Overview

The 2022 Nepal Demographic and Health Survey (NDHS) was implemented by New ERA under the aegis of the Ministry of Health and Population (MOHP). Data collection took place from January 5 to June 22, 2022. ICF provided technical assistance through The DHS Program, which is funded by the United States Agency for International Development (USAID) and offers financial support and technical assistance for population and health surveys in countries worldwide. Suaahara II, USAID’s integrated nutrition activity, supported the ethical review process of the survey in Nepal.

This Key Indicators Report presents a first look at selected findings from the 2022 NDHS. A comprehensive analysis of the data will be presented in a final report in 2023.

Survey Objectives

The primary objective of the 2022 NDHS is to present up-to-date estimates of basic demographic and health indicators. The NDHS provides a comprehensive overview of population, maternal, and child health issues in Nepal. Specifically, the 2022 NDHS collected information on fertility levels, marriage, fertility preferences, awareness and use of family planning methods, breastfeeding practices, nutrition, maternal and child health, childhood mortality, awareness and behavior regarding HIV and other sexually transmitted infections (STIs), women’s empowerment and domestic violence, fistula, mental health, accident and injury, disability, food insecurity, and other health-related issues such as smoking, knowledge of tuberculosis, and prevalence of hypertension.

The information collected through the 2022 NDHS is intended to assist policymakers and program managers in designing and evaluating programs and strategies for improving the health of Nepal’s population. The 2022 NDHS also provides indicators relevant to the Nepal Health Sector Strategy 2016– 22, the next health sector strategic plan under development, and the Sustainable Development Goals (SDGs) for Nepal.

Sample Design

The sampling frame used for the 2022 NDHS is an updated version of the frame of the Nepal Population and Housing Census (NPHC) conducted in 2011, provided by the Central Bureau of Statistics. The smallest administrative unit in Nepal is the sub ward. The census frame includes a complete list of Nepal’s 36,020 sub-wards. Each sub-ward has a residence type (urban or rural) and a measure of size is the number of households.

Facts & trends

Fertility

There has been a steady decline in the Total Fertility Rate from 4.8 births per woman in the 1996 NFHS to 2.1 births per woman in the 2022 NDHS.

Fertility is low among adolescents (71 births per 1,000 women age 15–19), peaks at 160 births per1,000 among women age 20–24, and then deceases thereafter.

Overall, 14% of women age 15–19 have ever been pregnant, including 10% who have had a live birth, 2% who have had a pregnancy loss, and 4% who are currently pregnant.

Teenage pregnancy is highest in Karnali Province (21%), followed by Madhesh Province (20%), and lowest in Bagmati Province (8%).

Ten percent (10%) of women want another child soon (within the next 2 years), 13% want to have another child later (in 2 or more years), and 1% want another child but have not decided when.

Fifty-three percent (53%) of women want no more children, 17% are sterilized, and 3% stated that they are infecund.

Family Planning

Use of any family planning method among currently married women rose from 29% in 1996 to 57% in 2022. Over the same period, use of modern methods of contraception increased from 26% in 1996 to 44% in 2006. It has held steady at 43% from 2011 through 2022.

Fifty-seven (57%) of currently married women are using a method of contraception; 43% are using a modern method, and 15% are using a traditional method.

The most popular modern methods used are female sterilization (13%), injectables (9%), and implants (6%).

Withdrawal is by far the most common traditional method used; 13% of currently married women use this method compared with 2% who use the rhythm method.

Twenty-one percent (21%) of currently married women in Nepal have an unmet need for family planning services.

Early Childhood Mortality

Between the 1996 NFHS and the 2022 NDHS surveys, under-5 mortality declined from 118 to 33 deaths per 1,000 live births, infant mortality declined from 78 to 28 deaths per 1,000 live births, and neonatal mortality declined from 50 to 21 deaths per 1,000 live births. Notably, however, between the 2016 and 2022 NDHS the neonatal mortality did not change.

• During the 5 years immediately preceding the survey, the overall under-5 mortality rate was 33 deaths per 1,000 live births.
• The infant mortality rate was 28 deaths per 1,000 live births.
• The child mortality rate was 5 deaths per 1,000 children surviving to age 12 months.
• The neonatal mortality rate was 21 deaths per 1,000 live births, during the 5 years immediately preceding the survey.
• Eighty-five percent (85%) of all deaths among children under age 5 in Nepal take place before a child’s first birthday, with 64% occurring during the first month of life.

Maternal Care

The percentage of women who received antenatal care from skilled provider for their most recent live birth in the 2 years preceding the survey increased from 25% in 1996 to 94% in 2022. Similarly, those who made four or more ANC visits increased from 9% in 1996 to 81% in 2022. The percentage of live births that are assisted by a skilled provider has increased markedly, from 10% in 1996 to 80% in 2022).

• Ninety-four percent (94%) of women reported receiving antenatal care from a skilled provider for their most recent live birth or stillbirth in the 2-year period preceding the survey.
• Four in five women (81%) had at least four ANC visits for their most recent live birth.
• Overall, 96% of women took iron-containing supplements during their most recent pregnancy.
• Overall, 93% of women with a live birth in the 2 years preceding the survey received sufficient doses of tetanus toxoid injections to protect their baby against neonatal tetanus.
• Overall, 79% of live births and still births in the 2 years preceding the survey were delivered in health facilities.
• Four in five (80%) live births and stillbirths were delivered by skilled providers.
• Overall, 70% of women with a live birth or stillbirth in the 2 years preceding the survey received a postnatal check within the 2 days after delivery.

Vaccination coverage

The percentage of children age 12–23 months who are fully vaccinated (received all the basic antigens) has fluctuated over time, rising from 43% in 1996 to a peak of 87% in 2011, then decreasing to 78% in 2016, and increasing slightly to 80% in 2022. The percentage of children age 12–23 months who did not receive any vaccinations has also fluctuated, notably increasing slightly from 1% in 2016 to 4% in 2022.

• Overall, 80% of children age 12–23 months are fully vaccinated with basic antigens.
• Ninety-five percent (95%) of children age 12–23 months received BCG vaccine, 89% received the third dose of DTP-HepB-Hib, 86% received the third dose of OPV, and 89% received a dose of MR.
• Slightly more than half of the children age 12–23 months (52%) are fully vaccinated according to the national schedule.
• Eighty-five percent (85%) of children received the second dose of fIPV, 81% received the third dose of PCV, 72% received the 2nd dose of RV, and 81% received a dose of JE vaccine.
• Four percent (4%) of children age 12–23 months have received no vaccinations.

Child Nutrition Status

The prevalence of stunting has declined from 57% in 1996 to 25% in 2022. During this same period, the prevalence of wasting declined from 15% to 8%, and the prevalence of overweight was steady at 1%.

• According to the three anthropometric indices: 25% of children under age 5 are stunted, 8% are wasted, and 19% are underweight. One percent of children under 5 are overweight.

Infant and Young Child feeding

Exclusive breastfeeding among children age 0–5 months has fluctuated widely—declining from 75% in 1996 to 53% in 2006, then rising to 70% in 2011, and declining to 56% in 2022.

• Fifty-five percent (55%) of children age 0–23 months engaged in early initiation of breastfeeding.
• Seventy-eight percent (78%) of children age 6–23 months met the minimum dietary diversity requirement.
• Fifty-six percent (56%) of children under 6 months were exclusively breastfeed.
• Forty-three percent (43%) of children age 6–23 months were fed a sweet beverage.
• Sixty-nine percent (69%) of children age 6–23 months consumed unhealthy foods.

Anemia

The prevalence of anemia among children age 6–59 months has decreased from 48% in 2006 to 43% in 2022. However, the trend has not been consistently downward—in 2016, 53% of children were anemic. The prevalence of anemia among women age 15–49 increased from 36% in 2006 to 41% in 2016 and declined to 34% in 2022.

• Fourty three (43)% of children age 6–59 months are anemic, including 25% who are mildly anemic, 18% who are moderately anemic, and less than 1% who are severely anemic.
• Thirty four (34)% of women are anemic, including 18% who are mildly anemic, 15% who
• are moderately anemic, and 1% who are severely anemic.
• Women living in the terai ecological zone are more likely to be anemic (45%) than those living in hills (20%) and mountain (23%) regions. More than half of the women (52%) are anemic in Madhesh Province, which is in the terai ecological zone.

HIV

• Sixty-five percent (65%) of young women and 88% of young men know that consistent use of condoms can reduce the risk of getting HIV.
• Sixty-nine percent (69%) of young women and 85% of young men know that having just one uninfected partner can reduce the chance of getting HIV.
• Only 16% of young women and 27% of young men have a thorough knowledge of HIV prevention methods.
• Overall, 10% of women and 13% of men age 15–49 have ever been tested for HIV.
• Three percent (3%) of women and 2% of men age 15–49 were tested for HIV in the 12-month period preceding the survey and received the results of the last test they took.

Disability

• Overall, 71% of the de facto household population age 5 or older have no difficulty in any of the functional domains.
• Among the de facto household population age 5 or older 23% have some difficulty in at least one functional domain, 5% have a lot of difficulty, and 1% cannot do at least one domain.
• Six percent (6%) of the de facto household members age 5 or older have a lot of difficulty or cannot function at all in at least one of the functional domains.
• Among the de facto household population age 5 and older, the most common disability reported is difficulty seeing (15% ) followed by difficulty walking or climbing steps (12%).

Ministry of Health and Population, Nepal; New ERA; and ICF. 2022. Nepal Demographic and Health Survey 2022: Key Indicators Report. Kathmandu, Nepal: Ministry of Health and Population, Nepal.

Recommended reading

• NEPAL DEMOGRAPHIC AND HEALTH SURVEY (NDHS) 2022 | KEY INDICATORS
• Nepal Health Facility Survey 2021 Preliminary Data Tables
• Preliminary Findings: Nepal Health Facility Survey 2021
• Second Round Seroprevalence Survey for SARS-COV-2
• The 2nd National Sero-prevalence Survey of Nepal for COVID-19
• Waste Management Baseline Survey of Nepal 2020
• National Mental Health Survey, Nepal-2020 Fact Sheet
• Nepal Multiple Indicator Cluster Survey 2019 (NMICS 2019): Key findings
• National TB Prevalence Survey, 2018-19 Key findings
• Nepal STEPS Survey 2019- Province wise Fact Sheets
• NEPAL–NCDs risk factors STEPS Survey 2019 – Tobacco Factsheet
• Nepal STEPS Survey 2019 Alcohol Consumption and Policy Fact Sheet
• National NCD Risk Factor Survey (WHO-STEP Survey) 2019,Nepal
• Nepal National Micronutrient Status Survey 2016
• The 2015 Nepal Health Facility Survey: Further Analysis Reports
• Key Indicators: The Nepal Demographic and Health Survey (1996 NDHS- 2016 NDHS)
• Key Findings (Nepali & English) – The 2016 Nepal Demographic and Health Survey (2016 NDHS)
• Nepal Demographic and Health Survey 2016 Key Indicators Report
• Nepal Demographic and Health Survey 2016 Key Indicators Report (Short Notes)
• The 2016 Nepal Demographic and Health Survey (2016 NDHS)
• Key findings – The 2015 Nepal Health Facility Survey (2015 NHFS)
• Nepal Health Facility Survey (2015 NHFS) Preliminary Report
• Nepal Multiple Indicator Cluster Survey (MICS 2014) Final Report