1. Public Health Concern of Birth
: Dhirendra, Prakash, Sunil, Tilak

2. Outline of Presentation
• Introduction
• Trend in global, regional and national
• Public Health concern of Birth
• Action required to address the issues

3. Conceptual meaning
 The emergence of a new individual from the body of its parent.
(Dictionary meaning)
 The process is initiated by hormones which cause the muscular walls
of the uterus to contract, expelling the fetus at a developmental stage
when it is ready to feed and breathe. (Biological meaning)
 Birth is the vital component of demography-influence demographic
process
 Birth is proxy measure of fertility
 Birth is event and fertility is child bearing capacity

4. Factors affecting birth rate:
Factors
affecting Birth
rate
Family
planning &
Spacing
Level of
Education
Duration of
marriage life
Religion and
tradition
Position of
Woman in
society and
career
Cost of
raising
children
Availability of
quality health
service
Government policy
( pro and anti natalism
;FP,Edu,law, incentives)

5. Source: data.worldbank.org
Global Trend of Crude Birth Rate

6. Region Wise Birth Rate
Source: data.worldbank.org

7. Civil Registration Coverage of Births
Civil registration coverage of births (%) Number of countries (%)
>80 % coverage 126 (64.9 %)
60 % - ≤80 % coverage 23 (11.9 %)
<60 % coverage 29 (15.0 %)
No data 16 (8.2 %)
Total 194 WHO Member States
(WHO,2015)

8. National Trend of CBR
In 2020, number of births for Nepal was 562.12 thousands
CBR: 19.26 (2020 AD)
Source: World Data Atlas
(https://knoema.com/)
Source: Population Monograph, Vol.4

9. National Trend CBR
•The current birth rate for Nepal in 2021
is 19.034 births per 1000 people, a 1.69%
decline from 2020.
•The birth rate for Nepal in 2020
was 19.362 births per 1000 people, a 1.67%
decline from 2019.
•The birth rate for Nepal in 2019
was 19.691 births per 1000 people, a 1.64%
decline from 2018.
•The birth rate for Nepal in 2018
was 20.019 births per 1000 people, a 1.72%
decline from 2017.
Source: United Nations-World Population Prospects

10. Public Health Concern of Birth
Birth Family and Community
Health services and
Health system
Nutrition
• Health Finance and
budget
• Human resources
• Health infrastructure
and commodities
• Social security
Benefits
• Economy
• Psychological and
social impacts.
• Social problems.
• Cost of education
• Production and
consumption
• Land Consumption
• Good nutrition and
child survival

11. Public Health Concern of Birth
Birth
Migration
Environment
Governance
(Policies and Programs)
• Internal migration
• External migration
• Pollution and health
outcomes
• Environmental
resources
• Anti natalist
population policies.
• Public Health Policies

12. Public Health Concern of Birth
Birth
Information and
data system of
country
• Effective policies
• For functional system
Human right

13. Addressing the issues of Birth
 Formulate population policies and translate into programme implementation
 More than half of all developing countries have national population policies,
and about 130 national governments subsidize family planning services
 Nepal population Policy 2071: Nepal has its first ever National Population
Policy endorsed by the Cabinet:
 TFR decrease to 2.1 by 2034.
 Family size from 4.6 to 4.1
 Promote two or less children
 Good health services
 Restrict child marriage and raise legal age of marriage (mulki aain: 20 years: review)

14. Addressing the issues of Birth
 Population control must be thought from Population management
perspective, not only reducing births.
 International Conference of Parliamentarians on Population and
Development (ICPD) in Cairo:
 Created a shift towards viewing population from a more humane and
equitable perspective.
 Commitment to remove all barriers that inhibit access to family planning
services, information and education
 Acknowledged the fact that abortions constitute a major public health
concern for women all over the world.
 Hence, reduce the needs for abortion by providing universal access to
family planning information and services.

15. Addressing the issues of Birth
 Empowerment of women and the improvement of their
political, economic and health status are highly important ends
 Human development cannot be sustained unless women are
guaranteed equal rights and equal status with men
 Education is the single most important element on the road to
equality and empowerment of women

16. Addressing the issues of Birth
 Rather than simply equating population policy with family planning,
the new thinking is that population growth should be stabilized - and
development enhanced
 Attacking some of the roots of the problem: by improving women’s
access to education, health care, and economic and political
decisions.

17. Examples
 China: has operated a one-child policy for a number of years, enforced
though a system of fines, relaxed after mass bereavements such as Sichuan
Earthquake
 Now, focus of China on population control helps provide a better health
service for women and a reduction in the risks of death and injury associated
with pregnancy
 India operates a two-child policy. During 1970s they used forced sterilization
of the poor.
 Most recent approach to population issues focuses on the advancement of
women economically, academically, and socially, as independent women are
more likely to have small families.

18.  Africa: birth rates in Africa are the highest in the world. By the year
2050, twenty percent of the world&#39;s population will live on the
African continent.
 Europe: by contrast, France offers financial incentives for larger (3 child)
families. The population of Europe is also aging faster than any other
part of the world, except Japan.
 European countries will have to increase for retirement, health care and
long-term care for old people in the future.
 Russia faces the most severe population decrease of any country. Drugs,
tobacco smoking and alcohol are some of the main causes of death
among Russian men. Russia also has low birth rates.

19. References
1. Ministry of health and population, Population Report, Nepal, 2011
2. 2. UN Department of economic and social affairs, Population Division, World Fertility
3. Report, 2013
4. 3. Ministry of health and population, Nepal Demographic and Health Survey, 2011
5. 4. UN Department of Economic and Social Affairs, Population Division World Mortality
6. Report, 2013
7. 5. World Health Organization, World Health Statistics, 2008
8. 6. UN, International migration Report, 2013
9. https://www.theguardian.com/environment/2014/sep/18/world-population-new-study-11bn-
2100
10. http://www.un.org/en/sections/issues-depth/population/
11. US Global Change Research Information Office, www.gcrio.org, Consequences Vol. 2, No.2
12. Dru C. Gladney, &quot;China&#39;s National Insecurity: Old Challenges at the Dawn of the
NewMillennium&quot;, Papers from &quot;Asian Perspectives on the Challenges of
China&quot;, Institute for National Security Studies, National Defense University, March 2000

20. Thank you !!!