based on BN 2nd year curriculum

2. GLOBAL SCENARIO
 Women’s health matters not only to women themselves. It is
also crucial to the health of the children they will bear.
 This underlines an important point: paying due attention to
the health of girls and women today is an investment not just
for the present but also for future generations.
 This implies addressing the underlying social and economic
determinants of women’s health – including education, which
directly benefits women and is important for the survival,
growth and development of their children.

3. CONTINUATION,,,
 Global causes of the overall burden of disease in females are
lower respiratory infections, depression and diarrhoeal
diseases.
 Neuropsychiatric conditions and sensory disorders – related,
for example, to vision and hearing – are also important
causes.
 Infectious diseases continue to cause over half the DALYs in
the African Region but have a much smaller impact in other
regions

4. CONTINUATION,,
 In all regions and age groups, girls and women in higher
income countries have lower levels of mortality and burden
of disease than those who live in lower income countries.
 Across all ages, the highest mortality and disability rates
are found in Africa.

5. CONTINUATION,,,
 In childhood, most deaths and disabilities result from
communicable diseases such as HIV, diarrhoeal and
respiratory diseases, malaria, and maternal and perinatal
conditions.
 At older ages, patterns of death and disability change to
noncommunicable chronic diseases such as heart disease,
stroke and cancers. The single exception is in Africa, where
communicable diseases remain the chief causes of female
deaths up to the age of 60 years.

6. CONTINUATION,,
 There are significant regional variations in the composition of
the overall burden of death and disability.
 In Africa and South-East Asia, communicable diseases are
important causes of death and disability at all ages.
 However, in women aged 60 years and over, in all regions,
most deaths are due to noncommunicable diseases.

7. CONTINUATION,,,
 Globally, the single leading risk factor for death and disability
in women of reproductive age in low- and middle-income
countries is unsafe sex, which can lead to sexually
transmitted infections, including HIV.
 Women who do not know how to protect themselves from
such infections, or who are unable to do so, face increased
risks of death or illness.
 So do those who cannot protect themselves from unwanted
pregnancy or control their fertility because of lack of access
to contraception.
 There is emerging evidence that violence against women is
an important risk factor for their health, although the full
dimensions of the problem remain insufficiently measured.

8. WOMEN'S HEALTH IN NEPAL
 Nepalese women and girls at large still suffer from poor
health compared with their male counterparts, due to lack of
adequate health services, general poverty and in some
cases, the sociocultural preference for male children.
 Women suffer from lack of medical facilities in case of
pregnancy complications, malnutrition, anemia, and many
other diseases related to their reproductive functions.
 The high incidence of malnutrition and a lack of health
awareness lead to much sickness in children and to high
infant and child mortality rates.

9. ISSUES IN WOMEN’S HEALTH
 Female foeticide
 Still high infant and child mortality rates and neglect
of girls’ health
 High maternal mortality rate
 Lack of access to adequate health services,
especially for reproductive health care and for
contraceptive devices

10. ISSUES IN EDUCATION
 Low absolute levels of female education (literacy
rate, educational attainment, and enrollment rates)
 Significant gender gaps in education
 Major reasons for not sending daughters to school
include lack of household resources; lack of sense
of importance since girls will marry; girls’ workload
at home; high school fees; lack of female teachers
or adequate facilities.

11. ISSUES IN PATRIARCHY AND
MARRIAGE
 Little control over marriage choice
 Early marriage, more so in rural, Terai uneducated
women
 Vulnerability of widows and divorcees

12. ISSUES IN FERTILITY AND FAMILY
PLANNING
 Little control over fertility
 Still high fertility rate among rural and uneducated
women
 Low contraceptive use

13. ISSUES IN GENDER-BASED VIOLENCE
 Lack of bargaining power of women, dowry, polygyny, and
alcoholism as underlying causes of domestic violence
 Trafficking of women widespread across all ethnic
groups/castes
 Poverty and lack of access to economic resources for
women outside marriage as causes of women entering into
commercial sex work
 Inadequate legal framework and general law enforcement
on gender-based violence.

14. ISSUES ON THE ECONOMIC PARTICIPATION OF WOMEN
 Women’s limited access to productive assets — land and property, credit,
and modern avenues of knowledge and information — reinforced by
unequal inheritance laws and by social norms that confine women’s
resource base only to marriage
 Lack of information on women’s employment and wages, and
underreporting or "invisibility" of women’s economic activities
 Concentration of women in low-productive, subsistence agriculture
 Concentration of women in low-wage, low-skill, menial jobs in the
agriculture and nonagricultural sectors, due to lack of education, training,
information, and bargaining power
 High and increasing work burden without concomitant increase in access
to resources
 Poor working environment — e.g. concentration at lower level jobs, poor
working conditions, lack of child care facilities at workplaces, and trade
unions’ lack of awareness of women's problems — and the gaps between
law and practice
 Child labor (girls more than boys)

15. FACTORS AFFECTING WOMEN’S HEALTH
 Behavioral and socio-cultural conditions or ways of living.
 Environment
 Economic status
 Education
 Occupation
 Political system
 Health services

16. BEHAVIORAL AND SOCIO-CULTURAL CONDITIONS OR WAYS OF LIVING
 Behavioral and socio-cultural conditions or ways of living is one of
the major factors influencing health in Nepal.
 Ways of living or life styles reflect a whole range of social value,
attitude, and behavior.
 It is composed of cultural and behavioral pattern and life long
personal habits (e.g. smoking, alcoholism) that have developed
through the process of socialization.
 Lifestyles are learnt through social interaction with parents, peer
groups, friends and siblings and through schools and mass media.
 It is known that developed countries have coronary artery disease,
lung cancer, drug addiction etc. which are mainly due to change in
life style as sedentary life, lack of exercise, excess use of fat etc.
 On the other hand, developing countries where old traditions are
still followed are suffering from illness and death which occur due
to poor sanitation, poor personal hygiene, bad custom and cultural
patterns.

17. CONTINUATION,,
 All lifestyles have their own good and harmful
points e.g. adequate sleep, enough nutrition,
regular exercise are good habit as per health point
of view.
 To fulfill (achieve) the optimum health of an
individual, we should handle healthy lifestyle.
 Health is both a consequence of an individual’s
lifestyle and a factor in determining it.

18. ENVIRONMENT
 Environment is one of the major factors influencing
health in Nepal. Environment can be defined as any
factor in which human being comes in contact either
directly or indirectly. According to ecological concept,
health is a positive interaction between man and his
environment.
 Environment can be classified as external and internal
environment. External environment means all that which
is external to human hosts and where they are exposed
after conception. Internal environment includes each
and every component, part, tissue, organ and system
and their harmonious functioning within the system.

19. ECONOMIC STATUS
 Economic status is one of the major factors influencing health in
Nepal.
 Now, in developing countries, the rate of morbidity is decreasing
and their life expectancy is increasing due to the slow increasing
pattern of socio-economic status.
 The economic status determines the purchasing power, standard
of living, quality of life, family size and the pattern of illness.
 It is also an important factor in seeking health care.
 But people with higher economic status are also suffering from
many diseases such as hypertension, diabetes, heart disease etc.
 If a person has low income, his nutrition will also be poor. He will
get poor education, which leads to poor hygiene practice. It causes
a problem of diminished body resistance, diminished body
resistance causes illness and illness decreases the work capacity,
which ultimately reduces the productivity.

20. EDUCATION
 Education of the individual is one of the major
factors influencing health in Nepal. Studies show
that higher the education, lower the morbidity and
increase life expectancy of an individual. It shows
that education has direct relation with health status
of an individual.

21. OCCUPATION
 Occupation of the individual is one of the major
factors influencing health in Nepal. The employed in
productive works promotes health. The unemployed
usually shows a higher incidence of ill health and
death. Loss of work may mean loss of income and
status. It can cause psychological and social
damage.

22. POLITICAL SYSTEM
 Political system is one of the major factors
influencing health in Nepal. Health and its service is
directly related to political system and policy of the
country. Decision concerning resource allocation,
manpower, choice of technology, availability and
accessibility of service is always determined by
political system.

23. HEALTH SERVICE
 Health service is one of the major factors influencing health in
Nepal.
 Health service means all those personal and community services
including medical care which are directed towards the promotion
and protection of health of the community.
 The population and health of the community are influenced not
only by its physical and social environment but also by the health
services provided to people.
 The medical care and health services help to protect different kinds
of illnesses.
 To be effective, the health services must reach the social
periphery, they should be equitably distributed, accessible at a cost
the country and the community can afford and socially acceptable.

24. GENDER AND GENDER BASED
VIOLENCE AND ABUSE
 Gender refers to the socially constructed characteristics
of women and men – such as norms(ways of behaving
that are considered normal in a particular society), roles
and relationships between groups of women and men.

25. GENDER-BASED VIOLENCE
 “Any act of gender-based violence that results in, or is
likely to result in, physical, sexual, or psychological harm or
suffering to women, including threats of such acts, coercion
or arbitrary deprivation of liberty, whether occurring in
public or private life”

26. GBS CONTINUATION
 Nepali women and girls are vulnerable to both –
domestic and – public violence, such as rape,
sexual abuse in the workplace, and – human
trafficking.
 Moreover, harmful traditional practices, such as –
dowry-related violence, – Deuki (offering infant girls
to temples where they live without education or
proper care), – Chhaupadi (keeping menstruating
women in a shed away from the home), and –
accusations of witchcraft, can also be life
threatening.

27. TYPES OF GBV
BASED ON PLACE OF OCCURRENCE
 Domestic
 Custodial
 Public violence & trafficking
 In conflict situation
DOMESTIC VIOLENCE
 Nepal passed the 2008 Domestic Violence (Offence and
Punishment) Act in May 2009; the act defines domestic violence as
“any form of physical, mental, sexual, and economic abuse
perpetrated by any person to the other person with whom he has a
family relationship.”
 Violence between two intimately linked partners of opposite sex.
 Physical, verbal, emotional, psychological and/or sexual battering
of women/men by her/his partner or spouse. – Examples: threats or
intimidating words; hitting, using a weapon, rape, imprisonment,
financial control, abusive or demeaning language.

28. CUSTODY
 The protective care or guardianship of institutions/people
or system (laws, policies etc.)
 Most common form of custodial violence :-Imprisonment-
By authority people ,By colleagues, Refugee camp &
Rehabilitation centre.

29. PUBLIC VIOLENCE & TRAFFICKING
 Ranges from teasing to forced prostitution & mass rape.
 Public places-vehicle, street, school, working places, hat
bazaar etc.
 Trafficking of women and children
VAW IN CONFLICT SITUATION
 Conflict increases all forms of GBV.
 Mass displacement leading to more vulnerability of women
and children. Examples: Mass rape, military sexual slavery,
forced prostitution, forced marriage and pregnancy.
 Women forced to offer sex for survival, or in exchange for
food, shelter or protection.

30. ESPECIAL FORM OF VAW IN NEPAL
 Culture is not only supporting GBV but also
aggravating it.
Examples:
 Deuki (western regions of Nepal young girl is offered
to the local temple)
 Jhuma (It is the system in which second girl child is
offered to the monastery)
 Bhatti pasal
 Kamalari
 Polygamy.

31. NDHS 2016
 Experience of violence: Twenty-two percent of
women in Nepal age 15-49 have experienced physical
violence since age 15, and 7% have ever experienced
sexual violence. Six percent of women who have ever
been pregnant have experienced violence during
pregnancy.
 Spousal violence: Twenty-six percent of ever-married
women have ever experienced spousal physical, sexual, or
emotional violence. The most common type of spousal
violence is physical violence (23%), followed by emotional
violence (12%). Seven percent of ever-married women have
experienced spousal sexual violence.

32. NDHS 2016
 Trends in spousal violence: Ever-married women’s
experience of spousal physical, sexual, or emotional violence
has declined from 32% in the 2011 NDHS to 26% in the 2016
NDHS. This decline is due to declines in emotional violence and
sexual violence only.
 Injuries due to spousal violence: Thirty-four percent of
women who have experienced spousal physical or sexual
violence have sustained injuries. Cuts and bruises are the
most common types of injuries reported. Discomfort in the
form of “aches” is also common.
 Help seeking: Sixty-six percent of women who have
experienced any type of physical or sexual violence have not
sought any help or talked with anyone about resisting or
stopping the violence they experience.

33. SDG 5- GENDER EQUALITY
 Despite significant improvements, discrimination and
violence against women and girls remains.
 More than a quarter (26 percent) of women aged 15-49 years
have experienced physical or sexual violence.
 Domestic violence predominates among the different forms of
violence followed by girl trafficking, physical and sexual
abuse, social abuses and malpractices such as allegations of
witchcraft, chhaupadi (exclusion from the family during
menstruation), dowry and early marriage (before the age of
18 years).

34. THE PROPOSED SPECIFIC TARGETS FOR SDG 5 FOR
NEPAL
INCLUDE THE FOLLOWING
(i) Eliminate gender disparities at all levels of education by
2030 particularly in tertiary level education (which currently
stands at 0.71) and in the literacy rates of women and men
aged 15-24 years (which currently stands at 0.85).
(ii) Eliminate wage discrimination for similar work.
(iii) Eliminate physical and sexual violence.
(iv) Eliminate all harmful practices, such as child, early and
forced marriage.
(v) Increase the proportion of seats held by women in the
national parliament to 40 percent.
(vi) Increase women‘s share in public service decision making
positions to at least 28 percent.

35. CHILD MARRIAGE AND PREGNANCY
 In Nepal, the civil code of 1963(11th amendment)fixed the
legal age for marriage is 18 for girls in parental conscent.
 Age at first marriage: The median age at first marriage
among women and men has increased by 1 year over the
past decade. On average, women marry 4 years earlier than
men (17.9 years versus 21.7 years).[NDHS 2016]
 Thirty-seven percent of girls in Nepal marry before age 18
and 10 percent are married by age 15.
 UNICEF data indicates that Nepal has the third highest rate
of child marriage in Asia, after Bangladesh and India.

36. CAUSES OF CHILD MARRIAGE
 poverty,
 lack of access to education,
 child labor,
 social pressures
 gender inequality,
 damaging social norms that make girls less valued
than boys in Nepali society.

37. CONSEQUENCES OF CHILD MARRIAGE
 Married children usually dropped out of school
 Married girls had babies early, because they did not
have information about and access to contraception,
and sometimes because their in-laws and husbands
pressured them to give birth as soon, and as frequently,
as possible.

38. LAW FOR CHILD MARRIAGE IN NEPAL
 Child marriage is illegal in Nepal and has been since 1963.
 The current law sets the minimum age of marriage at 20 for
both men and women.
 Under the law, adults who marry children, family members
and other adults who arrange marriages of children, and
religious leaders who perform child marriages are all
committing crimes and are subject to prosecution.
 Arranging a child marriage or marrying a child is punishable
by imprisonment and fines, which vary depending on the age
and gender of the child involved.

39. CONTINUATION
 These range from six months to three years in
prison and a fine of 1,000 to 10,000 rupees (US$9-
$94) if the case involves a girl under the age of ten.
 The lowest penalty under the law is a fine of up to
700 rupees ($6.60) for a person who has finalized
arrangements for a child marriage which has not
yet taken place.

40. GIRL TRAFFICKING
 Girl trafficking is defined as the selling and buying of girls
illegally. It is one of the major social crimes in Nepal that is
being closely monitored even by the international agencies.
 Trafficking of girls from Nepali land to Indian premises for
forced prostitution is one of the busiest trafficking routes in
all over the world. Approximately somewhere around 5 to 10
thousand girls are the victim of trafficking to India every year.
 Report of Maiti Nepal and government showed that about 10
to 15 thousand of girls are exported in the world from Nepal.

41. CAUSES OF GIRL TRAFFICKING
 Lack of education
 Unemployment
 Poverty
 Lack of awareness in the peoples’ mind especially in rural
area
 Nepalese girls are thinking by heart, not with mind.
 Open boarder between Nepal and India
 Lack of the development of infrastructures and social
services in the rural area
 Lack of government policies, strategy and laws to punish
and discourage trafficker

42. IMPACT OF GIRL TRAFFICKING
 These days, a lethal infection, AIDS has been
spread quickly because of girls trafficking.
 The girls who are sold in prostitution houses return
to Nepal being HIV contaminated.
 They pass on HIV to different young people in
Nepal.
 A few girls who are exploited by HIV and other
lethal sickness are probably going to submit
suicide.
 Our nation is constrained to contribute more cash to
cure the HIV tainted young people.

43. WOMEN'S RIGHTHUMAN RIGHTS
 Right to equality
 Right to freedom
 Press and publication rights
 Right to criminal justice
 Right against preventive detention
 Right to information
 Right to property
 Cultural and educational rights
 Right to religion
 Right against exploitation
 Right against exile
 Right to privacy
 Right to constitutional remedy

44. NEPALESE COUNTRY IS TO GUARANTEE ITS
CITIZENS THE FOLLOWING RIGHTS:-
 Right to work in safe, just and healthy conditions
 Right to equal pay for equal work, with a fair wage
that gives a decent living for the workers and their
families
 Right to social protection
 Right to adequate standard of living
 Right to education, cultural freedom and scientific
progress

45. SPECIAL NEEDS
 Special needs is defined as an individual with a
mental, emotional, or physical disability. An
individual with special needs may need help with:
 Communication
 Movement
 Self-care
 Decision-making

46. OTHER TYPES OF SPECIAL NEEDS INCLUDE
 Autism
 ADHD
 Cerebral palsy
 Down syndrome
 Emotional disturbance
 Epilepsy
 Reading and learning disabilities
 Intellectual disabilities
 Speech and language impairments
 Spina bifida
 Traumatic brain injury
 Visual impairments
Individuals with disabilities or special needs may require special
care. To ensure their safety, several laws have been enacted into
government.

47. DISABILITY
 A disability is a functional limitation or restriction of an
individual's ability to perform an activity.
 But that does not mean that a person with a disability
cannot participate equally.

48. DISABILITY DISCRIMINATION ACT
 The Disability Discrimination Act (DDA) 1995 aims to end the
discrimination that many disabled people face. This Act has
been significantly extended, including by the Disability
Discrimination Act 2005.
It now gives disabled people rights in the areas of:
 employment
 education
 access to goods, facilities and services, including land-based
transport services
 buying or renting land or property, including making it easier
for disabled people to rent property and for tenants to make
disability related adaptations
 functions of public bodies, for example issuing of licences

49. DISABILITY AND HUMAN RIGHTS
ISSUES IN DISABILITY & HUMAN RIGHTS
 People with disabilities experience inequalities – for
example, when they are denied equal access to health care,
employment, education, or political participation because of
their disability.
 People with disabilities are subject to violations of dignity –
for example:- abuse, prejudice, or disrespect because of
their disability.
 Some people with disability are denied autonomy – for
example, they are subjected to involuntary sterilization, or
they are confined in institutions against their will, or they are
regarded as legally incompetent because of their disability.

50. PHYSICAL DISABILITY
 A physical disability is one that affects a person's mobility
or dexterity.
 A person with a physical disability may need to use some
sort of equipment for assistance with mobility.
 It also includes people who have lost limbs or who require
slight adaptations to be made to enable them to participate
fully in society.

51. TYPES OF PHYSICAL DISABILITIES
Paraplegia
Quadriplegia
Multiple sclerosis (MS)
Hemiplegia
Cerebral palsy
Absent limb/reduced limb function
Dystrophy
Polio

52. CHRONIC HEALTH PROBLEM
 The term chronic is often applied when the course of the
disease lasts for more than three months.
 Common chronic diseases
include arthritis, asthma, cancer, COPD, diabetes and
some viral diseases such as hepatitis C and HIV/AIDS.

55. LGBT(LESBIAN, GAY,BISEXUAL &
TRANSGENDER)
 The Nepalese Government, following the monarchy that ended in
2007, legalized homosexuality across the country in 2007 along with
the introduction of several new laws.
 The new Nepalese Constitution, approved by the Constituent
Assembly on 16 September 2015, includes several provisions
pertaining to the rights of LGBT people, some of which include:
 The right to have their preferred gender display on their identity
cards
 A prohibition on discrimination on any ground, including sex or
sexual orientation by anyone
 Eligibility for special protections that may be provided by law
 Substitution of gender-neutral terms for the previous "male",
"female", "son", and "daughter"
 The right of access to country process and public services for
gender and sexual minorities

56. CONTINUATION
 In 2008, Bishnu Adhikari became the first Nepali citizen to
officially register under the "Third Gender" category.
 Sunil Babu Pant is a Nepalese activist and former
politician. He was the first openly gay national-level legislator
in Asia. He formed the Blue Diamond Society, Nepal's
first LGBT organization.
 Third gender in Nepal was described as biological males
who identify with feminine gender identity or for biological
females who identify with masculine attributes.

57. SURROGATE MOTHERS
 Due to absence of specific laws, many Nepalese sisters
and daughters are secretly becoming surrogate mothers
for foreigners under pressure.
 Surrogacy is a process where people wanting babies pay
for another women to have their baby delivered.
 In the absence of specific laws, there is high chance of
abuse leading to women trafficking and forced surrogacy
for money.

58. ISSUES
 status and rights of a baby delivered through surrogate
mother including baby’s right to inherit parental property.
 standard of cleanliness
 standard of medical expertise
 liability for fertility clinics, physicians and nurses
 social stigmatization.

59. ADOPTIVE MOTHER
 Adoption is a process whereby a person assumes
the parenting of another.
 According to the adoption rules of the Government in
Nepal, infertile couples married for four years or even
single women, widow, divorcee are eligible to adopt a
child.
 The age difference between the adopted child and the
parent should be not less than 35 and not more than 55
years.

60. CONTINUATION
 An application has to be submitted to adopt a Nepali son or
a daughter. In case of married couples, the application
should also include the infertility report, marriage certificate,
family and economic condition statement, health, character
certificates, copies of passport and visa and a letter of
consent to adopt a Nepali child authorized by the officer of
the concerned country.

61. CONTINUATION
 In the case of unmarried, divorced, windowed single
parent, a guarantee letter written by the government of
his/her country or the Embassy of his/her country in Nepal
has to be submitted confirming that he/she who is taking
the child in adoption shall bear the whole responsibility
including nourishment and education of the child including
the authorized evidence.