. Use these data to calculate the Total Fertility Rate. Age Group (Yrs.) 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Total ASFR 84 236 188 121 77 39 13 758 Solution: Here, The above table shows data regarding Age Specific Fertility Rates in the given year, The sum of the Age Specific Fertility Rates ∑ASFR = 758 Total Fertility Rates (TFR) = ? We know, ∑ASFR×5 1000 Total Fertility Rate TFR = = 758 × 5 1000 = 3.79 per woman ∴ Therefore, Total Fertility Rate (TFR) of the village was 3.79 per woman in the given year. Example 2: According to census 2068 BS and Nepal Demographic and Health Survey (NDHS) 2068 BS, data related to Total Fertility Rates are tabulated below: Calculate TFR for: a. Nepal (Whole) b. Urban areas of Nepal. Age group (Yrs.) 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Total 5 ∑ ASFR ASFR for Nepal 81 187 126 71 33 14 (Census, 2068BS) 2 517 ASFR (Only for 315 Urban areas in Nepal, 42 135 82 38 16 0 according to NDHS, 2068 BS) Health, Population and Environment - 10 27

Solution: • Calculation of TFR for whole Nepal, Here, The sum of the Age Specific Fertility Rates (∑ASFR) = 517 We know, ∑ASFR × Age interval of five (5) Total Fertility Rate (TFR) = 1000 517 × 5 Or, Total Fertility Rate (TFR) = 1000 = 2.6 per woman Therefore, Total Fertility Rate (TFR) for Nepal in 2068 was 3.79 per woman. • Calculation of TFR for Urban areas of Nepal, Here, The sum of the Age Specific Fertility Rates, (∑ASFR) = 315 We have, Total Fertility Rate (TFR) = ∑ ASFR × Age interval of five (5) 1000 Or, Total Fertility Rate (TFR) = 315 × 5 1000 = 1.6 per woman Therefore, Total Fertility Rate (TFR) for urban areas of Nepal in 2068 was 1.6 per woman. b) Mortality Rates Mortality is the occurrence of death. The demographic tools that measure the conditions of death-occurrence are known as mortality rates. Some of the mortality rates are Crude Death Rate, Age Specific Death Rate, Infant Mortality Rate, and Child Death Rate. i. Crude Death Rate (CDR) Crude Death Rate is the total number of deaths per 1000 mid-year population in a year within a certain place. It is the simplest measure of mortality. It is calculated by using the following formula: Crude Death Rate (CDR) = D × 1000 P Where, D = Total number of deaths in a given year. P = Mid-year population of the year. Example: The population of a certain village was 3500 in 1998 and altogether 70 people died during that year. Find out the Crude Death Rate. 28 Health, Population and Environment - 10

Solution: Here, Total number of deaths (D) = 70 Mid-year Population (P) = 3500 Crude Death Rate (CDR) = ? We know that, D P CDR = × 1000 = 70 × 1000 3500 = 20 per thousand. Therefore, 20 people out of 1000 died. ii. Age-Specific Death Rate (ASDR) Age Specific Death Rate is the total number of deaths in a certain age group per 1000 mid-year population of the same age group in that year in a certain place. Age-Specific Death Rate gives the nature of death occurring in different age groups. ASDR in old age is higher than that in younger age groups because most of the people die in their old age. ASDR is calculated as follows: Da Age Specific Death Rate (ASDR) = Pa × 1000 Where, Da = Total number of deaths in a certain age group. Pa = Total mid-year population in the same age group. Example: In an area of Kathmandu in 2005 AD, 1800 deaths were observed in the age group 0–4 years. If the mid-year population of that area was 20,000, calculate the ASDR. Solution: Here, Total number of deaths (Da) = 1800 Mid-year population (Pa) = 20000 We know that, Age Specific Death Rate Da (ASDR) = Pa × 1000 = 1800 × 1000 20000 = 90 per thousand Therefore, 90 children of age group 0-4 out of 1000 died in that area. iii. Infant Mortality Rate (IfMR) Infant Mortality Rate is the total number of deaths of infants (i.e., children below one year of age) per thousand live births at a certain place in a year. Infants are those Health, Population and Environment - 10 29

children who have not crossed one year of age. The Infant Mortality Rate is affected by the health of mothers too. As infants are unable to perform their health related activities and precautions, this rate depends upon the activities of senior members in the family and community. IMR is calculated by using the following formula: D0 Infant Mortality Rate (IfMR) = B × 1000 Where, D0 = Total number of infants death of in a year. B = Total no. of live births in the same year. Example: In a district, 8,000 live births were observed in 2016. Among them 800 died. Find out the Infant Mortality Rate. Solution: We have, D0 = 800 B = 8000 We know that, D0 IfMR = B × 1000 = 800 × 1000 = 100 per thousand 8000 Therefore, 100 infants of 0–1 years out of 1000 live births died in that year. iv. Child Mortality Rate (CMR) Child Mortality Rate is the total number of deaths of children (i.e. children below five year of age) in a year per 1000 mid-year population of children in the same year in a certain place. Children denote population below five years of age. Child mortality is found high in underdeveloped countries primarily due to malnutrition and infectious diseases. This rate is calculated by the following method: Dc Child Mortality Rate (CMR) = Pc × 1000 Where, Dc = Total number of death of children below 5 years. Pc = Total mid-year population of children below 5 years. Example: The number of children in a city was 15000 in 2016. If 300 children died in the year, find out the Child Mortality Rate. Solution: Here, Total number of children (Pc) = 15000 Total number of deaths of children (Dc) = 300 Child Mortality Rate (CMR) = ? We know that, Dc Pc Child Mortality Rate (CMR) = × 1000 30 Health, Population and Environment - 10

= 300 × 1000 15000 ∴ CMR = 20 per thousand Therefore, CMR was 20 per thousand, which means 20 children died out of 1000 children under five years age. v. Maternal Mortality Rate (MMR) Maternal Mortality Rate is the total number of deaths of pregnant and neonatal mothers (i.e. within 42 days after delivery) in a year per one lakhs (1,00,000) live births in the same year in a certain place. Maternal Mortality Rate is found higher in underdeveloped countries primarily due to gender violence, lack of knowledge, malnutrition, lack of health services and infectious diseases. According to WHO, \"Maternal death is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.\" It accounts for the death of women due to the process of maternity. In other words, it measures the death of mothers due to the complications of pregnancy and delivery of child. MMR is calculated by using the following formula: Maternal Mortality Rate (MMR) = Dm × 1,00,000 B Where, Dm = Total number of death of pregnant and neonatal mothers in a certain year. B = Total number of live birth in the same year. Example: The records from hospitals of a town in 2016 showed that the total number of maternal death was 2. According to the records, 40,000 new babies were safely born in the same year. Find out the Maternal Mortality Rate. Solution: Here, Total number of maternal deaths (Dm) = 2 Total number of live births (B) = 40,000 We know that, Maternal Mortality Rate (MMR) = Dm × 1,00,000 B = 2 × 1,00,000 40,000 ∴ MMR = 5 per lakh Therefore, MMR was 5 per lakh. Health, Population and Environment - 10 31

c) Migration Rates Migration is the movement of people from one place to another place for permanent or temporary settlement. Migration rates are the demographic tools that measure the different migratory characteristics of the people. There are four types of general migration rates. They are In-migration Rate, Out-Migration Rate, Gross Migration Rate, and Net Migration Rate. There are two types of migrants. They are in-migrants and out-migrants. They are also known as immigrants and emigrants respectively. Immigrants of a place are those who come and join the place from other places for permanent or temporary settlement. Conversely, emigrants of a place are those people who leave the place and move somewhere for permanent or temporary settlement. Visitors who visit a place for a short duration but do not settle there are not migrants. i. In-Migration Rate (IMR) In-Migration Rate is the total number of in-migrants within a given year per one thousand mid-year population. This rate is helpful to find out the trend of migration of a certain place. It is calculated by using the following formula: In Migration Rate (IMR) = I × 1000 P Where, I = Total number of immigrants in a country P = Total mid-year population of that country Example: The number of immigrants in a city is 500 in 1995. If the total population of that area is 50,000, find out the In Migration Rate. Solution: Here, Total number of in-migrants (I) = 500 Total mid-year population (P) = 50,000 We kn ow th at, IMR = PI × 1000 500 = 50000 × 1000 ∴ IMR = 10 per thousand Therefore, the In Migration Rate was 10 per thousand population. ii. Out Migration Rate (OMR) Out migrants for a place are those people who migrate to other places form there. Out Migration Rate is the total number of out-migrants (also called ‘emigrants’) per thousand mid-year population in a year at a certain place. Out Migration Rate reflects 32 Health, Population and Environment - 10

the trend of people leaving a place. The Out-Migration Rate is found more where the living situations and other facilities are less in comparison to the neighbourhood areas. The Out Migration Rate is calculated by using the following formula: Out-Migration Rate (OMR) = E × 1000 P Where, E = Total number of emigrants. P = Total mid-year population. Example: 14,000 people from an eastern district left for Kathmandu in search of work in 2005. The mid-year population of the district in that year was 90,000. Find out the Out Migration Rate. Solution: Given, Total number of emigrants (E) = 14,000 Total mid-year population (P) = 90,000 We know that, PMR = EP × 1000 14,000 = 90,000 × 1000 = 155.56 per thousand. Therefore, 155 people out of 1000 population left the district for Kathmandu in that year. iii. Net Migration Rate It is the surplus of In-Migration Rate over Out-Migration Rate. Net Migration Rate can be defined as the difference between the total number of immigrants and emigrants per 1,000 mid-year population of a certain place at a given time period. It is equivalent to the resultant difference between the In-Migration Rate and Out-Migration Rate. This rate reflects the trend of population change due to both types of migrations, in-migration and out-migration. It is calculated by using the following formula: Net Migration Rate (NMR) = I–E × 1000 P Or, NMR = In Migration Rate – Out Migration Rate Where, I = Total number of in-migrants (i.e., immigrants) in a country at a particular time. E = Total number of out-migrants (i.e., emigrants) in a country during that time, and P = Total mid-year population of that place at a given time. Health, Population and Environment - 10 33

Example: There came 900 people from different places in a city in 2004. The total number of out-migrants of that place was 400. If the total population of that place is 25000, find out the Net-Migration Rate. Solution: Here, Total number of immigrants i. = 900 Total number of emigrants (E) = 400 Total mid-year population (P) = 25000 NMR = ? We know that, NMR = I–E × 1000 P = 900–400 100 25000 × = 20 per thousand. Therefore, the Net Migration Rate of that city was 20 per 1000 population. iv. Gross Migration Rate (GMR) Gross Migration Rate can be defined as the sum of immigrants and emigrants per thousand mid-year population of a certain place in a given year. It is equivalent to the sum of the In-Migration Rate and Out-Migration Rate. As the Gross Migration Rate includes both in-migration and out-migration, it does not estimate the aggregate population change. It is useful in evaluating the trend of people who do not have permanency of their residence. In other words, it measures the migratory behavior of people, regardless of in-migration or out-migration. Gross Migration Rate is calculated by using the following equation: Gross Migration Rate (GMR) = I + E × 1000 P Or, GMR = In-Migration Rate + Out Migration Rate. Where, I = Total number of in-migrants in a country at a particular time. E = Total number of out-migrants in a country during that time, and P = Total mid-year population of that place at a given time. Example: The population of a city was 60,000 in a certain year. There came 600 people from outside to settle, and 1000 went out from that city. Find out the Gross Migration Rate. Solution: Here, 34 Health, Population and Environment - 10

Total number of immigrants i. = 600 Total number of emigrants (E) = 1000 Total mid-year population (P) = 60,000 GMR = ? I + E P We know that, GMR = × 1000 = 600+1000 × 1000 60000 ∴ GMR = 26.67 per thousand. Therefore, the Gross Migration Rate of that city was 26.67 per 1,000 mid-year population in that year. d) Other Demographic Measurements i. Rate of Natural Increase (RNI) Rate of Natural Increase includes the increase of population by natural processes only. It excludes the phenomenon of population change by migration process. The natural processes are fertility and mortality. Fertility and mortality are governed by the natural or biological processes. This rate is useful to evaluate the trend of population change due to the natural process only. Rate of natural increase can be defined as the total number of increased population due to natural processes (i.e., fertility and mortality) per hundred mid-year population of a certain place in a given year. In simple words, the rate of natural increase is the difference between the Crude Birth Rate and Crude Death Rate. As, CBR and CDR are generally expressed in per thousand unit and the Rate of Natural Increase (RNI) in per hundred (or, percent) unit, this difference is divided by ten. Symbolically: RNI = CBR – CDR per thousand. But, Rate of Natural Increase is commonly expressed in percent unit, RNI = CBR – CDR × 100 % 1000 RNI = CBR – CDR × 100 % 1000 Or, RNI = CBR – CDR % 10 Where, CBR = Crude Birth Rate. CDR = Crude Death Rate. Traditionally, when the values are expressed in their standard units, the unit ('percent' for RNI here) may not be mentioned. Health, Population and Environment - 10 35

Example: If a country has a Crude Birth Rate of 33.7 and Crude Death Rate of 9.6 per thousand, find out the Rate of Natural Increase. Solution: Here, Given, CBR = 33.7 per thousand. CDR = 9.6 per thousand. RNI = ? Rate of natural increase can be calculated by using the following formula: RNI = Total number of live births–total number deaths × 100 % Mid–year population of the year or, RNI = CBR – CDR % 10 33.7–9.6 or, RNI = 10 % = 2.31 % Therefore, Rate of Natural Increase = 2.31% per annum. ii. Population Growth Rate (PGR) Population Growth Rate is a demographic statistical tool, which helps to evaluate the trend of population increase and also to estimate the size of the population in the future. It is also used to formulate and implement different plans and policies related to population in any part of the nation or the whole nation. Population Growth Rate is the total increment of population per hundred people in a given year at a given place. This growth is due to all the three demographic processes, i.e., fertility, mortality and migration. Thus, it can be calculated as: Population Growth Rate (PGR) = CBR – CDR + NMR Per thousand. Conventionally, the preferred unit of PGR is percent. Therefore, PGR = CBR – CDR + NMR % 10 or, PGR = RNI + NMR % 10 or, PGR = CBR – CDR + NMR % 10 10 Since, RNI = CBR – CDR % 10 Where, CBR = Crude Birth Rate, CDR = Crude Death Rate, RNI = Rate of Natural Increase, and NMR = Net Migration Rate. These rates are calculated in per thousand units. But, population growth rate is generally taken in percent (or per hundred) unit. 36 Health, Population and Environment - 10

The above equations suggest that the Population Growth Rate, in simple words, is the summation of the Rate of Natural Increase and Net Migration Rate. Example: Statistical records of a country shows its Crude Birth Rate = 30, Crude Death Rate = 12, and Net Migration Rate = 5 per thousand. Find out Population Growth Rate. Solution: Given, 30 per thousand CBR = 12 per thousand CDR = 5 per thousand NMR = PGR = ? We have, Population Growth Rate (PGR) = CBR – CDR + NMR 10 = 30-15+15 = 10 20 10 ∴ PGR = 2% per annum. Therefore, Population Growth Rate of the country was 2 percent per annum. iii. Population Doubling Time (PDT) Population is always dynamic. It increases in general. In the course of its increment, total size of population will be double in a certain period of time. This time period is called population doubling time. Population Doubling Time is defined as the time taken by population to be double if growth rate remains constant. It gives an estimation of time period, when population will become double of present population size. Population growth rate, which is also a dynamic or changing factor, is used to calculate the doubling time. Therefore, we suppose that the rate remains constant for a long period of time. Population doubling time is calculated by using the following formula: Population Doubling Time (PDT) = 70 PGR It is expressed in year unit. Example: Population Growth Rate of Nepal, according to the census of 2001 AD, was 2.1 percent per annum. Find out the Population Doubling Time. Health, Population and Environment - 10 37

Solution: Given, Population Growth Rate (PGR) = 2.1% per annum Population Doubling Time (PDT) = ? We have, PDT = 70 PGR = 70 2.1 = 33.33 years Therefore, population doubling time = 33.33 years iv. Sex Ratio Sex Ratio is the ratio of the two sexes of a population. It is also known as the gender ratio. Sex Ratio can be defined as total number of males per one hundred females in a certain area in a given year. It is calculated by using the following formula: Sex Ratio = M × 100 F Where, M = Total number of males. F = Total number of females. Example: In a village, there are 200,000 males and an equal number of females. Find the sex ratio. Solution: Here, Total number of males (M) = 200,000 Total number of females (F) = 200,000 Sex Ratio = ? We have, 200,000 × 100 Sex Ratio = 200,000 = 100% Therefore, Sex Ratio of the village = 100% 100 % sex ratio means there are equal number of females and males in the village. v. Dependency Ratio In population studies, total population is categorized into two groups: active and dependent populations. Further, the dependent population has two groups: children below 15 years of age and elderly people of 60 years and above. Dependency Ratio is the ratio of the dependent population (i.e., the population in the age groups 0-14 years and 60+ years) to the active population (i.e., the population in the age group 15-59 years.) 38 Health, Population and Environment - 10

It is expressed in percent unit. It is calculated by using the following formula: Total dependent population Dependency Ratio = Total active population × 100% Or, Dependency Ratio (DR) = P0-14 + P60+ × 100% P15-59 Where, P0-14 = Population in the age group 0-14 years P60+ = Population above 60 years P15-59 = Active population from 15 to 59 years 2.2 Effects of Rapid Population Growth Rapid growth of population has become a worldwide problem. The annual population growth rate of Nepal was 2.25% per annum according to 2058 BS census report. It has been reduced to 1.35% per annum according to the 2068 BS census. Higher population growth rate directly affects the social and economic aspects of a country. Rapid population growth generally refers to the condition when Total Fertility Rate (TFR) and population growth rate (PGR) exceed 2.1 per woman and 2.1 percent per annum respectively. Growth rates below these values are regarded as normal natural phenomena. The population growth rate and available services and facilities must be maintained in a balanced way. A growing population consumes the available services and facilities. If the means and resources are enough, population growth will not adversely affect the different aspects of the environment. It means that population size should be managed according to the available means and resources. If the means and resources are properly mobilized, the provision of adequate services and facilities is possible. Population growth has adverse effects on environmental, social and economic aspects. These effects are described below: Health, Population and Environment - 10 39

Effects of Rapid Population Growth Areas of Socio-economic effects Areas of Environmental effects Health Forest and vegetation Education Aquatic and terrestrial animals Culture Air Employment Water Supply of drinking water Land Sound Food grain Minerals Housing Flood and Landslide Clothing Soil erosion Security and entertainment 2.2.1 Socio-economic Effects a) Health Sound health brings prosperity and happiness in our life. Health is the wealth of life. Only healthy people can work for the socio-economic development of the country. When the population increases at a high rate, it directly affects the health sector. Due to the rapid growth of population, the health services are not adequate in Nepal. It is estimated that only 20 percent of Nepalese people have a basic level of access to health services and facilities. Many people are dying untimely due to lack of health services at remote and rural areas. Table: Health services in Nepal (Government) Health services No. Health services No. Govt. Hospitals 102 Doctors (Govt. Employed) 1,798 Primary Health Centres 207 HA and AHW 8,013 Health Posts 1,698 Health Workers (MCHW) 3,190 Sub-Health Posts 2,095 Kaviraj/Vaidya 767 Ayurvedic Service Centres 291 b) Education Source: Nepal in Figures, 2011, CBS, Nepal Education is one of the most important factors for the socio-economic development of the country. \"Education is the first step of career development.\" People acquire knowledge, skills and attitudes through education. Education makes people skilled and qualified. That's why, quality and effective education is necessary to make the people efficient in their respective professions. But rapid population growth directly affects the educational sectors. The needs of the 40 Health, Population and Environment - 10

educational sectors increase and the supply of essential educational materials, physical facilities, etc. will be inadequate for the increased population. According to the census report of 2068 BS, the literate population of six years and above is only 60.9 percent. These data indicate that the educational facilities for people are still inadequate in spite of the great efforts of the government to provide education in Nepal. The following table shows the condition of education in Nepal. Table: Total number of schools, students and teachers Types of school Number of schools Number of students Number of teachers Year (A.D.) Primary 1991 2001 2010 1991 2001 2010 1991 1001 2010 L. secondary Secondary 19494 25927 32684 3034710 36231150 4951956 77948 97879 167216 4230 7289 46032 433428 957446 1699927 13225 25375 46032 2309 4350 33835 421709 372947 811910 12132 19498 33835 c) Culture Culture is one of the most important means of introducing one's country in the international arena. Nepal is a multi-ethnic, multicultural, multilingual and multi-religious country. There are different customs, religions, arts, cultures, languages as well as gumbas, monuments, temples, vihars, chaityas, etc. These are our cultural and religious property. UNESCO has listed eight such heritages in the world religious and cultural heritage. Due to the rapid population growth as well as modernization, our important religious and cultural heritages are being destroyed day by day. On the other hand, such heritages and areas are being encroached by people to use them as business spots and construction sites as well as for other various purposes. They are also polluting these heritages. It is very urgent to protect and repair them for their promotion and development by controlling the increased population pressure. Such cultures and heritages will disappear and collapse unless we adopt measures of protection and conservation. The best ways of protection and conservation are to control the growing population and manage it in time. d) Employment People have unlimited needs and demands. They need continuous labor to earn and to fulfill such needs and demands. Employment is the most important factor to earn a livelihood. But employment is very scarce nowadays due to the rapid growth of population. Increased unemployment creates not Health, Population and Environment - 10 41

only economic problems but also increases social evils, political instability, psychological evils, etc. People in the age group 15-59 years are regarded as active population. They need employment. According to 2011 census report, there is 47.1% active population in Nepal. All of them are not employed due to lack of employment opportunities in Nepal. Unemployment problem is rapidly increasing in our country with the rapid increase in population. The development of employment sectors mainly depends on the means and resources available in a country. On the one hand, the growing population highly consumes these resources; and on the other hand, the resources are inadequate for the people. As a result, people become jobless, resources are overused and brain-drain increases. e) Supply of drinking water Water is the biggest constituent of the human body. It contains about 65% of water. Water is one of the basic needs of human beings. The water that we drink should be pure and clean. The growing population adversely affects the water resources. Nepal is very rich in water resources. Nepal is the second richest country in the world and the richest country in Asia in water resources. The major resources of water are the river, well, ocean, pond, waterfalls, etc. which are drying up day by day with the increasing population. Forests help land to absorb rain water. But forest resources are being cleared up and encroached to expand settlements and agricultural activities by the growing population. Supply of water is decreasing day by day. The balance between population growth and water resources has not been managed well. So, the following effects are observed in our community: i. Lack of drinking water. ii. Increasing water pollution. iii. Increasing desertification in the surrounding. iv. Drying up of water resources. v. Depleting aquatic creatures and vegetation. If the population is not controlled in time, there will certainly be severe water problem in the future. f) Food Food provides the fuel for our body. It is the basic need of human life to run different functions of body. Food grains provide us the necessary nutrients. So, we must supply adequate quantity of food grains every day in appropriate amounts. But the rapid growth of population has created problems in supply 42 Health, Population and Environment - 10

of adequate food for people. As a result, starvation is one of the severe problems in the world. Nutritious food is necessary to remain healthy. Otherwise our immunity power will decrease. Fertile land on the earth's surface is limited whereas the consumer of food i.e., the human population is increasing rapidly. The rapid growth of population slowly occupies forest land, causing destruction of forests. Therefore, rapid population growth should be controlled. g) Housing Housing is another basic need of human beings. Our survival becomes difficult without getting proper shelter. Rapid population growth puts strong pressure to increase housing. Housing problem is rapidly increasing nowadays due to rapid population growth. Such problems are severe in the urban areas. According to the census report of 2068 BS, the total population of urban areas and rural areas in Nepal are 17% and 83% respectively. Housing problems also exist in the rural areas. It is very difficult to manage land for housing due to high population pressure. Crowded Housing Health, Population and Environment - 10 43

Rapid population growth is the root cause of problems related to unmanaged settlements. Unmanaged settlement are very high in the urban areas due to lack of proper planning. The effects of rapid population growth on housing are as follows: i. The growing population makes the settlement area very congested, and different kinds of health problems are created. ii. In highly populated areas, crowds, social crimes, waste materials, etc. increase. As a result, community health problems and social disorders are created. iii. Agricultural production decreases and desertification increases. iv. The trend of clearing forest area is increased for settlement. Therefore, housing is a big problem in Nepal because of rapid population growth. So, the population growth should be properly controlled. h) Clothing We need clothes to cover our body according to the season and climate. People in a cold climate need to wear thick and woollen cloths whereas people in a hot climate areas wear thin and cotton clothes. Clothing materials must be increased according to the number of people. Textile and ready-made garment industries are the main sources of clothes. But there is inadequate production of cloth in our country. There are limited number of such industries. The supply of cloth is less than the demand of the people in Nepal especially in the rural and hilly areas. The effects of rapid population growth on clothing are as follows: i. It is difficult to manage clothes according to season. ii. The price of clothes is very high due to the high demand and low supply. iii. Standard of clothes is decreasing day by day. iv. A lot of foreign exchange goes into the import of foreign clothes. i) Security and entertainment Security and entertainment are the basic needs of human being to lead a happy and peaceful life. When the population increases beyond limit, people cannot get security and proper protection. Different kinds of social crimes like theft, robbery, quarrels, gang fight, etc. take place in the society. Consequently, peace, security, pleasure, etc. are lost. The major entertainment sectors are trekking, games, sports, parks, picnic spots, etc. Such sectors will be overcrowded and polluted due to the rapid growth of population. 44 Health, Population and Environment - 10

2.2.2 Environmental Effects a) Forest and vegetation Forest is an important natural resource and important aspect of human life. It plays a vital role to maintain a balance between the natural environment and human life. It provides natural shelter for a number of wild animals. Natural calamities are also controlled by proper maintenance of forest and vegetation. Vegetation Five decades ago, about 57% of the total land area was covered by forest in Nepal. At present, it has reduced to 25.4% (IUCN, 2011) of the total land. It will continuously decrease in the future if population growth continues to increase without any conservation measures. The practice of clearing forests for cultivation and settlement is very high due to rapid population growth. Vegetation, wild birds and animals are reduced in numbers and the ecosystem is disturbed. Different kinds of effects are created on the environment such as: i. Destruction of natural resources. ii. Overuse of forest land and vegetation. iii. Depletion of ozone layer. iv. Imbalance in the ecosystem and environment. b) Aquatic and terrestrial animals Animals which live on land are called terrestrial animals and those which live in water are called aquatic animals. If population increases rapidly, the settlement areas of these creatures will be taken over by people. Their food, settlement and life cycle are slowly destroyed, and environment degradation starts. The growing population conducts different activities for their daily life. As Health, Population and Environment - 10 45

a result, resources like air, water, land are polluted; food for aquatic and terrestrial creatures will not be available in adequate amount. Aquatic and terrestrial animals Illegal hunting and poaching activities have made many animals and plants extinct. People encroach forest land; conduct different activities in water like fishing, boating, swimming, rafting etc. Such activities pose a threat to terrestrial and aquatic animals. Urbanization and industrialization increase with population growth. It has created problems for aquatic and terrestrial organisms. Urbanization and industrialization produce harmful chemicals, waste materials and smoke, etc. which mix up with the resources. The quality and condition of the resources are severely destroyed. Problems of acid rain, ozone layer depletion and scarcity of food grains arise. Therefore, a number of animals are becoming extinct due to the rapid population growth. c) Air, water and land All living creatures need resources in their everyday life. Their residence, respiration, life cycle and all other life-sustaining activities depend on air, water, land and other natural resources. Rapid growth of population is mainly responsible for the degradation and pollution of air, water and land. Urbanization and industrialization increase with increase in population. Due to this, abundant waste materials and harmful pollutants are created, and the environment is degraded. Available air, water, land along with other resources are also destroyed, and their quality and quantity decline. Human beings are responsible for the production of harmful waste materials. Excessive production of harmful chemicals increases the probability of air, water and land pollution. Solid wastes mix up with the soil, harmful chemicals mix up into water, and gases and smoke with air. Some of the effects of rapid population growth on air, water and land are as follows: 46 Health, Population and Environment - 10

i. Alteration in the composition of air (air pollution) ii. Spread of foul gas, smoke, etc. iii. Drying up the water resources. iv. Scarcity of drinking water. v. Encroachment of land for settlement. vi. Excessive dumping of wastage, sewage, garbage, etc. on land. vii. Spread air-borne and water-borne communicable diseases. d) Sound pollution Sound is a form of energy that we hear with our ears. Sound may originate from different sources. Its intensity is measured in decibels. The sound up to 80 decibels is regarded as normal and above 80 decibel is noisy or polluted. Therefore, sound with intensity of more than 80 decibel that causes harmful effects on our health is called sound pollution or noise. The crowds of people, bells, vehicles, machinery are the main sources of excessive sound. We, human beings are mainly responsible for sound pollution in the environment. Different kinds of activities like industrial establishment, running vehicles, use of electronic goods etc. by people create sound in the environment. The production of sound adversely affects different aspects of our lives. The effects of sound pollution are as follows: i. Loss of hearing power and deafness. ii. Mental irritation, anxiety and depression. iii. Change in behavioral pattern of people. iv. Cardiovascular, neurotic and other physiological disorders. e) Minerals Naturally occurring solid inorganic substances, formed as a result of some geological processes, are called minerals. Several types of minerals are used for development works. They are also needed to our body for proper functioning of different systems. There is close relationship between population size and minerals within a country. The rapid growth of population is responsible for the excessive and improper use of minerals. It creates imbalance between need of minerals and supply of them for human beings. It is sure that there is fear of shortage of required amount of minerals in future due to rapid population growth. It is better to reduce the use of minerals or to use alternative sources of mineral in order to sustain them. The effects of rapid population growth on minerals are as follows: Health, Population and Environment - 10 47

i. Scarcity of minerals in the environment. ii. Fear of shortage of mineral for future use. iii. Imbalance in the ecosystem. f) Flood, landslide and soil erosion Flood, landslide and soil erosion are the major environmental problems of Nepal. Main cause of such environmental problems is rapid population growth in Nepal. These are natural processes, but are directly or indirectly related with the increase in human population. Excessive use of forest, water, production of smoke, gases, etc. are the main causes of flood, landslide and soil erosion. Encroachment of land, rivers, and forest creates flood, landslide and soil erosion. During every rainy season, we get to hear and see news of floods, landslides and soil erosion in different parts of our country. 2.3 Population Management 2.3.1. Introduction to Population Management Population management refers to the proper distribution of population according to the availability of means and resources in a certain area. Equal distribution of population in all places is impossible because it is changing continuously. It is a dynamic matter. We should pay proper attention to the means and resources for the management of the population. The imbalance between population size and natural resources create problems. Sometimes, population is less to mobilize the available resources. In such a situation, population should be increased. This aspect is also included in population management. In short, population management means maintaining the number of people for the mobilization of available resources and trying to get maximum benefits. 2.3.2. Methods of Population Management The process of maintaining balance between total population and the resources available for them in a given area is called population management. In the present context with rapid growth of population globally, it primarily accounts for the efforts of population control. Methods of population management can be categorized into the following direct and indirect methods: 48 Health, Population and Environment - 10

Methods of Population Management Indirect methods Direct methods of population management of population management • Expansion of population • Delayed marriage. Education to the grassroots level. • Inclusion of Population Education • Birth spacing in the mainstream of national • Restricting in-migration. educational curricula. • Stimulating out-migration. • Raising awareness • Legal abortion • Gender equity and equality • Adequate provision of employment • Use of contraceptive devices and methods opportunities and busy life The process of reducing the growth rate of population manually and making plans to regulate migration in a controlled way is termed as population control. Population growth is a serious problem in the world, so the control of population growth is necessary. Different measures can be taken for controlling population growth, which are described below: a) Birth spacing The gap between the first child and second child, or two consecutive births, is known as birth spacing. It is an interval of time after a birth of a baby to the next. If birth spacing is a long period, it is good for both mother and child, and it also helps to control the population. The gap between two children should be at least four to five years to achieve sound health for the mother and children. That's why birth spacing is one of the best measures of population control. b) Age at marriage 'Age at marriage' is often understood as appropriate age at marriage. It denotes marriage after becoming physically, socially, mentally and economically capable to bear a child. The suitable age of marriage for girls and boys are 20 years and 25 years respectively from the reproductive point of view. Appropriate age at marriage reduces the total fertile life span of females. Suitable marriageable age from different points of view are as follows: Health, Population and Environment - 10 49

Bases Boy Girl From the legal point of view 20 years 20 years From reproductive point of view 25 years 20 years Delayed marriage reduces the fertility period of women and controls the population. The age of 15 to 49 is regarded as the fertility period. If a woman marries at the age of 15, the total length of the fertile period becomes 34 years (Since, 49-15 = 34). If she marries after 15 years, her fertility period becomes shorter than 34 years, which directly helps to control the population. Advantages of age at marriage i. Both the male and female can be mature and can control population growth. ii. They both can have the opportunity to get a higher education and experience in the job. iii. They can get employment and income generating skills. iv. It helps to control pre-natal, post natal death of the child and mother. v. It helps to prevent different risky factors related to birth like low body weight of the baby, premature birth, infant and maternal mortality rate. vi. Couples are able to bear responsibilities and duties towards the family. vii. It helps to maintain the family size and to have a happy life. viii. Less chances of complication for the mother during delivery, pregnancy and after delivery. c) Gender equality The provision of equal rights and opportunities for both the sexes, male and female, is called gender equality. Male and female should be equally treated. In other words the equal treatment with rational behavior and attitude towards the male and female is called gender equality. Only mutual friendship and cooperation between the male and female can establish 50 Health, Population and Environment - 10