Recently, I took an interview with HIV-positive female. Despite her experience of facing violence because of HIV infection, she beautifully said that "Though I have many expereinces of being violenced because of HIV infection, when I compare myself with other rural women of Nepal, who doesnt have access to the facilities, I feel proud, as I am getting a job, infected baby who is getting ART therapy and I am able to live like normal people". It really touched me when she said that she got infection from her husband and he died of the disease. Most astonishing thing is that, she has a child who is 9 years old and is infected with HIV.

It's our lives and we need to tackle as time demands with us.

Young people want to talk with their parents and careers about sexual health. Avoiding the subject won’t stop young people having sex, but it may result in them relying on inaccurate information, putting them at risk of unwanted sex, unintended pregnancy and sexually transmissible infections (STIs).

Young people are exposed to images and stories about sex in the media every day. They talk to their friends and seek out information on the Internet. Not all of this information, however, is accurate or empowering.

Most young people seek information about sexual health at some stage. They most commonly consult either their mother or a female friend; use their school sexual health program, pamphlets or their doctor for information on sexual health.

Talking to young people about sex does not encourage sexual experimentation. In fact, research indicates that young people who receive a comprehensive sexuality (sex) education have a lower risk of unintended pregnancy and are less likely to have sex at an early age.

 Today, on 31st October, 2011 world population is estimated to be 7th billion. The 7 billionth child declared was Nargis, born in India today. Amazing, everything happens in India (just a humor).
Within 50 years, the population of world has doubled, and lets imagine what will happen in next 50 years. If the population grows in the same trend, then will earth be able to hold 14 billion people? Will earths’ resources be enough to full the needs of the human beings? And a dreadful thing, the tigers will be just beautiful in museum, including all animals. If the population will be 50 billion, then will there be a place to live for all human beings. The rainforest will be invaded; even people will start living under the water making houses. I am afraid if the new species of human beings will be generated replacing all other diversity of earth.
Dreadful days are to come and we are to see it. As it is said, for every problem, there is a solution. So, we too have solution to control the population, the net growth rate is not going to work, that one couple produce 2 children replacing them. It will again multiply the population, as for now, one couple bear no or one child. It is the only solution to control population and stop human beings to transform into another species.
Just a flash back, major attempts that I have known to control population, though they were indirectly or directly autocratic.
• European countries like Hungary, Germany, Denmark, etc are having negative population growth rate. The reasons for it are rapid development through industrialization and involvement of people at work. Also, there is large freedom to express their sexuality like either they are lesbian or gay. It might have helped to control population as well.
• Japan, world’s second largest economic country, has caste system, there is discrimination on the basis of caste. It’s a typical Asian country, whatever, there is, it is simply able to engage its people at work for more than 60% of day. So, 40% of time at your house won’t provide you enough time to bear and rear children.
• China, third largest economic country, has one child policy. WOW!!! If you will bear a second child on your will then you are hanged to death. Truly autocratic.
• India, during early ’80s, Indira Gandhi, then president broadly started a campaign of family planning. It became so intense, in fact, it caught the attention of then president so intense and deeply, that even men traveling in train were forcefully vasectomized. Strange but true, and this action was against the human rights and Gandhi’s government was filed a case and the case was in favor of human rights.
In today’s era, everybody loves to be free and do whatever they like. But lets just think what will happen, if everybody is doing whatever they like, then the day is not that far that we will be lucky enough to see new species of human beings.

October 30, 2011 is supposed to get the 7 billionth baby, making the earth’s population to be seven billion.
It’s both a treasure and misery to the earth, the population is a treasure from the business and economic point of view but it’s a misery from the ecological, environmental and reproductive health point of view.
Today, I was Facebooking, and found interesting post from BBC, “what’s your number”, http://www.bbc.co.uk/news/world-15391515 , it interested me as anyone could know which number tag they have carried when they were born on this earth, an assumption. When I was born then I had the tag of 5,009,359,893rd person. It might be interesting to some people in which number they were born. I was quite interested which number would I get, at first. But when I analyzed the consequences that we are facing due to population growth, I was as sad as a gloomy day. Should I not bear baby/babies? Because we have already so many babies on earth, but it sounds ridicule to myself, because I am a human being and of course I would love to see my offspring, I would love to transfer my genes. But the question is will the offspring of all of us get a healthy life as I am getting? We all might feel the same that we are not as strong as our parents and our parents say their parents were so strong in comparison to them. If the trend continues, just imagine how weak and diseased the people of the world will be?
Before 24 years, the population of earth was 5 billion and today (in next few weeks) we are to step in 7th billion number. The population of earth has more than doubled in 50 years. WOW, thanks to family planning, which has been able to ensure so many survivals on earth. But the lagging point was that not all the people used contraceptives, rather they reproduced children and were able to provide care to children and babies due to education and advancement.
As per my knowledge, in Nepal, family planning methods aka contraceptive were introduced in ‘60s but still we have the problem that just 48% people do have access to contraceptives. It’s a shame that in more than 50 years, we are not able to meet the needs of contraception up to 72% (which is supposed to be achieved to control population)
We are to welcome 7 billionth person on this earth with a big question mark to all the people who are concerned about future consequences due to population growth.

“Family Planning saves lives” was first published in 1986 by population Reference Bureau. It provided valuable information to policymakers, program planners, and journalists on the health benefits of family planning. In response to the overwhelming demand for the subsequent editions (published in 1991 and 1997). I was going through the fourth edition which was published in 2009. While the message has not changed, 4th editions show data from the latest research on maternal and child health in developing countries. It has also included new information on how family planning reduces the rate of new HIV infections and deaths from AIDS as well as a Special Focus section on repositioning family planning in sub-Saharan Africa. Some of the relevant points are there that verifies that it saves lives. It of course does. But the problems like high dropout rate due to lack of trust, forgetfulness and belief that family planning reduces pleasure are hindering in the prevalence of FP use.
Adoption of FP is one of the most dramatic changes of the 20th century. The growing use of contraception around the world has given couples the ability to choose the number and spacing of their children and has had tremendous lifesaving benefits. Yet despite these impressive gains, contraceptive use is still low and the need for contraception high in some of the world’s poorest and most populous places.
Recent research is shedding light on how family planning increases survival, improves the health of millions of people, and helps achieve national goals.
A “best buy” among health investments, family planning is one of the most cost-effective, high-yield interventions that exist today. Countries that invest in family planning can reap immediate health benefits, investment savings in the health and education sectors, and social and environmental benefits that extend well beyond a single generation.
Family planning could prevent many more deaths particularly in the poorest countries. The following are the reasons why it saves lives:
• Family planning saves women’s lives. Family planning could prevent as many as one in every three maternal deaths by allowing women to delay motherhood, space births, avoid unintended pregnancies and abortions, and stop childbearing when they have reached their desired family size.
• Family planning saves children’s lives. After giving birth, family planning can help women wait at least two years before trying to become pregnant again, thereby reducing newborn, infant, and child deaths significantly.
• Family planning saves adolescents’ lives. Teen pregnancies pose health risks not only for the babies but also for the young mothers, particularly those under age 18. Family planning can help young women avoid having children during this high-risk time and also avoid the social and economic consequences of early childbearing.
• Family planning reduces deaths from AIDS. The consistent and correct use of condoms can significantly reduce the rate of new HIV infections. Many HIV-positive women and couples want to avoid becoming pregnant and many effective methods are available to assist them.
By averting unintended and high-risk pregnancies, family planning reduces mother-to-child transmission of HIV and the number of AIDS orphans, whose life chances are seriously diminished because they have lost a parent, particularly the mother.
• Family planning helps governments achieve national and international development goals.
Governments around the world are focused on combating poverty and achieving a range of health and development goals, such as those outlined in the United Nations’ Millennium Development Goals (MDGs). Family planning can contribute to nearly all of these goals,

Some of the reasons why teenage pregnancy is being higher around the globe are as follows:

Alcohol: As time has passed, teenagers are being more exposed to alcoholism by different mediums may it be due to the inspirations from the elders or may it be because the advertisers or the promoters of the alcohol target teenagers as the main customers. Many of teenagers go and hang out in the late night parties, girls night out or boy’s night are famous. In many such events, girls come to break their virginity if the parties are for both male and female.

Low aspirations: Teenagers as their age is very tender, they are facing hard times in coping with their changes they are going through. They don’t really don’t feel like they are be handling with responsibilities they will need to take. Most of them set their minds like “It comes and goes, no need to think before twice doing an activity”

Lack of self esteem: Because of the tender age, they have lack of self esteem and are frequently going through the ups and downs in their nerves, sometimes, which may cause their low morale and may be prone to risky behaviors.

Behavioral problems: Again as the adolescents are exposed to drugs, smoking, alcoholism and mass media, they may gain behavioral problems and feel that sex is one of the options to reduce their mental tension. They have the hope that having a partner and romantic relationship may reduce the mental tension they are going through.

Culture that supports teen motherhood: Many countries don’t have restrictions in teenage marriage and pregnancy. The indigenous groups and tribal people have a practice or there is the trend of marrying at teenage.

Lack of appropriate services: Teenage friendly services are very minimal; if present they are not appropriate or according to the demand of their needs. It is recommended that at schools there are AIDS clubs or likeminded clubs at schools so that the teenagers could get suggestions and solve their problems.

This month has been a wonderful month for me. I got an opportunity to meet with adolescents of variety of backgrounds in Surkhet district. The thing is that I am doing a thesis related to adolescent health about their knowledge, exposure to information and risky sexual behavior.
I could feel the ambition in their eyes full of dreams, yet very vulnerable and uncertain about their future, what it would be like. Their enthusiasm and hope for a good life. Some tried to show off because they might have the thinking that they are the ones who know a lot about life.
After the data collection, I had interaction with girls. They were aware that they should not be exposed to risky sexual behavior. They opted for career rather than marriage at an early age. They had access to contraceptives and almost all were aware about the diseases related to reproductive health like HIV and AIDS, the issues like abortion and unwanted pregnancy.
Overall, it was fantabulous experience meeting adolescents feeling their insights and views about their lives and especially what makes me feel great is that I found a vast change in thoughts of the young people than it was before 7-8 years back.

A wise idea would be to provide family planning services rather providing contraception. Contraception is just to control the birth. Family planning is holistic approach where concepts of how to make a family happy are discussed.
World population day was observed on July 11, 2011. It has a special resonance as on this day, world observed a population level of seven million. The population structure is changing as the a huge number of children are reaching child bearing age, so the projection is also going in the same form. If the population projection goes in the same trend then population will reach 10 million by 2050. The consequences like biodiversity loss, loss of non renewable resources and climate are being observed.
The technology and life style of people are also changing, so the paradigm is changing, the trend of demand is also changing its paradigm. Though there are changes still there are high birth rates, along with triple burden of diseases. Still there is high maternal mortality rate and child mortality rate. The parents lack access and utilization of the family planning services.
As one of the key strategies is the achievement of MDGs, it is one of the highlighted and of course a challenge to all the nations of the world. If we need to address development then MDGS achievement is one of the crucial portals.

UN agencies has highlighted a wide areas of issues, with the major three areas of concern in which the intersecting area is “ability to make free and informed childbearing decisions”, the areas are:
• Reproductive health
• Women’s empowerment
• Population and development strategies


One of the critical issues of population dynamics are reproductive health and gender issues. Reproductive and health decisions drive fertility that women and men can or cannot make. The decisions depend on the information, services and commodities available to them. The cultural context, socio economic and educational opportunities have direct impact on the decisions made on fertility. One of the major drivers of population dynamics is affected in terms of the survival of mothers and children during neonatal, prevention and treatment of HIV and AIDS and the general health of families.
Women empowerment is the key to play a fundamental role in the well being of the families by their reproductive and productive lives in their families and community. BY educating the women, there can be a great impact in younger generation. The trends of demography has also altered the decisions that like the social, economic and cultural landscapes that are impacted by the individual reproductive decisions.
ICPD developed the programme of Action which clearly lays out a far sighted 20 year plan for advancing human well being. The Programme of Action clearly addresses a crucial role of every women and addresses almost every aspect of population and development as primary education and health care impact of urbanization, migration, ageing and climate change were as their crucial importance.

Reproductive Health Education is commonly known as sexuality education. Now sexuality education has been a holistic term. The process of acquiring information and forming attitudes and beliefs about sex, sexual identity, relationships and intimacy is known as sex education. It aims at developing young people's skills so that they make informed choices about their behavior, and feel confident and competent about acting on these choices. The sexuality education has been widely accepted worldwide. It is a means to protect themselves against abuse, exploitation, unintended pregnancies, STDs, HIV and AIDS.
Sex education aims
 to reduce the risks of negative outcomes from sexual behavior, such as unwanted or unplanned pregnancies and infection with sexually transmitted diseases including HIV
 contribute to positive experience of sexuality to make informed decisions over lifetime
 helping young people to be safe and enjoy their sexuality
The sexuality education should develop the following skills. The skills are divided into two categories ie general skills and skills to differentiate between right and wrong.
• General life-skills
 communicate, listen, negotiate with others, ask for and identify sources of help and advice which can be applied to sexual relationships
 develops young people's skills in negotiation, decision-making, assertion and listening
 recognize pressures, dealing with and challenging prejudice and seek help from adults
• Enable to differentiate between
 accurate and inaccurate information
 discuss moral and social issues and perspectives on sex
Sexuality, including different cultural attitudes and sensitive issues like sexuality, abortion and contraception.
The following information should be provided to young people
Exposure to a wide range of sources including each other, through the media including advertising, television and magazines, as well as leaflets, books and websites. Some of this will be accurate and some inaccurate. For example, young people may have heard that condoms are not effective against HIV or that there is a cure for AIDS. It is important to provide information which corrects mistaken beliefs. Without correct information young people can put themselves at greater risk.
1. Information about sex and sexuality
• Sexual development & reproduction - the physical and emotional changes associated with puberty and sexual reproduction, including fertilization and conception, as well as sexually transmitted diseases and HIV.
• Contraception & birth control - what contraceptives there are, how they work, how people use them, how they decide what to use or not, and how they can be obtained.
• Relationships - what kinds of relationships there are, love and commitment, marriage and partnership and the law relating to sexual behavior and relationships as well as the range of religious and cultural views on sex and sexuality and sexual diversity.
Information about abortion, sexuality, and confidentiality, as well as about the range of sources of advice and support that is available in the community and nationally.
When should sex education start?
Sex education that works starts early, before young people reach puberty, and before they have developed established patterns of behavior. The precise age at which information should be provided depends on the physical, emotional and intellectual development of the young people as well as their level of understanding. It is important for sex education to begin at a young age and also that it is sustained. Provides the foundation on which more complex knowledge is built up over time. Examples: Human life cycle and knowledge on bacteria and viruses.
“Providing basic information provides the foundation on which more complex knowledge is built up over time.”

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