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Fighting poverty with condoms!

In Nepal people have realised that they can no longer afford to have large families.

india Updated: Mar 10, 2006 17:41 IST

One of the biggest-selling items in the tiny chemists in the rebel-held Nepali hill town of Tila are condoms -- several hundred a month for a total population of just 2,000.

In one of the world's poorest countries, people are starting to realise that they can no longer afford the large families once considered vital for supporting parents in old age.

"People are generally getting increasingly aware that if you have a big family, life becomes difficult," says local chemist and government community health worker Yam Bahadur Basnet.

"So people are getting a taste for smaller families."

Nepal's family planning programme, which began in 1959, about the same time the hermit kingdom opened up to the outside world, is considered a success.

Fertility rates -- the average number of children a woman bears -- have come down to 4.1 in 2001 from 5.6 a decade earlier.

"This is quite an achievement," says Giridhari Sharma Poudel, an official with the Family Planning Association Nepal (FPAN), a leading group for counselling among couples.

The Himalayan country has 26 million people, the vast majority surviving on subsistence farming, living on rice and a few vegetables.

The economy, heavily dependent by foreign aid and tourism, has been shattered by a 10-year Maoist revolt against the world's only Hindu monarch.

In a land with no welfare net, to have many children was traditionally considered the best way to provide for retirement, as in many Asian countries.

"The family planning programme is a successful one," says Nara Bahadur Dangi, 40, another of Tila's three community health workers.

"Many people now think they have enough kids. People are realising that if they have a big family they will have problems sending them to school, problems feeding them."

Run by FPAN, the programme involves women volunteers going door-to-door to counsel couples in villages across Nepal.

Authorities run mobile family planning camps in remote areas and community health posts hand out free condoms. The Maoist rebels support the push and government health workers are among the few public servants allowed in rebel-held areas.

FPAN's Poudel says the proportion of couples using contraceptives has increased to 39 percent in 2001 from 3 percent in 1976. More recent figures are not available as they are compiled every five years.

Nepal trails behind its giant neighbour India and Bangladesh in family planning, Poudel said, and ranked almost on a par with Pakistan.

While condoms and birth control pills are big sellers in Tila, in the far west, health workers say the most popular contraceptive is depo-provera, injected once every three months.

Kanchhi Tamang, a struggling domestic worker and mother of three daughters, has been using birth control for seven years.

"I started using the family-planning methods because I did not want to have a fourth child, raising three kids was already a problem," the 45-year-old Tamang says outside a Kathmandu clinic.

In a part of the world where having a son is considered paramount, Tamang says she does not care.

"If I can educate the three daughters, that's okay. I don't mind not having a son," she says shyly.

First Published: Mar 10, 2006 17:41 IST