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Introduction: latest ndhs report of nepal

The 2022 Nepal Demographic and Health Survey (2022 NDHS) was implemented by New ERA under the aegis
of the Ministry of Health and Population of Nepal. The funding for the NDHS was provided by the United States
Agency for International Development (USAID). ICF provided technical assistance through The DHS Program,
a USAID-funded project providing support and technical assistance in the implementation of population and
health surveys in countries worldwide. It replaces ndhs 2016
 which is past report. 
ndhs 2022 report
ndhs 2022 report

ndhs full form

Nepal demographic and household survey.

The contents of this report are the sole responsibility of the Ministry of Health and Population, New ERA, and

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.

Objectives NDHS survey 2022

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.



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.

In September 2015, Nepal’s Constituent Assembly declared changes in the administrative units and a re-
classification of urban and rural areas in the country. Nepal is divided into seven provinces: Province 1,

Madhesh Province, Bagmati Province, Gandaki Province, Lumbini Province, Karnali Province, and
Sudurpashchim Province. Each province is divided into districts, districts into municipalities,
municipalities into wards, and wards into sub-wards. Nepal has 77 districts, which include a total of 753
(local level) municipalities. Of the municipalities, 293 are urban and 460 are rural.
Originally, the 2011 NPHC included 58 urban municipalities. This number increased to 217 by 2015. On
March 10, 2017, structural changes were made in the classification system for urban (Nagarpalika) and
rural (Gaonpalika) locations. Nepal currently has 293 Nagarpalika, with 65% of the population living in
these urban areas. The 2022 NDHS used this updated urban-rural classification system. The 2022 NDHS
sample is a stratified sample selected in two stages. Stratification was achieved by dividing each of the
seven provinces into urban and rural areas which together formed the sampling stratum for that province.
A total of 14 sampling strata were created in this way. Implicit stratification with proportional allocation
was achieved at each of the lower administrative levels by sorting the sampling frame within each
sampling stratum before sample selection, according to administrative units in the different levels, and by
using a probability-proportional-to-size selection at the first stage of sampling. In the first stage of
sampling, 476 primary sampling units (PSUs) were selected with probability proportional to the PSU size
and with independent selection in each sampling stratum within the sample allocation. Among the 476
PSUs, 248 were from urban areas and 228 were from rural areas. A household listing operation was carried
out in all the selected PSUs before the main survey. The resulting list of households served as the sampling
frame for the selection of sample households in the second stage. Thirty households were selected from
each cluster, for a total sample size of 14,280 households. Of these, 7,440 households were in urban areas,
and 6,840 households were in the rural areas. Some of the selected sub-wards were found to be overly
large during the household listing operation. Selected sub-wards with an estimated number of households
greater than 300 were segmented. Only one segment was selected for the survey with probability
proportional to the segment size. Global positioning system (GPS) data was collected at the household
level during the household listing and the individual interviews.


nepal demographic and health survey 2021

Four questionnaires were used for the 2022 NDHS: the Household Questionnaire, the Woman’s
Questionnaire, the Man’s Questionnaire, and the Biomarker Questionnaire. The questionnaires, based on
The DHS Program’s standard Demographic and Health Survey (DHS-8) questionnaires, were adapted to
reflect the population and health issues relevant to Nepal. In addition, a self-administered Fieldworker
Questionnaire collected information about the survey’s fieldworkers. Input was solicited from various
stakeholders representing government ministries and agencies, nongovernmental organizations, and
international donors. The survey protocol was reviewed by the Nepal Health Research Council and the ICF
Institutional Review Board. The 2022 NDHS required written consent from the household head to carry
out the interviews and to test for anemia. Similarly, written consent/assent was required from individuals
for anemia testing and from parents/guardians for children age 6–59 months.
After all questionnaires were finalized in English, they were translated into Nepali, Maithili, and Bhojpuri
languages. The Household, Woman’s, and Man’s Questionnaires were programmed into tablet computers
to facilitate computer-assisted personal interviewing (CAPI) for data collection purposes, with the
capability to choose any of the three languages for each questionnaire. The Biomarker Questionnaire was
completed on paper during the data collection and then entered in the CAPI system.

Woman's questionnaire NDHS 2022

The Woman’s Questionnaire was used to collect information from all women age 15–49. These women
were asked questions on the following topics:
▪ Background characteristics (including age, education, and media exposure)
▪ Pregnancy history and child mortality
▪ Knowledge, use, and source of family planning methods
▪ Fertility preferences (including desire for more children, ideal number of children)
▪ Antenatal, delivery, and postnatal care
▪ Vaccinations and childhood illnesses
▪ Breastfeeding and infant feeding practices
▪ Women’s work and husbands’ background characteristics
▪ Knowledge, awareness, and behavior regarding HIV and other sexually transmitted infections (STIs)
▪ Fistula
▪ Mental health
▪ Domestic violence
▪ Knowledge, attitudes, and behavior related to other health issues (for example, cancer, smoking,
tuberculosis, and COVID-19)

KEY findings of NDHS 2022 report


Table 1 shows the results of the household and individual interviews, and response rates, according to
residence, for the 2022 NDHS. A total of 14,243 households were selected for the 2022 NDHS sample, of
which 13,833 were found to be occupied. Of the occupied households, 13,786 were successfully
interviewed, yielding a response rate of 99.7%. In the interviewed households, 15,238 women age 15–49
were identified as eligible for individual interview. Interviews were completed with 14,845 women,
yielding a response rate of 97%. In the subsample of households selected for the men’s survey, 5,185 men
age 15–49 were identified as eligible for individual interview and 4,913 were successfully interviewed,
yielding a response rate of 95%.

FERTILITY repot on NDHS 2022

Under SDG 3.7.1 (b) the government of Nepal targets achieving a total fertility rate of 2.1 births per
woman by 2030 (National Planning Commission, 2020). Table 3 shows the total fertility rate (TFR) and
the age-specific fertility rates (ASFRs) among women by 5-year age groups for the 3-year period
preceding the survey.
Total fertility rate
The average number of children a woman would have by the end of her
childbearing years if she bore children at the current age-specific fertility rates.
Age-specific fertility rates are calculated for the 3 years before the survey,
based on detailed pregnancy histories provided by women.
Sample: Women age 15–49

▪ If fertility were to remain constant at current levels, a woman in Nepal would bear an average of 2.1
children in her lifetime.
▪ Fertility is low among adolescents (71 births per 1,000 women age 15–19), peaks at 160 births per
1,000 among women age 20–24, and then deceases thereafter.

TEENAGE FERTILITY ndhs 2022 nepal

Teenage pregnancy

Percentage of women age 15–19 who have ever been pregnant.
Sample: Women age 15–19

Table 4 shows the percentage of women age 15–19 who have ever been pregnant at the time of the survey,
according to background characteristics.
▪ 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.

The percentage of women age 15–19 who have ever been pregnant rises with age, from 1% at age 15
to 32% by age 19.
▪ Teenage pregnancy is highest in Karnali Province (21%), followed by Madhesh Province (20%), and
lowest in Bagmati Province (8%).
▪ Women age 15–19 with no education (33%) are more likely to start childbearing earlier than those
with at least some secondary education (8%).


Desire for another child

Women were asked whether they wanted more children and, if so, how long
they would prefer to wait before the birth of the next child. Women who are
sterilized are assumed not to want any more children.
Sample: Currently married women age 15–49

Information on fertility preferences is used to assess the potential demand for family planning services for
the purposes of spacing or limiting future childbearing. Table 5 shows fertility preferences among
currently married women age 15–49 by number of living children.
▪ 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.
▪ The percentage of women who want another child soon decreases from 59% among those with no
living children to 2% or less among those with three or more children. In general, the more children a
woman has, the higher the likelihood that she does not want another child or is sterilized.

FAMILY PLANNING ndhs 2022 nepal

Contraceptive use

Contraceptive prevalence

Percentage of women who use any contraceptive method.
Sample: Currently married women age 15–49

Modern methods

Include male and female sterilization, injectables, intrauterine contraceptive
device (IUCD), contraceptive pill, implants, male condoms, emergency
contraception, the standard days method, and lactational amenorrhea method.

The government of Nepal’s target under SDG 3.7.1 (a) includes specific targets for use of modern methods
of contraception by women of reproductive age (15–49). The targets are 53% by 2022 and 60% by 2030
(Ministry of Health and Population 2022). Table 6 shows current levels of contraceptive use among
currently married women age 15–49.
▪ 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
▪ 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.
Trends: 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

need for family planning NDHS 2022
need for family planning NDHS 2022

Need and demand for family planning

Table 7 presents data on unmet need, met need, and total demand for family planning among currently
married women. These indicators help evaluate the extent to which family planning programs in Nepal are
meeting the demand for services. The government of Nepal’s target for SDG 3.7.1, is that 74% of all
women age 15–49 have a met need for family planning with modern methods by 2022 and 80% by 2030
(National Planning Commission 2020).
Twenty-one percent (21%) of currently married women in Nepal have an unmet need for family
planning services. Fifty-seven percent (57%) of currently married women are currently using a
contraceptive method. Therefore, 78% of currently married women have a demand for family
planning. Thus, if all married women who said they want to space or limit their children were to use
family planning methods, the contraceptive prevalence rate would increase from 57% to 78%.
▪ The total demand for family planning that is satisfied is 73%; 55% of the total demand is satisfied by
modern methods.


Neonatal mortality: The probability of dying within the first month of life.

Postneonatal mortality: The probability of dying between the first month of
life and the first birthday (computed as the difference between infant and
neonatal mortality).

Infant mortality: The probability of dying between birth and the first birthday.

Child mortality: The probability of dying between the first and fifth birthday.
Under-5 mortality: The probability of dying between birth and the fifth

The government of Nepal’s target for SDG 3.2.1, is to reduce the under-five mortality rate to 27 deaths per
1,000 live births by 2022 and to 20 deaths per 1,000 live births by 2030. Similarly, the government’s target
for SDG 3.2.2, is to reduce the neonatal mortality rate to 16 deaths per 1,000 live births by 2022 and to 12
deaths per 1,000 live births by 2030 (National Planning Commission, 2020).
Table 8 presents estimates of early childhood mortality rates for three successive 5-year periods prior to
the 2022 NDHS. The rates are estimated directly from the information collected as part of a retrospective
pregnancy history, in which female respondents list all of the children to whom they have given birth,
along with each child’s date of birth, survivorship status, and current age or age at death.
▪ 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.


Proper care during pregnancy and delivery is important for the health of both the mother and the baby.
Table 9 presents key indicators related to maternal care.

3.8.1 Antenatal care

Antenatal care (ANC) from a skilled provider

Pregnancy care received from skilled providers, such as doctors, nurses, and
auxiliary nurse midwives.
Sample: Women age 15–49 who had a live birth or stillbirth in the 2 years
preceding the survey

Antenatal care (ANC) from a skilled provider is important to monitor pregnancy and reduce morbidity and
mortality risks for the mother and child during pregnancy, at delivery, and during the postnatal period.
▪ 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.
Trends: 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.

Tetanus toxoid

Protection against neonatal tetanus

The number of tetanus toxoid injections needed to protect a baby from
neonatal tetanus depends on the mother’s vaccinations. A birth is protected
against neonatal tetanus if the mother has received any of the following:
▪ Two tetanus toxoid injections during the pregnancy
▪ Two or more injections, the last one within 3 years of the birth
▪ Three or more injections, the last one within 5 years of the birth
▪ Four or more injections, the last one within 10 years of the birth
▪ Five or more injections at any time prior to the birth
Sample: Women age 15-49 with a live birth in the 2 years preceding the

Delivery care

Institutional deliveries

Deliveries that occur in a health facility.
Sample: All live births and/or stillbirths in the 2 years preceding the survey

Skilled assistance during delivery

Births delivered with the assistance of a doctor, nurse, or midwife.
Sample: All live births and/or stillbirths in the 2 years preceding the survey
Access to proper medical attention and hygienic conditions during delivery can reduce the risk of
complications and infections that may lead to death or serious illness for the mother and/or baby (Van
Lerberghe and De Brouwere 2001; WHO 2006a). The government of Nepal’s target for SDG 3.1.2, is that
73% of births are delivered with assistance from skilled provider by 2022 and achieve 90% by 2030
(National Planning Commission 2020).
▪ Overall, 79% of live births and still births in the 2 years preceding the survey were delivered in health
▪ Four in five (80%) live births and stillbirths were delivered by skilled providers.
Trends: The percentage of live births that are assisted by a skilled provider has increased markedly, from
10% in 1996 to 80% in 2022)

Postnatal care for the mother ndhs 2022 nepal

A large proportion of maternal and neonatal deaths occur during the first 48 hours after delivery. Thus,
prompt postnatal care (PNC) for both the mother and the child is important to treat any complications
arising from the delivery, as well as to provide the mother with important information on how to care for
herself and her child. Safe motherhood programs recommend that all women receive a health check during
the first 2 days after birth.
▪ 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.
▪ Among women with a live birth, women in the lowest wealth quintile are less likely to receive
postnatal check within 2 days after delivery than women in the highest wealth quintile (56% versus

maternal mortality rate in nepal ndhs 2016

check text above


Universal immunization of children against common vaccine-preventable diseases is crucial to reducing

infant and child morbidity and mortality. In Nepal, routine childhood vaccines include bacillus Calmette-
Guérin (BCG) (tuberculosis); oral polio vaccine (OPV) and fractional inactivated poliomyelitis vaccine

(fIPV); pentavalent or DPT-HepB-Hib (diphtheria, pertussis, tetanus, hepatitis B, and Haemophilus
influenzae type b); pneumococcal conjugate vaccine (PCV); rotavirus vaccine (RV); Japanese encephalitis
(JE) vaccine; and measles rubella (MR) vaccine. The rotavirus vaccine was introduced into the routine
schedule in July 2020. The Nepal Health Sector Strategy 2016–22 target for vaccination coverage specifies
that 95% of children age 12–23 months should be covered for all vaccines included in the national program
by 2030 (Ministry of Health and Population, 2022).

Fully vaccinated—basic antigens ndhs 2022 nepal

Percentage of children who received specific vaccines at any time before the
survey (according to a vaccination card or the mother’s report). To have
received all the basic antigens in Nepal, a child must receive at least:
▪ One dose of BCG vaccine, which protects against tuberculosis
▪ Three doses of polio vaccine given as oral polio vaccine (OPV)
▪ Three doses of DPT-containing vaccine, which protects against diphtheria,
pertussis (whooping cough), and tetanus
▪ One dose of measles-containing vaccine given as measles rubella (MR)
Sample: Children age 12–23 months


Anthropometry is commonly used to measure child nutritional status. Anthropometric measurements are
used to report on child growth indicators. The distribution of height and weight for children under age 5 is
compared with the World Health Organization growth standard reference population (WHO 2006b). The
distribution of children in a well-nourished population will be similar to the reference population, while the
distribution of children in a poorly nourished population will not. In DHS surveys, the anthropometric
indices height-for-age (stunting), weight-for-height (wasting), and weight-for-age (underweight) are used
to measure nutritional status in young children. The three indices can be expressed in standard deviation
units (z scores) from the median of the reference population. Values that are more than two standard
deviations below (-2 SD) the median of the WHO Child Growth Standards population are used to define
undernutrition. Each of the indices provides different information about growth and body composition that
can be used to assess nutritional status.

In the 2022 NDHS, height and weight measurements were obtained for 2,765 children under age 5; the
percentages with valid data for height-for-age, weight-for-height, and weight-for-age were 97%, 97%, and
98%, respectively.
The government of Nepal’s target for SDG 2.1.1 is that the prevalence of stunting (height-for-age) among
children under 5 years be at or below 29% by 2022, and at or below 15% by 2030. Similarly, the target for
SDG 2.2.2, the prevalence of wasting (height-for-weight) among children under 5 years, is 7% by 2022
and 4% by 2030 (National Planning Commission 2020).
Table 12 shows the nutritional status of children under age 5, 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.
Trends: The prevalence of stunting has declined from 57% in 1996 to 25% in 2022 (Figure 6). During
this same period, the prevalence of wasting declined from 15% to 8%, and the prevalence of overweight
was steady at 1%.

nepal demographic and health survey 2021


Optimal infant and young child feeding (IYCF) practices are critical to the health and survival of young
children, Recommended IYCF practices include early initiation of breastfeeding within the first hour of
life, exclusively breastfeeding for the first 6 months of life, and feeding children a diet that meets a
minimum diversity (WHO and UNICEF 2021).

Early initiation of breastfeeding
Percentage of children age 0–23 months who were put to the breast within
1 hour of birth
Sample: Children age 0–23 months
Exclusive breastfeeding under 6 months

Percentage of children age 0–5 months who are fed exclusively with
breastmilk during the previous day
Sample: Youngest children age 0–5 months living with the mother

Minimum dietary diversity 6–23 months
Percentage of children age 6–23 months who are fed a minimum of 5 out of
8 defined food groups during the previous day. The 8 food groups are as
follows: breastmilk; grains, roots, and tubers; legumes and nuts; dairy products
(milk yogurt, cheese); flesh foods (meat, fish, poultry, and organ meat); eggs;
vitamin A-rich fruits and vegetables; and other fruits and vegetables.
Sample: Youngest children age 6–23 months living with the mother

nepal demographic and health survey 2021

Key IYCF indicators are presented in Table 13.

▪ 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


▪ Fifty-six percent (56%) of children under 6 months were exclusively breastfeed.


3.13.1 Prevalence of anemia in children

Anemia is a condition that is marked by low levels of hemoglobin in the blood. Causes of anemia include

iron deficiency and other nutritional deficiencies, malaria, infections with hookworm or other helminths,

chronic infections, and genetic conditions such as sickle cell disease. Anemia is a serious concern for

children because it can impair cognitive development and is associated with long-term health and

economic consequences. Severe anemia leads to increased mortality (Chaparro and Suchdev 2019).

nepal demographic and health survey 2021


3.14.1 Knowledge of HIV prevention among young people

Knowledge about HIV prevention

Knowing that consistent use of condoms during sexual intercourse and having

just one uninfected faithful partner can reduce the chances of getting HIV,

knowing that a healthy-looking person can have HIV, and rejecting two major

misconceptions about HIV transmission: HIV can be transmitted by mosquito

bites and a person can become infected by sharing food with a person who

has HIV.

Sample: Women and men age 15–24

Knowledge of how HIV is transmitted is crucial to enabling people to avoid HIV infection. This is

especially true for young people, who are often at greater risk because they may have shorter relationships

with more partners or may engage in other risky behaviors.

▪ 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 (Table 16).

▪ 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


Prior HIV testing

HIV testing programs diagnose people living with HIV so that they can be linked to care and access

antiretroviral therapy (ART). Knowledge of HIV status helps HIV negative individuals reduce risk and

remain negative.

▪ Overall, 10% of women and 13% of men age 15–49 have ever been tested for HIV (Table 17.1 and

Table 17.2, respectively). Almost all of those who were tested received the test results.

▪ 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 ndhs 2022 nepal

Functional domains

Seeing, hearing, communicating, remembering or concentrating, walking or

climbing steps, and washing all over or dressing.

Sample: de facto household population age 5 and above

The 2022 NDHS included The DHS Program’s Disability Module, a series of questions based on the

Washington Group on Disability Statistics (WG) Short Set of questions, which in turn are based on the

framework of the World Health Organization’s International Classification of Functioning, Disability, and

Health. The questions address six core functional domains and provide basic information on disability

comparable to that being collected worldwide via the WG disability tools.

Respondents to the Household Questionnaire provided information for all the household members and

visitors on disability status for each of the functional domains: whether they had no difficulty, some

difficulty, a lot of difficulty, or no ability at all in the specified functional domain. Table 18 shows the

results for the de facto household population age 5 and older.

▪ 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%).

nepal demographic and health survey 2021

which is not correct name for NDHS 2022 report

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