Adolescent Sexual and Reproductive Health and Rights in Nepal

In the early 2000s, Nepal adopted its first National Health and Development Strategy, integrated sexuality education into school curricula, increased the legal age for marriage to 20, and removed the legal barriers to safe abortion care—foundational steps that fueled a steep decline in adolescent fertility through the late 2000s. Amid upheavals in the late 2000s, service delivery and program implementation became uneven. The adolescent fertility rate increased in the early 2010s, peaking at 85 births per 1,000 girls in 2014.

In 2015, Nepal updated its social contract and reset its ASRHR trajectory, redoubling its commitment to ending child marriage. The new constitution enshrined women’s rights (including the right to safe motherhood and reproductive health), affirmed equality and education as fundamental rights, and restructured the state into a federal system that pushed accountability and resources closer to communities. Under this new framework, early reforms were expanded, localized, and strengthened to reach more girls with higher-quality services, creating a more coherent, rights-based, and accountable system.

For Nepali girls, the transformation was tangible. Free and compulsory education, targeted scholarships, and safer, more inclusive schools kept them in classrooms longer, while flexible learning programs helped those who had dropped out to return. Complementary community initiatives that engaged parents, religious leaders, and local governments shifted social norms around girls’ education and delayed marriage. As a result, more girls stayed in school through the secondary level, child marriage rates steadily declined, and adolescents gained greater agency over their bodies and futures—all of which contributed to reductions in early pregnancy and meaningful progress in advancing ASRHR.