The harms done by inadequate sexual and reproductive education in Nepal

In Nepal, many girls navigate their adolescence without formal education on their sexual and reproductive health and rights (SRHR). As a nurse working in public hospitals in Nepal for more than 17 years and as a professor training health education teachers for the past four years, I have seen the negative impacts of teenage pregnancy on girls’ personal, social, and educational lives. Early marriage affects an alarming 33% of Nepal’s 2.89 million adolescent girls, many of whom not only become pregnant at an early age, but also suffer from domestic violence and social discrimination due to health and rights.

As Kumari’s story above demonstrates, many adolescent girls do not have a comfortable space or people with whom to share their personal experiences. She was not aware of how early marriage would affect her personal and family life. Her story also shows a missed opportunity for schools and teachers to help adolescent girls understand their sexual and reproductive rights, including those related to early marriage.

In the context of Nepal, adolescent girls like Kumari rarely find open and free spaces in schools to learn about  issues related to sexual and reproductive health and rights, as they are generally perceived to be personal problems rather than collective and sociocultural issues that require systemic responses. This leaves many adolescent girls feeling inhibited about sharing their stories on topics such as reproductive decisionmaking, reproductive education, modern contraception, gender-based violence, and sexuality. These conditions have constrained their agency to claim and exercise their rights, and made them vulnerable to early marriage, violence, rape, unwanted pregnancy, and other forms of gender-based discriminations. As voiced by Kumari, many end up living in rather difficult and uncertain conditions.  

Kumari’s story also highlights the gap between policies and their implementation. At the policy level, Nepal is committed to the Global Strategy for Women’s, Children’s, and Adolescents’ Health (2016–2030) and has endorsed various policies for adolescent SRHR, such as the National Adolescent Health and Development Strategy 2000 and the Nepal Health Sector Strategy (NHSS) 2015-2020. Yet, these national and international commitments have largely failed to reach adolescent girls in Nepal. A recent report showed that  only 21% of girls have access to family planning services and only 48% of adolescents are utilizing adolescent-friendly health services, with limited access to abortion services.   

During my fellowship as a 2024 Echidna Global Scholar at the Center for Universal Education at Brookings, I will focus on empowering Nepali adolescent girls by engaging them in exploring SRHR-related issues and in designing and implementing relevant activities to develop their awareness and agency through participatory action research (PAR). This study will follow different cycles, beginning with a phase where students identify the SRHR-related problems they face, through surveys, drawing pictures, or participating in group conversations. Next, students will be involved in discussions, workshops, and awareness sessions related to SRHR. They will be encouraged to develop action plans to raise awareness about SRHR policies through activities such as community rallies, school exhibitions, and drama, thereby acting as change agents within the existing school system. Furthermore, students will be encouraged to extend these initiatives to neighboring schools. I will also collaborate with teachers and community members to support the girls in co-designing activities and promoting their activism and advocacy for community transformation.

The overall goal of my PAR study is to inform broader SRHR policy in Nepal. Building on the findings and lessons from the study, I will suggest strategies for achieving the goals of SRHR policies by building the agency of adolescent girl students and by ensuring that government, communities, schools and teachers can work with girls to create safe, inclusive, and empowering spaces for adolescent girls to enjoy their SRHRs.