Demography and Health

MPH Ist Year
Demography and Health
Prabesh Ghimire
Demography and Health MPH 1st
Year
Table of Contents
UNIT 1: INTRODUCTION TO DEMOGRAPHY AND HEALTH ..................................................................... 4
Introduction to Demography: ................................................................................................................... 4
Population Pyramid................................................................................................................................... 5
Concept of Young and Old Population ...................................................................................................... 6
Aging of Population ................................................................................................................................... 7
Dependency Ratio ..................................................................................................................................... 8
UNIT 2: MEASURES OF FERTILITY, MORTALITY, MIGRATION, URBANIZATION AND NUPTIALITY ........... 8
UNIT 2.1: FERTILITY AND ITS MEASURES .............................................................................................. 8
Measures of fertility and reproduction: ................................................................................................... 8
Measures of Reproduction ................................................................................................................. 10
Replacement Level Fertility................................................................................................................. 10
Population Momentum....................................................................................................................... 10
Determinants of Fertility ......................................................................................................................... 11
Baby Boom and Baby Bust Syndrome ..................................................................................................... 12
UNIT 2.2: MORTALITY AND ITS MEASURES ......................................................................................... 13
Measures of Mortality ............................................................................................................................ 13
Determinants of Mortality ...................................................................................................................... 15
Standardization of Death Rates .............................................................................................................. 16
Life Table ................................................................................................................................................. 19
UNIT 2.3 MIGRATION AND ITS MEASURES ......................................................................................... 23
Basic Terminology of Migration .............................................................................................................. 23
Determinants of Migration ..................................................................................................................... 23
Measures of Migration............................................................................................................................ 24
Simple Measure to Calculate Internal Migration ................................................................................ 24
UNIT 2.4: NUPTIALITY AND ITS MEASURES ......................................................................................... 25
Basic Terminologies of Nuptiality ........................................................................................................... 25
Determinants of Nuptiality ..................................................................................................................... 26
Simple Measures of Nuptiality ................................................................................................................ 26
UNIT 2.5: URBANIZATION AND ITS MEASURES ................................................................................... 28
Basic Terminology of Urbanization ......................................................................................................... 28
Prabesh Ghimire Page | 2

Year
Measures of Urbanization....................................................................................................................... 29
UNIT 3: POPULATION ESTIMATES AND PROJECTIONS ......................................................................... 33
UNIT 4: POPULATION THEORIES AND POLICY ..................................................................................... 38
UNIT 4.1: POPULATION THEORIES ...................................................................................................... 38
Early Thinking on Population Issues........................................................................................................ 38
Malthusian Theory of Population: .......................................................................................................... 39
NEO-MALTHUSIANISM ............................................................................................................................ 40
Demographic Transition Theory ............................................................................................................. 41
UNIT 4.2: POPULATION POLICY .......................................................................................................... 43
Concept of Population Policy .................................................................................................................. 43
UNIT 5: HUMAN DEVELOPMENT INDEX .............................................................................................. 46
Concept of Human Development Index.................................................................................................. 46
Construction technique of HDI ............................................................................................................... 47
Current position of countries in HDI ....................................................................................................... 48
UNIT 6: POPULATION, ECOLOGY AND DEVELOPMENT ........................................................................ 48
Population Explosion and Its Effect in Ecology and Public Health .......................................................... 48
IMPORTANT FORMULA ...................................................................................................................... 50

Year
UNIT 1: INTRODUCTION TO DEMOGRAPHY AND HEALTH
Introduction to Demography:
Donald Bogue, in his book entitled Principles of Demography defines demography as the statistical and
mathematical study of the size, composition and spatial distribution of human population, and of changes
over time in these aspects through the operation of the five processes of fertility, mortality, marriage,
migration and social mobility.
Sources of Demographic and health data

Reliable, timely and relevant demographic data have been considered essential to develop, implement,
monitor and evaluate the population and associated programmes. Sufficient data need to be made
available at national, regional and local level to undertake research works and policy decisions
concerning population and development.
Basically demographic data in Nepal can be obtained from five different sources such as
i. Population Censuses
ii. Demographic Sample Surveys
iii. Vital Registration
iv. Population Registers
v. Administrative Statistics/Official records
i. Population Census:
United Nations (1958) defines census as A census of Population May be defined as the total process
of collecting compiling and publishing demographic economic and social data pertaining at a specified
time or times to all persons in a country or delimited territory.
The most comprehensive and widespread demographic data for Nepal can be obtained from census
which is conducted every ten years. The first population count in Nepal was carried out in the year
1911. Since then censuses in Nepal are being carried out at an interval of more or less ten years.
Latest census of Nepal was carried out in 2011 which provides data on numerous demographic
variables.
ii. The Demographic and Sample Surveys

A sample survey is cheaper and easier to administer than a census. It involves the selection of
population who represent the whole population, or a particular sub-group of population. A sample can
get more detailed and higher quality information than a census, because more time and effort can be
spent on each interview.
Some of the major demographic and sample surveys conducted in Nepal are
SN Surveys Years conducted Organization
1 Nepal Demographic and Health Survey 2001, 2006, 2011 MOH(P)
2 Nepal Adolescent and Youth Survey 2010/11 MOHP
3 Nepal Living Standard Survey 1996, 2003, 2009 CBS
4 Nepal Family Health Survey 1996 MOHP
Nepal Demographic Health and Survey is one of the most popular sample survey conducted in Nepal
every five years. These surveys have provided reliable estimates of fertility, family planning, mortality
and health indicators for Nepal.

Year
iii. Vital Registration

Vital Statistics viz; data on births deaths, migration, marriages, and divorces etc; provide data on a
continuous basis. Therefore these data are very useful in studying population dynamics over the
years.
The vital registration system in Nepal covers the following events
Birth
Deaths
Marriage
Migration and finally
Divorce
In Nepal, Vital registration was launched in 2035 B.S and was gradually expanded to all the 75
districts of the country. This system is currently maintained by Ministry of Federal Affairs and Local
Development. However due to various reasons /limitations & constraints, most of the vital events are
not registered or even if they are registered, they are registered very late. Thus the data obtained
from the vital registration system are not often used for demographic analysis.
iv. Population Registers

Another source of population data is Population Register, which provides a continuous record of
changes in population movements. Population movements and changes therein are registered in
population registers in an integrated manner.
Basically the population registers are maintained for data on a) vital events b) Current estimate of the
population both at the national and sub-national level and c) statistics on migratory movements.
Although these registers provide useful data, this system is not maintained in Nepal.
v. Administrative Statistics/ Official Records:

Population related data are also available through administrative records/official records. These
records are maintained as part of the service delivery by the government. For example, the Family
Health Division under Department of Health Services maintains data on number of sterilization
performed under the mobile sterilization services. More detailed data on the health services delivered
are available through the annual report of the Department of Health Services. In a likewise manner,
the annual reports and different reports published by the Ministry of Education, other ministries and
organizations including researchers are important sources of data related to population.
Population Pyramid
A Population Pyramid is a graph that shows the age-sex distribution of a given population. It a graphic
profile of the populations residents. Sex is shown on the left/right sides, age on the y-axis, and the
percentage of population on the x-axis. Each grouping (eg: males aged 0-4) is called a cohort.
A population pyramid does not tell about the actual population in numbers. Rather, it displays
percentages and shows what portion of people fall into each cohort. Public Health experts can use
population pyramids to see population trends in the past, examine the current resident profile, and also to
project how the population will increase/decrease in the future. This can provide valuable information for
current and future health planning.
Pyramids can be used in helping to predict changes in the age structure of the population over the next
fifty or so years so that necessary health plans can be introduced to cope with the predicted demographic

Year
changes. For example, increase in female population of reproductive age may suggest increasing
availability of reproductive health services including family planning measures.
Types of Population Pyramid

There are generally three types of population pyramids created from age-sex distributions--expansive,
constrictive and stationary.
i. Expansive
- Expansive population pyramids show larger numbers or percentages of the population in the younger
age groups.
- These types of pyramids are usually found in populations with very large fertility rates and lower than
average life expectancies.
- The age-sex distributions of many Third World countries would probably display expansive population
pyramids.
ii. Constrictive
- Constrictive population pyramids display lower numbers or percentages of younger people.
- The age-sex distributions of the United States fall into this type of pyramid.
iii. Stationary
- Stationary or near-stationary population pyramids display somewhat equal numbers or percentages
for almost all age groups.
- Of course, smaller figures are still to be expected at the oldest age groups.
- The age-sex distributions of some European countries, especially Scandinavian ones, will tend to fall
into this category.
Concept of Young and Old Population
The age structure of a society is shaped by the processes of fertility, mortality and migration. A country
may grow older or younger depending upon changes in the fertility rate, mortality rate, or the rate of
migration.
- When we refer to a population becoming younger or older, we are actually referring to the age
distribution of a population, or the age-structure.
- A population is considered to be young when there are proportionately more young people than
people of other ages. A very popular measure of the youngness of a population is the percentage of
population under 15 years of age. The high-fertility countries of Africa with large proportions of young
adults and children are examples.
- It may be equally important to know something about the older part of a population. Currently, many
European countries are concerned over the fact that the population is growing older.

Year
- Normally we think of a population growing older when people live longer, but another factor that
causes a population to age is declining fertility.
- The average age of a population will increase when fewer babies are being born, because there will
be fewer young people to pull the average down. Conversely, when the fertility rate is high or
increases, a population will become younger.
- Mortality changes also influence the age distribution of a population. However, under certain
condition, death rate declines may actually cause a population to become younger.
- These two types of populations have markedly different age compositions; as a consequence, they
also have different proportions of the population in the labor force or in school, as well as different
medical needs, consumer preferences, and even crime patterns. A populations age structure has a
great deal to do with how that population lives.
- Developing countries have relatively young populations while most developed countries have old or
aging populations. In many developing countries, 40 percent or more of the population is under age
15, while 4 percent is 65 or older. On the other hand, in virtually every developed country, less than
25 percent of the population is under age 15 and more than 10 percent is 65 or older.
- In Nepal, currently 34.9% population is in a younger age while 8.1% population is in the older age
(60+ yrs) and 5.3% (in 65+ yrs). . This data shows that the country falls slightly towards the young
population but is gradually aging.
Aging of Population
In demographic studies, increase in the mean or median age of the population is called the ageing of the
population.
Aging of population (also known as population aging) is a summary term for shifts in the age distribution
(i.e., age structure) of a population toward older ages. It is a natural outcome of demographic transition
from high fertility and mortality to low fertility and mortality.
Recently, worldwide population aging has been considered one of the most important demographic
phenomena. It is the product of clear decreases in birth and mortality rates and an increase in life
expectancy. the worldwide population aged 60 years and older will surpass from approximately 770
million in 2010 to an estimated one billion in 2020, and 20.0% of these people will be concentrated in
developing countries.
The number of people aged 65 years and above in Nepal was 1,397,583 according to the population
census of 2011. This number accounts for 0.24% of old persons in the world and 5.27 % of Nepals
population in 2011. In relation to the growing population, the volume of old persons is also increasing in
Nepal in every successive census.
In Nepal, recently ageing of population is an emerging social issue because fertility has started going
down in recent years, the mortality is declining fast and the life expectancy is continuing to increase for
both sexes in Nepal. According to the Nepal Demographic Health Survey 2011, the total fertility
decreased to 2.6 from 3.1 in 2006. However, a continued increase in the percentage of aged persons in
the population is creating humanitarian, social and economic problems in many less developed countries
like Nepal. Past high fertility rates, combined with the decline in mortality has resulted in substantial
growth in the number of old persons and, in conjunction with the subsequent fertility decline, to an
increasing share of the elderly in the overall population.

Year
SN Census Year Elderly Population Indices of Ageing (60+) Percent of elderly (60+)
growth rate
1 2001 3.5 16.7 6.5
2 2011 23.3 8.1
The increasing proportion of older persons compared to young person is called the ageing index. In 2011,
the ageing index increased sharply and reached 23.3, higher for females than males. This might be due
to the combined effects of declined fertility and mortality and a population shift from younger to old age.
All age related indicators are in an increasing trend which suggests that the ageing of population is
increasing
Dependency Ratio
The age-dependency ratio is the ratio of people in the dependent ages (those under age 15 and ages
60 and older) to those in the economically productive ages (15 to 60 years) in a population.
The age-dependency ratio is often used as an indicator of the economic burden the productive portion of
a population must carryeven though some people defined as dependent are producers and some
people in the productive ages are economically dependent
Countries with very high birth rates usually have the highest age-dependency ratios because of the large
proportion of children in the population. The age-dependency ratio is sometimes divided into old-age
dependency (the ratio of people ages 60 and older to those ages 15 to 60) and child dependency (the
ratio of people under age 15 to those ages 15 to 60).
Nepals dependency ratio in 2011 was 76 per 100, meaning that for every 100 persons in the working age
population, 76 persons were dependents. The data from last two censuses show that child dependency is
decreasing while old dependency is increasing in Nepal.
UNIT 2: MEASURES OF FERTILITY, MORTALITY, MIGRATION, URBANIZATION AND NUPTIALITY
UNIT 2.1: FERTILITY AND ITS MEASURES
Fertility refers to the number of live births women have. Fertility is one of the main factors in determining
the age structure of a population. The study of fertility is complex because it is affected by host factors
including biological as well as behavioral
Measures of fertility and reproduction:
i. Crude Birth Rate: The Crude Birth Rate (CBR) indicates the number of live births per 1,000 mid-year
total population in a given year.
- The Crude Birth Rate of Nepal is 24.3 births per 1000 mid-year population (2011)

= 1000

- Crude death rate is affected by age structure of the population

Year
ii. Child Women Ratio:

- Child Woman ratio is one of the proxy indicators of fertility levels.
- This ratio is particularly useful in a country where there is no fertility related information either from
censuses/surveys or a vital registration system.
- This ratio is normally calculated by dividing the total observed number of children below five years by
the number of women aged 15 to 49 years.
- The child women ration of Nepal is 0.36 in 2011 which declined from 0.49 in 2011.
5
=
15 49
iii. General Fertility Rate:

- The general fertility rate (also called the fertility rate) is the number of live births per 1,000 women
ages 15 to 49 in a given year.
- The general fertility rate is a somewhat more refined measure than the birth rate because it relates
births to the age-sex group at risk of giving birth (usually defined as women ages 15 to 49). This
limitation helps eradicate distortions that might arise because of different age and sex distributions
among populations.
- Thus, the general fertility rate is a better basis to compare fertility levels among populations than are
changes in the crude birth rate.
/
= 1000
15 49
iv. Age Specific Fertility Rate (ASFR)

- The general fertility rate is not a very effective refinement of crude birth rate. It loses sight of the fact
that fecundity of women changes during the span of the child bearing period. Therefore further
refinement of fertility measured leads to the development of Age Specific Fertility Rate

= 1000

- Age specific fertility rates are not affected by variations in age structure.
v. Total Fertility Rate (TFR)

- The total fertility rate (TFR) is the average number of children that would be born to a woman by the
time she ended childbearing if she were to pass through all her childbearing years conforming to the
age specific fertility rates of a given year.
- The TFR is one of the most useful indicators of fertility because it gives the best picture of how many
children women are currently having.
- Total fertility rate is the sum of the age specific fertility rates of women in each five-year age group
from 15 to 49 years.
- This is computed by dividing the number of births with the number of women multiplied by 1,000.
- The TFR is a synthetic measure; no individual woman is very likely to pass through three decades
conforming to the age-specific fertility rates of any single year.
- The Total Fertility Rate of Nepal is 2.6 (NDHS,2011)
7=0 ASFR age interval

=
1000

Year
Measures of Reproduction
i. Gross Reproduction Rate (GRR)
- The gross reproduction rate (GRR) is the average number of daughters that would be born to a
woman (or group of women) during her lifetime if she passed through her childbearing years
conforming to the age-specific fertility rates of a given year.
- This rate is like the TFR except that it counts only daughters and literally measures reproductiona
woman reproducing herself by having a daughter.
GRR = TFR * proportion of female births

GRR = TFR * (female births/ total births)
ii. Net Reproduction Rate (NRR)

- The net reproduction rate (NRR) is the average number of daughters that would be born to a woman
(or group of women) if she passed from birth to the rest of her life conforming to the age-specific
fertility and mortality rates of a given year.
- This rate is like the GRR, but it is always lower because it takes into account the fact that some
women will die before completing their childbearing years.
7
5 =0(ASFR S)
=
1000
Where, S= Survival rate
Replacement Level Fertility

- Replacement-level fertility is the level of fertility at which women in the same cohort have exactly
enough daughters (on average) to replace themselves in the population. A NRR of 1.00 is equal to
replacement level.
- Once replacement-level fertility has been reached and remains there, births will gradually reach
equilibrium with deaths, and in the absence of immigration and emigration, a population ultimately will
stop growing and become stationary in both size and age structure. The time this process takes
varies greatly depending upon the current age structure of the population.
- Today, virtually all developed countries are at or below replacement-level fertility.
- The TFR can also be used to indicate replacement-level fertility by showing the average number of
children sufficient to replace both parents in the population. In developed countries today, a TFR of
about 2.1 is considered to be replacement level.
- Replacement-level TFRs higher than 2.0 (one child for each parent) are needed because there are
slightly more males than females born and not all females survive to their childbearing years. In
developing countries with much higher mortality rates, TFRs of more than 2.1 result in replacement-
level fertility.
Population Momentum
- Population momentum refers to the tendency of a population to continue to grow after replacement-
level fertility has been achieved.
- A population that has achieved replacement or below-replacement fertility may still continue to grow
for some decades because past high fertility leads to a high concentration of people in the youngest
ages. Total births continue to exceed total deaths as these youths become parents. Eventually, this
large group becomes elderly and deaths increase to equal the number of births or outnumber them.
Thus it may take two or three generations (50 to 70 years) before each new birth is offset by a death
in the population.
- Population momentum represents natural increase to the population.

Year
Determinants of Fertility
The various factors affecting fertility includes:

1. Age at Marriage:
- Age at marriage is an important determinant of total fertility.
- There is a direct relationship between age at marriage and fertility- the lower age at marriage, the
longer is the fertility period or the fertility span, and the higher is the fertility.
- Conversely, the higher the age at marriage, the shorter is the fertility span and the fertility rate
decreases.
- More than half of young girls are married off by the age of 18 years in all rural areas and most urban
areas of Nepal. The median age at Marriage for females in Nepal was 18 years in 2011.
2. Fecundity
- It refers to the capacity to reproduce children. The genetic fertility of women is an important biological
factor.
3. Sterility
- Both men and women are responsible for lower fertility.
- The lower the proportion of sterility, the higher is the rate of fertility.
4. Age at first birth

- The onset of childbearing at an early age lengthens the reproductive period, thereby increasing the
level of fertility.
- The median age of first birth is 20.1 years.
5. Intervals between birth (spacing):

- Birth interval is the length of time between two successive live births.
- Information on birth intervals provides insight into birth spacing patterns, which affect fertility.
- The median birth interval in Nepal is 36.2 months.
6. Postpartum Amenorrhea, abstinence and insusceptibility:

- Postpartum amenorrhea is the interval between the birth of a child and the resumption of
menstruation, a period during which the risk of pregnancy is much reduced thereby reducing the
fertility.
- Postpartum protection from conception depends upon the intensity and duration of breastfeeding.
Postpartum abstinence refers to the period of voluntary sexual inactivity after childbirth.
- A woman is considered insusceptible if she is not exposed to the risk of pregnancy, either because
she is amenorrheic or because she is abstaining from sexual intercourse following a birth.
- Nepalese women are amenorrheic for a median of 6.6 months, abstain for a median of 3.0 months,
and are insusceptible to pregnancy for a median of 8.2 months.
7. Menopause:
- The risk of becoming pregnant declines with age.
- The term infecundity refers to a process rather than a well-defined event, and although the onset of
infecundity is difficult to determine for an individual woman, there are ways of estimating it for a group
of women.
- NDHS, 2011 of Nepal shows decreasing exposure to the risk of pregnancy (infecundity) for women
age 30 or above.

Year
8. Education
9. Proportion of married women or in union
10. Percentage of women breastfeeding exclusively
11. Universality of marriage
12. Duration of married life
13. Less available health care
14. Contraceptive use
15. Economic status
16. High infant mortality
Baby Boom and Baby Bust Syndrome
Baby Boom Syndrome

- The term baby boom syndrome is used to identify a massive and unprecedented increase in birth
following world war II.
- The period following world war II from 1946-1964 was marked by a dramatic increase in fertility rates
and in the absolute number of births in countries (United States, Canada, Australia, New Zealand)
who participated in world war II.
- Baby boomers are those persons born worldwide between 1946 and 1964.
- During this period of baby boom, approximately 79 million babies were born in US alone.
Impacts of Baby Boom

- After WWII, returning military personnel faced a severe housing shortage
- In response to the crisis, developers used assembly-line methods to mass produce houses. Suburbs
were born.
- Men were expected to work, while women were expected to stay home and care for the children.
- Divorce rates surged.
- Baby boomers filled the job market making it difficult for next cohort (Baby Bust) to find jobs.
- Increase loads to health care, social services and pension plans.
Causes of baby boom syndrome

i. Catch up fertility
- The fertility went up after the war because marriages and pregnancies that had been postponed
during wartime or during the economic depression were taken up again.
ii. Role of marriage

- Rising marriage rates during the baby boom era was a key factor behind the rise of period fertility.
- Decline in average age at marriage contributed to a rise of total marital fertility.
iii. Demobilization of military personnel

iv. Relative wage of women
- It is argued that during the baby boom period, the relative wages of women were low and this lowered
the opportunity costs of having children. At the same time, the wages of husbands were rising. This
generated a positive income effect on fertility.

Year
Baby Bust Syndrome

- The period immediately after the baby boom from late 1960s and early 1970s marked by a rapid
sudden decline in the fertility rates is termed as baby bust syndrome.
Causes of baby bust syndrome

- High divorce rate
- Increase in the proportion of never married
- Increase in illegitimate fertility
- Development of concept of equal status of women
- Increase in abortion rate
- Development of science and technology
- Increase in female wages and income; women entered the workforce
UNIT 2.2: MORTALITY AND ITS MEASURES
Measures of Mortality
Various measure of Mortality Includes

i. Crude Death Rate
ii. Age Specific Death Rate
iii. Under-5 Mortality Rate- 54 per 1000 live birth
iv. Infant Mortality Rate- 46 per 1000 live births
v. Neonatal Mortality Rate (0 -28 days) 33 per 1000 live births
a. Early Neonatal Mortality Rate (0-7 days)
b. Late Neonatal Mortality Rate (8-28 days)
vi. Post Neonatal Mortality Rate (29 days to 1 yr)
vii. Perinatal Mortality Rate (still birth+ early neonate)- 37 per 1000 pregnancies
i. Crude Death Rate: The Crude Death Rate (CBR) indicates the number of deaths per 1,000 mid-year
total population in a given year.

= 1000

- Crude death rate is affected by age structure of the population.
ii. Age Specific Death Rate (ASDR)

- The age specific fertility rate is defined as the number of deaths per year in a specific age group per
1000 persons in the same age-group

= 1000

Advantages
- Age specific fertility rates are not affected by variations in age structure.
- Can compare mortality at different ages
- Can compare mortality in the same age groups over time and/or between countries and areas.
- Can be used to calculate life tables to create an age-independent measure of mortality (life-
expectancy)

Year
iii. Cause specific death rate

- Cause specific death rates are deaths attributable to particular cause per 10,000 or 100,000 total
number of deaths.
iv. Infant Mortality Rate (IMR)

- Number of deaths of infants under age 1 per year per 1000 live births in the same year.
(. )
= 1000

- Infant Mortality of Nepal in 46 per 1000 live births (NDHS, 2011)
Why infant mortality rate?

- IMR is a good indicator of the overall health status of a population.
- It is a major determinant of life expectancy at birth
- IMR is sensitive to levels and changes in socio-economic conditions of a population.
Factors affecting IMR of a country

Endogenous Factor Exogenous Factors
- Age of Mother - Nutrition of mother and infants
- Birth order of the child - Infections and disease (malaria, measles,
- Parity diarrhoea, pneumonia, etc.)
- Birth Intervals - Adverse environmental conditions
- Weight at birth (congestion, lack of sanitation and safe
- Multiple birth drinking water)
- Premature birth - Availability of health services
Immunization
Diarrhoea control
ARI control
- Socio-economic status
- Maternal literacy
v. Neonatal Mortality Rate (NMR)

- Deaths of neonates (upto 28 days of life) per 1000 live births.
- NMR of Nepal is 33 deaths per 1,000 live births.
(. (0 28 ) )
= 1000

vi. Maternal Mortality Ratio

- Number of women who die as a result of complications of pregnancy or childbearing in a given year
per 100,000 live births in that year.
- MMR represents the risk associated with pregnancy.
(. )
= 100,000


Year
vii. Life Expectancy at Birth

- Life expectancy at birth is defined as the average number of years a new born baby will survive if s/he
is subjected to the current mortality pattern.
- Life expectancy like the TFR is also a synthetic cohort measure.
- It is a hypothetical measure because it is based on current death rates and actual deaths changes
(usually improves) over the course of persons lifetime.
- This measure of mortality is free from distortions of age composition and thus international
comparisons can readily be made.
- To calculate life expectancy we need the age specific mortality rates, which are difficult to obtain, as it
requires a survey of large sample size. Furthermore, as the coverage of birth and death registration
data is poor, life expectancy in Nepal is usually estimated based on the census data, employing
indirect techniques such as life table technique.
Determinants of Mortality
Determinants of mortality can be categorized into proximate (direct) and non-proximate (indirect)
determinants. Proximate determinants could also be described as the biological and the behavioural
causes of death, whereas the indirect determinants of mortality concern social, economic, political and
cultural factors that influence mortality.
Determinants of mortality differ for children and adults which are summarized separately as follows:
Determinants of mortality in children

i. Proximate determinants
- Maternal fertility behaviour
- Household environmental pollution- ARI, diarrhoeal diseases
- Feeding practices Reduced breast-feedingmalnutrition repeated infections
- Diseases- measles, pertusis, diphtheria, poliomyelitis, tetanus, etc
- Injuries and poisoning
ii. Non-proximate determinants

- Ecological factors
- Individual factors- e.g education level of mother
- Household factors e.g. housing, sanitation facilities, water supply, etc.
- Institutional factors- accessibility and affordability of MCH services
- Cultural factors
Determinants of mortality in adults

i. Apparent poor health: e,g, heart attack, stroke, cancer, cirrhosis of liver, etc.
ii. Individual health behaviour: e.g. smoking, diet practices, alcohol and drug abuse, lack of physical
activity.
iii. Social determinants: marital status, educational level, income, degree of health conscious,
profession, migration status
iv. Environmental factors: Exposure to infectious or chemical or physical agents, occupational hazards,
etc.
v. Injuries: Incidental or accidental injuries
vi. Health Service factors: use of health services, accessibility, affordability, etc.

Year
Standardization of Death Rates
Standardization is a method of adjustment generally done for age differentials with an objective to remove
the effect of differential mortality or differential structure of the subgroups in the two populations under
comparison. The rates are then brought to a common base and thus made comparable.
- When comparing two or more populations with respect to a health outcome, it is tempting to compare
crude rates of disease, i.e., the number of disease events divided by the size of the population.
- Comparisons of crude rates can be misleading because of confounding if the populations being
compared have different distributions of other determinants of disease, such as age which has an
important effect on many health outcomes.
- As a result, differences in age can distort other comparisons between populations, and this distortion
is called confounding.
- To eliminate the distortion caused by different underlying age distributions in different populations,
statistical techniques are used to adjust or standardize the rates among the populations to be
compared.
- The two closely related techniques are commonly used to compute standardized rates that facilitate
comparisons among population.
i. Direct standardization
- Direct standardization applies a standard age distribution (standard population) to the populations
being compared in order to compute summary rates indicating how overall rates would have
compared if the populations had had the same age distribution.
- This method is used when age-specific rates of disease are known for the populations being
compared.
- The standard population is usually the population of the whole country if we are making
comparison of rate in two districts.
- The physical meaning of direct standardized death rate of population is that it is a crude death
rate that would result if the age specific death of the population under study would be applied to
that of standard population.
- Direct standardized rate can be calculated as
( )
=

Where,
= Age specific death rate of population to be standardized
= Population in a specific age group of a standard population
= Total population in a standard population
Steps in direct standardization

i. Calculate the age specific death rates for each age group in population which is to be compared.
ii. Create a new "Standard Population" for each age group by adding population say A and B for each
age group or by taking one of the population itself as standard.
iii. Calculate the expected number of deaths for each age group in the standard population by
multiplying the standard population by the age specific rates for the population, which is to be
compared.
iv. Complete this process for each age group and for each population separately.

Year
ii. Indirect standardization

- Indirect standardization applies a standard set of age-specific rates of disease to the populations
being compared in order to compute the number of cases of disease that would be expected in a
given population, based on its size and age-distribution.
- In this method, we require the knowledge of age distribution and crude death rate of the
population being compared and age-specific death rate of standard population.
- The formula for calculating ISDR can be expressed as:

=
( )

Where,
= Crude death rate of population (P) being standardized
= Crude death rate of standard population (S)
= Population of particular age group in population being standardized
= ASDR in standard population
= Total population in the population being standardized
Numerical Example:
2. Compare the mortality rates of two population using direct standardized technique
Age Group Population A Population B
(in years) Population (000) Deaths Population (000) Deaths
0-10 20 400 40 400
10-35 50 500 120 240
35-55 90 450 160 800
55+ 40 800 80 2560
Total 200 2150 400 4000
Solution,
First, we consider one of the population as standard. Here, we assume population A as standard.
Therefore, we calculate ASDR for each age group in population B.
Population Deaths Population Deaths ASDR
(000) (000)
0-10 20 400 40 400 10
10-35 50 500 120 240 2
35-55 90 450 160 800 5
55+ 40 800 80 2560 32
Total 200 2150 400 4000
2150
= 1000 = 10.75/1000
200000
4000
= 1000 = 10/1000
400000

Year
When comparing CDR of two places, mortality seems higher in city A. Now, we wish to compare two
mortalities by age-adjusting the population of city B.
( )
=

(1020,000)+ (250,000)+ (590,000)+ (3240,000)

=
200,000
2,030,000
= = 10.15
200,000
When this standardized mortality rate of city B is compared with CDR of City A, we can conclude that
death rate of City A is higher than city B even after standardization.
3. Compare the mortality rates of two population using indirect standardized technique
(in years) Population (000) Deaths Population (000) Deaths
0-10 20 400 40 400
10-35 50 500 120 240
35-55 90 450 160 800
55+ 40 800 80 2560
Total 200 2150 400 4000
Solution
First, we consider one of the population as standard. Here, we assume population A as standard.
Therefore, we calculate ASDR for each age group in population A.
(Note: Usually in indirect standardization technique, the age-specific death rate of population being
compared is unknown)

(in years) Population (000) Deaths ASDR Population Deaths
(000)
0-10 20 400 20 40 400
10-35 50 500 10 120 240
35-55 90 450 5 160 800
55+ 40 800 20 80 2560
Total 200 2150 400 4000
2150
= 1000 = 10.75/1000
200000
4000
= 1000 = 10/1000
400000
When comparing CDR of two places, mortality seems higher in city A. Now, we wish to compare two
mortalities by age-adjusting the population of city B by indirect technique.

=
( )


Year
First we calculate index of death rate as

(40,000 20) + (120,000 10) + (160,000 5) + (80,000 20)
=
400,000
4,400,000
= = 11
400,000
Now,

=

10 10.75
= = 9.77
11
When this standardized mortality rate of city B is compared with CDR of City A, we can conclude that
death rate of City A is higher than city B even after standardization. i.e. City B is healthier.
Life Table
According to Donald Bogue, the life table is a mathematical model that portrays mortality condition at a
particular time among a population and provides a basis for measuring longevity.
A life table is a table which shows, for a person at each age, what the probability is that they die before
their next birthday. From this starting point, a number of statistics can be derived and thus also included
in the table is:
the probability of surviving any particular year of age
the remaining life expectancy for people at different ages
the proportion of the original birth cohort still alive.
Uses and Applications

Life table is a simple tool used not only for mortality but also for other vital events like natality (fertility),
reproduction, chances of survival etc. So it has diverse applications.
Life table can be used to find the number of survivors out of 1000 at birth e.g.
- Number of children likely to enter primary school at the age of 5
- The number of women entering fertile period, or no. of women reaching menopause at particular age
- Expectation of life at birth
- Survival rate after treatment or operation
Other Applications
- Life table can be used to study divorce pattern, labour force participation
- Life table has also been used to estimate the population by age sex
Types of Life Tables

Basically life table can be categorized into two types according to reference year:
i. Current Life Table
ii. Cohort/ Generation Life Table

Year
i. Current Life Table

- It is based upon the mortality experience of a community for a short period of time such as one year.
- The current life table does not depict mortality experience of an actual cohort.
- Here we assume a hypothetical cohort that experience the ASDR observed during a particular time.
- Thus current life table can be viewed as a snapshot of current situation of mortality.
- It gives an excellent summary description of mortality in a year or short period of time.
ii. Cohort/ Generation Life Table

- The generation life table is based on the mortality rates experienced by a particular cohort such as all
persons born in the year 2011 data are collected by following a cohort throughout its life.
- This life table would observe the mortality experience of that particular birth cohort from its beginning
till the death of member of the cohort.
- Data over a long period of years are needed to complete a single life table and hence cohort life
tables are not much practical and not commonly used.
Usually there are two ways of presenting current or cohort/generation life table: Complete and Abridge life
table
- In complete life table, information is given for every single year of age from birth until the last age.
- In abridge life table, information is given only for broader age intervals such as X to X+1 years or X to
X+5 years.
- Simple abridge table is usually preferred than more detailed complete life table because it is less
laborious to prepare and is reliable for most purposes and more convenient to use.
Assumptions for construction of life table

- There is no change in mortality rates over time, which means that the given schedule of risks remain
constant.
- The cohort is closed which means that there is no out migration or in-migration. Changes take place
only due to mortality.
- A hypothetical cohort or radix is usually set at 1000 or 10,000 persons to simplify the comparability of
survivors in the life table. This is also useful to study two life tables for different times and place.
- Life tables are generally proposed for homogenous sexes because there is difference in age-specific
death rates for men and women.
Structure of Life Table

Life table consists of eight columns which are described as follows:
i. First Column (x)
- In this column, age is entered in serial order from zero to maximum.
- Age-intervals may also be used.
ii. Second Column (l x )

- This column shows the number of persons living at age x in which the initial figure will be those of
newborn babies who begin the first year of their life together.
- For example, 10,000 babies at birth, 95,531 survivors at age 1, 95,250 survivors at age 5 and so on.
iii. Third Column (d x )

- This column reveals the number of dead persons between each age x and the succeeding year of
age (x+1).
- Usually it is a age specific death.

Year
- d x = l x -l x+1 or d x = l x q x
- Thus number of survivors at age x+1 will be l x+1 = l x - d x
iv. Fourth Column (q x )

- This column presents the probable mortality rate between every age and succeeding age (x+1).
- The mortality rate is obtained by dividing the number of dying persons (d x ) at each age by the number
of people surviving at that age
- q x = d x /l x
v. Fifth Column (P x )
- P x indicates the probability of survival between the year x and x+1.
- The relative P x can be obtained by subtracting q x from 1.
- P x = 1-q x
vi. Sixth Column (L x )

- This column portrays the average number of survivals between age x and x+n,
+ +1
- Under assumption of linearity, = , where n is the age interval
2
vii. Seventh Column (T x )

- It shows the total number of surviving people at L x age who are likely to live for some more years.
- This can be calculated by adding the values in the preceeding column from bottom to top.
- T x = L x +L x+1 +L x+3 .
- T x = T x-1 L x-1
viii. Eighth Column (e0 X )

- This column gives the average life expectancy of the population at x years of age.

- 0 =

Age (x) Living at Dying Mortality Survival Living Living Expectation

age x (l x ) between Rate (q x ) Rate (P x ) between above age of life at
ages x to ages x to x (T x ) age x (e0 X )
x+1 (d x ) x+1 (L x )
X years lx= d x = l x -l x+1 q x = d x /l x P x = 1-q x , = T x = T x-1
+ +1
0 =
number L x-1
2
that
started life
Numerical Example
1. Fill up the blanks, which are marked with a question mark in the skeleton life table
Age (x) lx dx qx Px Lx Tx e0 X
30 762227 ? ? ? ? 27296732 ?
31 758580 ?
Solution:
d x = l x -l x+1
d 30 = l 30 -l 31

Year
d 30 = 762227-758580 = 3647
q x = d x /l x
q x = 3647/762227 = 0.005
p x = 1- q x
p x = 1- 0.005 = 0.995
30 + 31
30 =
2
= (762227+758580)/2 = 760404
0
30
30 =
30
0
30 = 27296732/ 762227 = 35.81
T 31 = T 30 L 30
T 31 = 27296732- 760404 = 26536328
Hence, the table can be filled by calculate values as follows:
30 762227 3647 0.995 0.005 760404 27296732 35.81
31 758580 26536328
2. Fill in the blanks in the following skeleton life table which are marked with question marks
20 90000 500 ? ? ? 4850000 ?
21 ? 400 ? ? ? ? ?
Solution:
Column 2
l 21 =I 20 -d 20
l 21 =90000-500 = 89500
l 22 =89500-400 = 89100 (will be required for calculating L 21 )
Column 4
q x = d x /l x
q 20 = d 20 /l 20 = 500/90000 = 0.0056
q 21 = d 21 /l 21 = 400/89500 = 0.0045
Column 5
p x = 1- q x
p 20 = 1- q 20 = 1-0.0056 = 0.9944
p 21 = 1- q 21 = 1- 0.0045 = 0.9955
Column 6
L x = (l x +l x+1 )/2
L 20 = (l 20 +l 21 )/2 = (90000+89500)/2 = 89750
L 21 = (l 21 +l 22 )/2 = (89500+89100)/2 = 89300
Column 7

Year
T x = T x-1 L x-1
T 21 = T 20 L 20 = 4850000-89750 = 4760250
Column 8
e0 20 = T 20 /I 20 = 4850000/90000 = 53.89
e0 21 = T 21 /I 21 = 4760250/89500 = 53.19
UNIT 2.3 MIGRATION AND ITS MEASURES
Basic Terminology of Migration
Migration is a demographic component that determines the size, growth, distribution and composition of
population.
Migration Migration is a movement from one geographical area to another geographical area crossing
the administrative boundaries for permanent or semi permanent residence. The starting place is known
place of origin whilst the ending place is called place of destination.
- Life time migration (The place of birth is different from place of residence).
- Recent migration (The place of current residence is different from the place of previous residence)
Types of Migration
On the basis of geographical boundaries
- International Migration
- Internal Migration
Rural to rural migration
Rural to urban migration
Urban to urban migration
Urban to rural migration
On the basis of time

- Temporary migration (less than 10 years)
- Permanent Migration (More than 10 years)
- Seasonal Migration (Less than six months)
Determinants of Migration
The determinants can be categorized into push and pull determinants.

Pull factors are those determinants which attract migration at the destination and push factors are those
which force to move the migrant from place of origin.
Determinants Push Factors Pull Factors
Economic and Poverty Prospects of higher wages
demographic Unemployment Potential for improved standard of living
Low wages Personal or professional development
Lack of basic health and education
Political Conflict, insecurity, violence Safety and security
Poor governance Political freedom
Corruption

Year
Human right abuse

Social and Discrimination based on ethnicity, Family reunification
cultural gender, religion, etc. Ethnic homeland
Poor education opportunity Freedom from discrimination
Marriage
Natural Natural calamities
Disasters (earthquakes, floods, etc.)
Measures of Migration
Measurement of migration deals about the flow of migration. It measures the quantity of migrant who
have shifted from their place of residence.
There are four different measures of migration

i. In-Migration Rate
- The number of people received by an area at a specific time per thousand population of that specific
area is known as in migration rate.
- It can be mathematically expressed as

= 1000

ii. Out-Migration Rate

- The number of out-migrants departing an area of origin per 1,000 populations at that area of origin in
a given year.

= 1000

iii. Net-Migration Rate

- The net effect of in-migration and out-migration on an areas population is known as net-migration
rate.
- It is expressed as increase or decrease per 1,000 populations of that area in a given year.
. .
= 1000
a
iv. Gross-Migration Rate

- The total number of in-migrants and out-migrants per 1,000 population of the area in a given year/
period is known as gross migration rate.
. + .
= 1000

= +
Simple Measure to Calculate Internal Migration

Year
If we are interested to know the magnitude of in and out migrants then it becomes difficult to calculate. In
this case we can estimate the internal migration by simply asking questions about the place of birth
statistics.
Based on this enumeration, the population can be classified into
Region of enumeration
Region of birth
Let us assume there are three sub-divisions A,B, C (e.g. Terai, Hills and Mountain) in a country. Then we
can lay out the information by classifying the populations according to region of birth and region of
enumeration as shown below:
Region of Birth Region of Enumeration Total

A B C
A N AA N AB N AC NA
B N BA N BB N BC NB
C N CA N CB N CC NC
Total N.A N.B N.C N
Here,
Out-migrants for A (O A ) = N AB + N AC
Out-migrants for B (O B ) = N BA + N BC
Out-migrants for C (O C ) = N CA + N CB
Also,
In-migrant for A (I A ) = N BA + N CA
In-migrant for B (I B ) = N AB + N CB
In-migrant for C (I C ) = N AC + N BC
In the classification, N AA , N BB , N CC are non-migrants for region A,B and C respectively.
Finally, Net-migration can be calculated for each regions as follows:

Net-Migration for A (NM A ) = I A - O A
Net-Migration for B (NM B ) = I B O B
Net-Migration for C (NM C ) = I C O C
UNIT 2.4: NUPTIALITY AND ITS MEASURES
Basic Terminologies of Nuptiality
Nuptiality
- The study of nuptiality deals with the frequency of marriage.
- Marital status is an important element of population composition and is a significant factor in
population dynamics as it affects fertility to a large extent, particularly in societies like Nepal where
marriage is almost universal and most births take place within wedlock.
Marital Status
- The marital status consists of four categories
i. Never Married
ii. Married

Year
a. Single Married
b. Multiple Married
c. Re-Married
iii. Widowed
iv. Divorces/ separated
a. Divorced
b. Separated
- In the 1952/54 censuses, information on marital status was obtained for the population aged 5 years
and above, whereas the age limit for collecting the particulars related to marital status was 6 years in
1961 and 1971. However, the age limit was raised to 10 years and above in the subsequent four
censuses.
Determinants of Nuptiality
i. Beauty
ii. Personality traits: Personality traits might be attributed to the facial shape (preferred large eyes, lips,
height, ethnic group, skin, hair and capital)
iii. Being modest, intelligent
iv. Non-conflicting
v. Income generating
vi. Education
vii. Age of spouses
viii. Being protective/ caring
ix. Social status, social norms
x. Marital fidelity (loyalty)
xi. BMI (Body Mass Index)
xii. Waist to Hip Ratio Reproductive potential
Simple Measures of Nuptiality
Various Measures of Nuptiality includes

i. Crude Marriage Rate
ii. General Marriage Rate
iii. Age-Sex Specific Marriage Rate
iv. Total Marriage Rate
v. Average Age at Marriage
vi. Singulate Mean Age at Marriage
vii. Crude Divorce Rate
viii. Period Total Divorce Rate
i. Crude Marriage Rate
- Number of marriages (including first and remarriage) in a specified area during the given year per
1,000 mid-year population of a particular age in the same year.
- This rate is calculated using the number of marriages and not the number of people getting married.

= 1000

ii. General Marriage Rate

Year
- The rate is the refinement of crude marriage rate by restricting the population to marriageable age
(i.e. 10 years and above) instead of whole population.
(10 +)
= 1000
(> 10 )
iii. Age-Sex Specific Marriage Rate
- This rate can be considered as more refined than above measures.
- This considers marriage rate according to different age groups separately.
- This rate is defined as the number of marriage according to different age groups separately for male
and female.
. /
= 1000
/
iv. Total Marriage Rate

- Total marriage rate indicates the total number of first marriage in a particular cohort.
- It is the total number of marriages in a cohort.
- The total marriage rate described the proportion of women (generally per 100 or 1,000 persons)
groups of 15 to 49 years.
- It is computed by adding up the age-specific marriage rates of first marriages in the whole age period.

= 1000

v. Average Age at First Marriage

- This is the median age of those people who get married in a given year.
- The median age at first marriage is usually calculated separately for males and females because
females typically marry at younger ages.
- Age at marriage with parental consent for both boys and girls is set at 18 years and if boys and girls
want to marry on their own, then the minimum legal age at marriage for both boys and girls 20 years.
- However, the observed age at marriage is for male is 22.9 yrs and female is 19.5 yrs.
vi. Singulate mean age at marriage (SMAM)

- Singulate mean age at marriage is an estimate of the average number of years lived as Single or
Never Married by those who marry before the age of 50.
- A high value of SMAM means postponement of marriage to a higher age. A high SMAM for females
reduces lifetime fertility.
- It is computed from the proportion of single persons or Never Married in each age group from 15-19
to 50-54 yrs.
- According to census 2011, the SMAM for males is 23.8 yrs and for females is 20.6 yrs.
vii. Crude divorce rate

- The crude divorce rate is the annual number of divorces per 1000 population.
- Divorce is a final legal dissolution of a marriage, that is, separation of husband and wife which confers
on the parties the right to remarriage under civil, religious and/or other provisions according to the
laws of each country.
viii. Total period Divorce Rate

Year
- The total period divorce rate indicates the number of divorces in an imaginary class of 1000
marriages in which divorce rates for each length of marriage are equal to those observed in the year
in question.
.
= 1000

UNIT 2.5: URBANIZATION AND ITS MEASURES
Basic Terminology of Urbanization

Urbanization is defined as defined as the growth in the proportion of total population, which resides in
urban places.
Determinants of Urbanization
Determinants Causes
Demographic - Population increase
- Migration
Geographical - Location of mineral deposits
- Port town
- Boundary changes
Social and economic - Industrialization
- Specialization in occupation
- Political factors
- Educational and cultural centers
- Transport and communication facilities
Definition of urban area

Municipality Act 1992 define urban area as locality
- With 20,000 or more inhabitants
- Having facility of electricity, road, drinking water, communication and other similar minimum urban
facilities.
According to Local Self-Governance Act 1999, municipality are classified into three categories on the
basis on inhabitants, sources of revenue and other urban environment
- Mahanagarpalika- population of 300,000 or more; having annual revenue of at least Rs. 400 million
and having adequate urban facilities.
- Upa-Mahanagarpalika- population of 100,000 or more; having an annual revenue of at least Rs. 100
million and having adequate urban facilities
- Nagarpalika- minimum population of 20,000; having annual revenue of at least one million rupees and
having basic urban facilities.
Urbanization in Nepal
- Nepals urbanization is observed to be low (27%).
- Currently there are 4 metropolitan cities, 13 sub-metropolitan city, 246 municipality and 81 rural
municipalities in Nepal.
- Nepals urbanization is primarily characterized by
An increase in the number of municipalities
An expansion in the urban area
Rapid increase of population in recent years

Year
Consistent increase in the percentage share of urban population to the total population and rural
population.
Measures of Urbanization
There are three important measures of urbanization

1. Degree of urbanization
2. Tempo of urbanization
3. The concentration and dispersion of population
Degree of Urbanization
- The degree of urbanization refers to the extent to which an area is urbanized.
- Since there are varieties of dimensions of urbanization process, a number of methods have been
developed and adopted to measure it precisely.
i. Percent distribution
- It measures the percentage of population in the urban area.
- Percent of urban population is simply obtained by dividing the population living in urban area by total
population of a country.
Merits
- This is a simple measure and easy to calculate
- Easy to interpret
Weakness
- Does not give any indication of the percentage of population according to size.
- Change in boundary of the locality from time to time
ii. Ratio of urban to rural population

- It is the ratio of population living in urban area to that living in rural area.
- This measure measures another aspect of urbanization and is better measure of urbanization.
iii. Size of locality of residence of median inhabitant

- This index established the size of locality where the median inhabitant lives.
- Bigger the locality size of the median inhabitant, the greater is the degree of urbanization
- The index is obtained by using the formula
50
= + (+1 )
+1
Where,
MI = median inhabitant
PP i = cumulative percent of the population for the locality size just under 50%
PP i+1 = cumulative percent of the next locality size category
Q i = upper limit of the locality size I, just under 50%
iv. Mean city population size

- It is the average of the sizes of the cities
- Mean city population size is given by

Year
2
=1
=

Where,
C i = Population in the ith localities
P is the total population of the country
M is the total number of localities
Numerical Example
Calculate the size of locality of residence of median of median inhabitant in the given population
distribution by categories of localities (Municipalities of Nepal, 2011)
Size class distribution Municipalities Population Cumulative %
Number Percent Size Percent
Less than 20000 14 10.8 238,431 3.3 3.3
20000-29999 33 25.4 833,353 11.6 14.9
30000-39999 25 19.2 855,406 11.9 26.8
40000-49999 (Q i ) 19 14.6 850,327 11.8 38.6 (PP i )
50000-99999 (Q i+1 ) 28 21.5 1,895,554 26.3 64.9 (PP i+1 )
100000-199999 7 5.4 873,598 12.1 77
200000+ 4 3.1 1,652,845 23.0 100
130 100 7,199,514 100
Here, cumulative percent just above 50% is 64.9. Therefore the corresponding population class 50000-
99999 is the median class.
So
PP i = 38.6
PP i+1 = 64.9
Q i = 49999 (upper limit)
Q i+1 = 99999 (upper limit)
50
= + (+1 )
+1
50 38.6
= 49999 + (99999 49999)
64.9 38.6
= 71,672
Tempo (Speed) of Urbanization

- Tempo or speed of urbanization refers to the annual rate of change in the degree of urbanization.
- Tempo of urbanization can be measured in two broad ways
i. Annual change of percentage points
ii. Annual average rates of change of the percent urban
i. Annual change of percentage points

- One of the basic ways of measuring tempo of urbanization is calculation of absolute annual change in
percentage points.
- This method of measuring tempo of urbanization is affected by the degree of urbanization already
achieved at the beginning of the period.
- Annual change of percentage points is calculated by

Year
+
=

Where,
TU A = Tempo of urbanization as annual change in percentage points
n = number of years
PU t = Percent of urban population in time t
PU t+n = Percent of urban population in time t+n
ii. Annual average rate of change of percent urban
- This gives the annual rate of change in number of people in urban areas per 100 population
- This method assumes the growth of urbanization in three different ways
a. Arithmetic (Linear) growth

- If the percent of urban population is assumed to change arithmetically, then
= 0 (1 + )
Where,
P t = Percent of urban population at time t
P 0 = Percent of urban population at baseline (as start of time t)
R a = arithmetic rate in the change of percent urban
t = time period (no. of years)
Therefore, the tempo of urbanization using arithmetic growth can be calculated as
0
=
0
b. Geometric growth
- If the percent of urban population is assumed to change geometrically
= 0 (1 + )
Where,
P t = Percent of urban population at time t
P 0 = Percent of urban population at baseline (as start of time t)
R g = geometric rate in the change of percent urban
- Therefore, tempo of urbanization using geometric growth can be calculated as
1

= 1
0
c. Exponential growth
- If the percent of urban population is assumed to change exponentially,
= 0
Where,
R e = geometric rate in the change of percent urban
- Therefore, tempo of urbanization using exponential growth can be calculated as
1
=
0

Year
- The most convenient model for calculating the tempo of urbanization is the exponential growth
model.

Year
UNIT 3: POPULATION ESTIMATES AND PROJECTIONS
- Population estimation is the statistical method of determining a population of a particular country at a

particular time between two censuses of post-census.
- Population estimation is done to help planners by providing magnified image of the consequences of
current trends, to guide then for taking appropriate actions.
There are three types of population estimates

i. Inter-censal estimates
- Inter-censal estimates are estimates for the years between any consecutive censuses, based on data
from both the censuses.
ii. Post-censal estimates

- Post-censal estimates are estimates for years following a census, which may also use other sources.
- Thus an estimate of the population of Nepal for the year 2014, based on the data of last census of
2011 and the records of births, deaths and migration, from 2011 to 2014 is essentially a post-censal
estimate.
iii. Future estimates and projections

- Future estimates and projections are in general less accurate than the post censal estimates.
- They are always based on some assumptions of the trends of population growth
Assumptions for population estimation

- Same growth rate continues for the projection period.
- The socio-economic setting affecting the population size is fairly unchanging.
- No allowance is made for the irregular fluctuations in population growth.
Methods of Estimation
i. Demographic Method (Natural Increase)
ii. Mathematical Methods
a. Linear Growth Model
b. Geometric Growth Model
c. Exponential Growth Model
iii. Component Method
i. Demographic Method (Natural Increase/ Balancing Equation)

- In this method, the components of population growth (viz:fertility, mortality and migration) information
are used.
- The estimate of population at time t is given by
= 0 + ( + )
ii. Mathematical Methods

- In general mathematical methods are used for both inter-censal and post-censal estimates of
population.
- It is useful for estimation of future population for shorter time period (less than 10 years).

Year
a. Linear (Arithmetic) Growth Model

- Based on the assumption that the annual change in population remains the same (or population
increases in arithmetic progression), the estimate of population for any time t is given by,
= 0 (1 + )
0
=
0
Where,
P t = Population estimate at time t
P 0 = Population of base census
r = Rate of population growth
t = Time period
Alternative formula,
= 0 +
0
=

Where, P 0 = Population of last census
b. Geometric Growth Model

- Based on the assumption that the annual change in population increase in geometric progression,
the estimate of population for any time t is given by,
= 0 (1 + )
1

= 1
0
c. Exponential Growth Model

- On the assumption that the population is continuously growing in an exponential pattern, the estimate
of population for nay given time t is given by,
= 0
1
=
0
Numerical Example
# The population of Nepal in 1991 is 1,84,91,097 and 2001 is 2,31,51,423. Estimate the population of
Nepal in 2007 and 2011 by Arithmetic, Geometric and Exponential growth method
Solution:
Arithmetic Growth Method
First, to estimate the population, we find arithmetic rate of progression,
2001 1991
=
1991

Year
23151423 18491097
=
18491097 10
= 0.0252
Estimation of Population for 2007

We have, time (t) = 2007-1991 = 16 yrs (1991 is the base census, not 2001)
2007 = 1991 (1 + )
2007 = 18491097 (1 + 0.0252 16)
2007 = 25946707
Estimation of population for 2011

Time (t) = 2011-1911 = 20 yrs
2011 = 1991 (1 + )
2011 = 18491097 (1 + 0.0252 20)
2007 = 27810610
Geometric Growth Method
The rate of geometric progression can be calculated as,

1

= 1
0
1
23151423 10
= 1
18491097
= 0.0227

Time (t) = 2007-2001 = 6 yrs
= 0 (1 + )
2007 = 2001 (1 + 0.0227)6
2007 = 23151423(1 + 0.0227)6

2007 = 26489858
Estimate of population for 2011

Time (t) = 2011-2001 = 10 yrs
= 0 (1 + )

Year
2011 = 2001 (1 + 0.0227)10
2011 = 23151423(1 + 0.0227)10

2011 = 28976321
Exponential Growth Method

The rate of geometric progression can be calculated as follows:
1
=
0
1 23151423
=
10 18491097
= 0.0225

Time (t) = 2007-2001 = 6 yrs
2007 = 2001 6
2007 = 23151423 0.02256
2007 = 26496804

Time (t) = 2007-2001 = 6 yrs
2011 = 2001 10
2007 = 23151423 0.022510
2007 = 28992527
Tips for calculation in examination:

- Use rounding on four places decimal.
- For log e use ln symbol in calculator
Other Concepts of Population Growth

Natural Increase: Surplus of births over deaths i.e natural increase = Birth Death
Rate of Natural Increase (NIR)

= 100

=
10

Year
Population Growth Rate (PGR)

+
= 100

Decadal Population Growth Rate (DPGR)
2 1
=
100
1
Where, P 2 and P 1 are population of last census and previous census.
Annual Population Growth Rate (APGR)
1 2 1
=
100
1
Where, t is the time period between two censuses.
Population Doubling Time

- Population growth expressed as a percentage is not always appropriate in order to see whether the
growth of the population is fast or slow in order to see whether the growth of the population is fast or
slow. (i.e to see its speed).
- The quick way of estimating doubling time to divide 70 by the present annual growth rate
70
=
(%)
- Doubling time is a crude way of estimating future population size, because it is calculated in the
assumption that growth rate will be constant over the decade.
- Calculating doubling time just explains how fast a population is growing at a present time.

Year
UNIT 4: POPULATION THEORIES AND POLICY
UNIT 4.1: POPULATION THEORIES
Early Thinking on Population Issues
i. Confucius and Other Chinese Thought

- Confucius was a Chinese philosopher
- Confucius and other Chinese thinkers related population with agriculture.
- Doctrines of Confusiuson marriage, family and procreation were generally in the favor of population
growth.
ii. Greek and Roman Thought

- In the Greek scheme of life, the individual part of the state. The purpose of marriage was procreation.
Wars required a continuous demand of soldiers. Therefore, procreation was encouraged and even
rewarded by Greeks and the Romans.
- The Spartans and the Athenians encouraged population due to expansionist policy.
- They also tried to avoid overpopulation and encouraged abortions and even infanticides.
a. Plato
- According to Plato, city states should have 5040 citizens so that highest good may be achieved.
- In this ideal population Plato did not include women, children and slaves. Including them the total
population of an ideal city state in Platos time was about 50,000.
- He also recommended infanticide on the grounds of eugenics.
- In order to control population and maintain its highest quality, Plato recommended selective
breeding among human beings.
- He recommended that the age of marriage for the girls should be between 16 and 20.
b. Aristotle
- Aristotle maintained that fast population growth leads to increase in poverty and suggested
abortions and infanticides, in order to control the size of the city state.
- He also proposed family planning to be prescribed by the state.
iii. Religious Thoughts

a. Hindu
- Hindus have prescribed marriage as almost compulsory.
- According to Dharmasastras, no one can go to heaven without procreating a son.
- The hindu marriage aimed at the three fold ideal: fulfillment of Dharma, procreation and sex
enjoyment.
b. Judaism
- The sacred books of Jews emphasize the need of procreation.
- Childlessness is considered as a serious misfortune.
c. Christianity
- Marriage and reproduction were sometimes regarded as necessary evils.
- In later years, this underwent a change and marriage was said to be desirable and reproduction
divinely approved mode of living.
d. Islam
- The most populationistic religion is the Islam.
- It is both because it prescribes polygamy and also encourages procreation.

Year
iv. Pre-Malthusian Thoughts

- Pre-Malthusian theory encouraged industrialization rather than agriculture.
- As the demand of labour increased, population size also increased,
- A large size population was considered an essential factor for economic and political power of the
country.
- At that time birth rate was increased by adopting following measures:
Encouraging marriage directly
Encouraging fertility
Encouraging immigration and preventing emigration
Making punishment for illegitimate birth.
- Niccolo Machiavelli and Giovanni Botero were considered as precursors of Malthus. Niccolo gave the
relationship between the population growth and development. Giovanni said that population after
increasing for some time cannot continue to increase at the same rate; it may grow slowly or even
may start declining.
Malthusian Theory of Population:
The most important theory in the history of demography was presented by Thomas Robert Malthus. In his
theory Malthus laid down two postulates:
First, that food is necessary to the existence of man
Secondly, the passion between the sexes is necessary and will remain in its present state
The following propositions were put forth by Malthus to establish his theory:
i. Population is necessarily limited by means of subsistence
ii. Population invariably increases when the means of subsistence increases unless prevented by some
very powerful and obvious checks.
iii. These checks, and the checks which repress the superior power of population and its effects on a
level with means of subsistence, are all resolvable into moral restraint, vice and misery.
Therefore, Malthus concluded that food supply is subject to the law of diminishing returns and grows in
arithmetic progression (1,2,3,4,5,6,) while the population left to itself grows in geometric progression
(1,2,4,8,16,32,.). Since the population increases at a faster rate than the food supply, there is bound to
be disequilibrium between the two and this disequilibrium has tendency to widen as time passes.
The disequilibrium would result in starvation, misery and death. It can be prevented by taking preventive
checks or vice like late marriage, abstinence, etc. If however, society does not control the growth of
population, nature will come into operation and undertake positive checks like diseases, earthquakes,
famines, floods, natural disasters, etc. In the long-run, nature will maintain a balance between means of
subsistence and size of population.

Year
Significance of the theory:

i. Inspite of limitations, the theory played important role because it emphasized the need for increasing
food production and controlling the growth of population.
ii. This theory alerted the government and people of the world about the dangers of unrestrained growth
of population.
Criticisms:
i. The ratio of arithmetic progression of means of subsistence and the geometrical progression of
population growth were never proved.
ii. Malthus did not clearly distinguish between fecundity and fertility or the physiological capacity to
reproduce and the actual reproductive performance.
iii. The classification of checks on population growth as preventive and positive were cited as an
example of poor classification, since they were not independent categories.
iv. Malthus placed undue emphasis on the limitation of the supply of land. Agricultural production
tremendously increased through agricultural revolution in the 19th century.
v. Malthus underestimated the importance of industrial development in increasing the means of
subsistence.
vi. He favoured postponement of marriage and even total abstinence.
vii. Malthus could not foresee that in future, family planning techniques may be devised to control growth
rate of population.
NEO-MALTHUSIANISM
- Neo-Malthusians are the successors of Malthus. They were keen supporters of family planning
movement.
- According to them, Malthus was the first thinker who established that uncontrolled birth control must
be popularized.
- Among the most important neo-Malthusian thinkers may be mentioned Mary Stopes of Great Britain
and Margaret Sanger of USA.
- These people popularized chemical and mechanical methods of birth control.
The Neo-Malthusians maintain that in the second edition of his essay, Malthus concluded that population
cannot be expected to be controlled by moral restraint alone. Moral restraint is a means which cannot be
expected to be practiced by ordinary people. Therefore, Malthus was prepared to allow artificial means of
birth control.
Neo-Malthusians have advanced the following arguments in favor of their artificial birth control movement.
i. Birth control is necessary to limit the family size in the context of available economic means,
otherwise the standard of living will fall down considerably.
ii. Birth control is equally necessary to limit the burden on world economy. This has already reached its
saturation point. Therefore, it has no more capacity to feed the additional growing number of
population.
iii. Birth control is necessary on the ground of health and medical care as well.
iv. Those-who oppose the neo-Malthusian approach maintained that birth control is unnatural. Neo-
Malthusians point out that if birth control is unnatural, the same can be said about wearing clothes
since man is born nude and this is his natural condition.
Despite of criticism and opposition to this theory, message gradually spread in the west and also in the
east.

Year
Demographic Transition Theory
- Demographic transition means the progress of country from one demographic condition to a different
stage.
- Several demographers such as Landry in 1909 and Warren Thompson in 1929 attempted to construct
a typology to describe the demographic transition from condition of high mortality and high fertility to
the condition of low mortality and low fertility. None of these demographers however made an attempt
to explain these changes.
- In 1947, C.P. Blacker identified five phases of the demographic transition as follows:
i. High Stationary Stage

- The high stationary stage is characterized by high birth rates and death rates giving a small
population growth.
- High birth rate were because of
No birth control/ family planning
High infant mortality rate
Children needed to work
Religious beliefs encouraging large families
- High death rate were because of

Disease and plague
Famine, uncertain food supply, poor diet
Poor sanitation
ii. Early Expanding Stage

- The early expanding stage characterized by high birth rates and high but declining mortality rates
resulting high population explosion.
- Fall in death rate are observed due to
Improved medical care (vaccination, hospitals, new drugs)
Improved sanitation and water supply
Improvements in food production
A decrease in child mortality
iii. Late Expanding Stage

- The late expanding stage is characterized by death rates declining much faster than birth rates
resulting in population explosion.
- Fall in birth rate is because:
Family planning- contraceptives, sterilization
Lower infant mortality rate
Increased industrialization and mechanization
Equal status of men and women, allowing them to follow own careers.
iv. Low Stationary Stage

- The low stationary stage is characterized by both birth rates and death rates resulting in fluctuating or
slightly a slow population.

Year
v. Declining stage
- The declining stage is characterized by death exceeding birth (death rate declining much faster than
birth rates) resulting in negative growth rate.
- Several developed countries appear to be entering fifth stage.
- If this trend continues, country will eventually observe a decrease in total population.
Criticism of Demographic Transition Theory

i. This theory was based on the experience of population changes in western countries. But since the
population growth in different countries does not follow identical patterns, this theory is only a broad
generalization.
ii. This theory fails to explain the phenomenon of the baby boom in western countries after the Second
World War.
iii. This theory does not provide a theoretical explanation of fertility as a force in demographic transition.
iv. This theory cannot be called a theory in real sense.
Demographic Transition of Nepal

- In Nepal, both fertility and mortality appear to start declining from 1970.
- During 1995 to 2010, birth rates declined from 30 to 24 per thousand populations.
- The population of Nepal is still growing faster.
- In terms of demographic transition, it is in its third stage.

Year
UNIT 4.2: POPULATION POLICY

Concept of Population Policy
- Population policy represents a strategy for achieving a particular pattern of population change.
- Population policies are the policies established by government to control population growth.
- Population policy includes deliberate effort by a national government to
Retard growth
Promote growth
Maintain growth
Type of population policies

According to Paul Meadows, any of the following four types of population policies are adopted by less
developed country
i. First Type: Policy to reduce the rates of population growth where government provides infrastructure;
ii. Second Type: Policy to reduce the population growth but entirely on voluntary basis and the
government simply educates the person about the need for such approach.
iii. Third Type: Policy to reduce birthrates and have small families and family who have crossed the
permitted threshold are sterilized
iv. Fourth Type: Instituting packages of disincentives if there is need for conception control and
packages of incentives, if there is need for higher rates of replacements (as in France and singapore)
Population Policy of Nepal

Chronological Development of Population Policy in Nepal
- Population issues have been an integral part of development planning in Nepal since the first plan
(1956-61).
- The importance of population policy has been explicitly mentioned in development planning since the
third plan, 1965-70.
Plan Period Development of Population Policy

First and - Both plan focused on resettlement policy
Second Plan - There were programs to redistribute population from the densely populated hill
region to sparsely populated terai region
- FPAN was established at private level in 1959
Third Plan - This plan period focused on family planning programmes
Period - Official family planning programme was established in 1968
Fourth Plan - Vital registration system was introduced in some districts as a pilot project
Period to - In sixth plan, due attention was given to manage population distribution and
Seventh internal migration.
Plan Period - In 1983, National Population Strategy was developed
- In seventh plan, the population policy document was more comprehensive in
dealing with different issues such as women and development, child development,
family planning and concept of unmet need, population and development and
other issues.
Eighth Plan - Population strategy was revised to address consequences of high population
Period growth rate.
- Objective of the plan was to bring balance between population growth and socio-
economic development and the environment.

Year
Ninth Plan - This plan addressed the need of the Population Perspective Plan to manage
Period population and reduce poverty.
- Long term objective of reducing the TFR to replacement level within 20 years was
adopted.
Tenth Plan - This was called the poverty reduction strategy paper
Period - The major objectives of population management was to integrate population into
development activities and manage the migration process
Eleventh - The Objectives were to support poverty alleviation by reducing the population
Plan (2007- growth rate, integrating population management process with development
2010) programmes and promote SRH rights.
- One of the emphasized program was to prepare Population Perspective Plan
Twelfth Plan - Objectives were to promote small families, reduce population growth, launch
(2010-13) special program for youths, increase access to SRH, etc.
Thirteenth - Thirteenth plan has a long-term perspective of transforming Nepal into a
Plan (2013- developing country from least developed country within next ten years.
15) - National Population Policy was launched in 2015
National Population Policy

The National Population Policy was endorsed in 2015 (2071 BS). This overarching policy contains nine
areas of focus and 78 strategies.
Objectives of National Population Policy

- To establish coordination between population and socio-economic development for overall
development of the society.
- To ensure peoples reproductive health and reproductive rights as fundamental human rights.
- To promote gender equality and social inclusion in all sustainable development strategies.
- To plan external, internal migration and urbanization in a systematic way.
Targets
SN Indicators Targets for 2034
1 TFR, per female 2.1
2 Annual growth rate, percentage 1.1
3 CDR, per 1000 5
4 IMR, per 1000 live births 25
5 Average life expectancy 75
6 Average family size 4.1
7 Absent population, percentage 5
8 Literate percentage (>10 yr age) 95
9 Urban population, percentage 60
Major Policies of National Population Policy are

- Coordination of population and development work to integrate population management in all
development programs by all concerned partners.
- Develop reproductive health, family planning and safe abortion as right based program.
- Creating an appropriate environment for a healthy lifestyle.
- Regulating internal and external migration for planned urbanization.

Year
- Promoting policies, laws, institutional arrangements to mainstream targeted groups (minority,

marginalized, social and economically deprived population, persons with physical and mental
disabilities, etc.) in all population and development programs.
- Strengthening the organizational structures to develop policies, plans and ensure proper
implementation, monitoring and evaluation of population and development programs.
- Undertaking Information, education and communication strategy (IEC) to support such program
- Implementation of development programs only after studying the impact on population.
- Creating employment opportunities for the younger active population and capitalizing on the
Demographic Dividend.
Population Perspective Plan (2010-2031)

A long-term population perspective plan (2010-31) was adopted by Government of Nepal in 2010.
Key themes
- Poverty reduction
- Gender mainstreaming
- Social inclusion
The general objective of the PPP is to enhance the quality of the lives of Nepals population. The specific
objectives suggested are:
Integration of population concerns in all areas of development and environment.
Facilitation of rapid demographic transition.
Facilitation of spatio-economic development processes conducive to poverty alleviation, sustainable
urbanization and migration.
Institutional arrangements and implementation mechanisms for the coordination, implementation and
monitoring of population programmes.
The need for the PPP was conceived on three main grounds:
Integration of population concern at the policy level so that the PPP becomes the comprehensive
document that compliments other sectoral plans.
To help prioritize specific sectoral policy/programme areas related to population that impact on
poverty alleviation and sustainable development.
To attempt to address commitments that Nepal made in endorsing plans of action related to issues of
population in various international forums, particularly ICPD (1994) and MDGs 2000-2015.
Core areas of PPP

i. Demographic Analysis
- Under this area, the trend and differentials in demographic indicators of Nepal according to 25 years
projection at five year intervals are analysed.
ii. Reproductive Health (RH)

- Reproductive health is one of the main focus areas of the ICPD. Accordingly, the plan in the RH area
attempts to develop reproductive health as rights within the socio-cultural context of the country.
iii. Economic Dimension

- This includes the integration of population and development and shows the impact of economic
policies on access to social services.
- Also discussed is the implication of economic activities on population processes, with a special
emphasis on the poor and disadvantaged populations.

Year
iv. Poverty Dimension

- This reviews the poverty situation of Nepal and attempts to establish the link between population and
poverty.
v. Spatial Dimension
- This section emphasizes the issue of urbanization and migration in Nepal.
vi. Gender Mainstreaming

- This discusses the legal, institutional and socio-economic aspects of women and discusses measures
for interventions against discrimination.
vii. Social Dimension

- This section focuses on the social and cultural aspects of Janajati and Dalit in detail.
viii. Decentralisation
- This focuses on local level population management and includes the importance of decentralising
population management and data collection at the local level.
ix. Institutional Mechanism

- Institutional mechanism is suggested particularly to monitor and evaluate the implemented population
and development programmes.
UNIT 5: HUMAN DEVELOPMENT INDEX
Concept of Human Development Index
The Human Development Index (HDI) is a summary composite index that measures a country's average
achievements in three basic aspects of human development: health, knowledge, and income.
The HDI sets a minimum and a maximum for each dimension, called goalposts, and then shows where
each country stands in relation to these goalposts, expressed as a value between 0 and 1.
Components of HDI

Year
Construction technique of HDI
In order to calculate HDI, following data for different dimensions/ indicators are required:
i. Life expectancy at birth
ii. Mean Years of Schooling
iii. Expected Years of Schooling
iv. Per Capita Income
Steps of Construction:
Step 1. Creating the dimension indices
- Minimum and maximum values (goalposts) need to be set in order to transform the indicators into
indices between 0 and 1.
- The minimum and maximum values have been set as given in the table:
Dimension Dimension/Indicator Minimum Value Maximum Value
Health Life Expectancy at Birth 20 85
Education Mean Years of Schooling 0 20
Expected Years of Schooling 0 18
Standard of Living GNI Per Capita PPP USD 100 75,000
- In the next step, dimensional index are calculated by using the following formula
actual value mimimum value

Dimension index =
maximum value minimum value
- Now combined education index is calculated using the following formula

If MSI = Mean years of schooling index
ESI = Expected years of schooling index
Then,
(MSI + ESI)
Combined Education Index =
2
- For income index log is taken as

ln
(actual value) ln
(mimimum value)
Income index =
ln(maximum value) ln (minimum value)
Step 2: Aggregating the dimensional indices

- Finally HDI is calculated by aggregating all three dimension indices.
- HDI is the geometric mean of the three dimension indices.
= 3
Where,
= Life Expectancy Index
= Combined Education Index
= Income Index

Year
Current position of countries in HDI
According to Human Development Report 2015, Norway (0.944), Australia (0.935) and Switzerland
(0.930) are the top three countries in terms of HDI rankings of 2014. Niger has the lowest HDI ranks 188th
position with HDI index (0.348).
Nepal stands in the 145th ranking with HDI index of 0.548. Nepal has been categorized among the
countries with low human development.
For Nepal,
Life Expectancy at Birth = 69.6
Expected years of schooling = 12.4
Mean years of schooling = 3.3
Gross National Income (GNI) per capita = 2311
In SAARC region,
HDI Rank in Country HDI Rank HDI Index Category

SAARC in World
1 Sri Lanka 73 0.757 High Human Development
2 Maldives 104 0.706
3 India 130 0.609 Medium Human Development
4 Bhutan 132 0.605
5 Bangladesh 142 0.570
6 Nepal 145 0.548 Low Human Development
7 Pakistan 147 0.538
8 Afghanistan 171 0.465
UNIT 6: POPULATION, ECOLOGY AND DEVELOPMENT
Population Explosion and Its Effect in Ecology and Public Health
Impacts of population growth on ecology

i. Impacts on water resources
- As global population increases, so does the demand for water.
- Today, more than 2 billion people live in 47 countries that are experiencing water stress or scarcity.
By 2025, based on projections of population growth, even more people (more than 3.1 billion) may
live under water-scarce or water-stressed conditions.
- In most of the countries where water shortage is severe and worsening, high rates of population
growth exacerbate the declining availability of renewable fresh water.
ii. Impact on croplands

- Global food production depends on two critical inputs: cropland and water availability. These two
inputs are currently under pressure from increasing human population.
- FAO estimates that 37 countries face a crisis over food. Prices of cereals are up 129% since 2006.

Year
iii. Impact on forest ecosystem

- The future availability of forest resources for food, fuel and shelter looks discouraging in those
countries experiencing high deforestation rates.
- Based on current deforestation trends, the number of people living in forest-scarce countries may
increase to 3.1 billion by 2025 and to 4.1 by 2050.
iv. Impact on energy resources

- The International Energy Outlook 2016 projects the levels of energy demand will rise over the next
three decades (2012-2040).
- Much of the world increase in energy demand occurs among the developing non-OECD nations,
where strong economic growth and expanding populations lead the increase in world energy use.
Impacts of Population Growth on Public Health

i. Impacts on Water
- Water supply shortage
- Pollution of water sources and distribution of poor quality drinking water
ii. Impacts on health services

- Increased demand for services (e.g. immunization, maternal health services)
- Expansion of public health services (increase logistics supply, drugs, equipments and vaccines) to
meet the needs of growing population.
- Increased investments in health care and disease prevention.
iii. Impacts on food supply

- Rapid population growths in many poor countries have lead to chronic food shortages.
- Chronic food shortages and crisis may exacerbate problems of undernutrition.
iv. Impacts on environment

- Over-crowding and poor housing
- Increased pollution of air, land and water impacting population health
- Loss of biodiversity
Interrelationship between population resources, environment and sustainable development

- Population and deforestation and agriculture development
- Population and employment including labour force
- Population growth and education
- Population, food and nutrition
- Population and water resources
- Population and urbanization

Year
IMPORTANT FORMULA
Fertility
Crude Birth Rate
= 1000

General Fertility Rate /
= 1000
15 49
Age Specific Fertility Rate

= 1000

Total Fertility Rate 7=0 ASFR age interval
=
1000
Gross Reproduction Rate
GRR = TFR * proportion of female births
7
Net Reproduction Rate 5 =0(ASFR S)
=
1000
Mortality
Crude Death Rate
= 1000

Age Specific Death Rate

= 1000

Infant Mortality Rate (. )

= 1000

Neonatal Mortality Rate (. (0 28 )

= 1000

Maternal Mortality Ratio (. )

= 100,000

Direct Standardized Death ( )

Rate =

Indirect Standardized
Death Rate =
( )

Population Projection
Balancing Equation = 0 + ( + )
(Demographic Method)
Arithmetic Growth
= 0 (1 + )

Year
0
=
0
Geometric Growth = 0 (1 + )
1

= 1
0
Exponential Growth = 0
1
=
0
Miscellaneous
Rate of Natural Increase

10
Population Growth Rate +

= 100

Decadal Population 2 1
= 100
Growth Rate 1

Demography and Health

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MPH Ist Year

Demography and Health

Prabesh Ghimire Page | 2

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UNIT 1: INTRODUCTION TO DEMOGRAPHY AND HEALTH

Sources of Demographic and health data

ii. The Demographic and Sample Surveys

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iii. Vital Registration

iv. Population Registers

v. Administrative Statistics/ Official Records:

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Types of Population Pyramid

Concept of Young and Old Population

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UNIT 2: MEASURES OF FERTILITY, MORTALITY, MIGRATION, URBANIZATION AND NUPTIALITY

UNIT 2.1: FERTILITY AND ITS MEASURES

Measures of fertility and reproduction:

- Crude death rate is affected by age structure of the population

Prabesh Ghimire Page | 8

ii. Child Women Ratio:

iii. General Fertility Rate:

iv. Age Specific Fertility Rate (ASFR)

v. Total Fertility Rate (TFR)

7=0 ASFR age interval

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GRR = TFR * proportion of female births

ii. Net Reproduction Rate (NRR)

Replacement Level Fertility

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The various factors affecting fertility includes:

4. Age at first birth

5. Intervals between birth (spacing):

6. Postpartum Amenorrhea, abstinence and insusceptibility:

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Baby Boom and Baby Bust Syndrome

Baby Boom Syndrome

Impacts of Baby Boom

Causes of baby boom syndrome

ii. Role of marriage

iii. Demobilization of military personnel

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Baby Bust Syndrome

Causes of baby bust syndrome

UNIT 2.2: MORTALITY AND ITS MEASURES

Various measure of Mortality Includes

- Crude death rate is affected by age structure of the population.

ii. Age Specific Death Rate (ASDR)

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iii. Cause specific death rate

iv. Infant Mortality Rate (IMR)

Why infant mortality rate?

Factors affecting IMR of a country

v. Neonatal Mortality Rate (NMR)

vi. Maternal Mortality Ratio

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vii. Life Expectancy at Birth

Determinants of mortality in children

ii. Non-proximate determinants

Determinants of mortality in adults

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Standardization of Death Rates

Steps in direct standardization

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ii. Indirect standardization

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