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Nepal is undergoing two momentous transformations-from a rural to an urbanizing economy and from a unitary to a federal state. This book aims at understanding the first of these two transitions: Nepal's journey toward becoming a predominantly urban economy. The study carries out an initial assessment of Nepal's transition from a predominantly rural to an urbanizing economy. This assessment aims at strengthening our understanding of the demographic and economic dimensions of the transition, and exploring the links between urbanization and economic growth in the context of Nepal. This book has five chapters. Chapter one presents an overview of the urban and economic transition in Nepal. Chapter two discusses the spatial patterns of Nepal's rapid urbanization and internal migration-a driving force of urban change from both a demographic and an economic perspective. Chapter three presents an initial assessment of the challenges facing Nepal's cities in urban planning and the delivery of infrastructure and services. And it discusses the spatial distribution of public expenditure for local infrastructure based on the results of a public expenditure survey carried out as part of the study. Chapter four presents a scoping assessment of the growth drivers of Nepal's urban economies and the main constraints to turning these comparative advantages into competitive advantages. And chapter five draws the main conclusions and proposes strategic directions and actions to accelerate urban-based economic growth and foster sustainable urban development.

The main objectives were to assess the adequacy of the micronutrient intakes of lactating women in a peri-urban area in Nepal and to describe the relationships between micronutrient intake adequacy, dietary diversity and sociodemographic variables. A cross-sectional survey was performed during 2008-2009. We used 24 h dietary recall to assess dietary intake on three non-consecutive days and calculated the probability of adequacy (PA) of the usual intake of eleven micronutrients and the overall mean probability of adequacy (MPA). A mean dietary diversity score (MDDS) was calculated of eight food groups averaged over 3 d. Multiple linear regression was used to identify the determinants of the MPA. Bhaktapur municipality, Nepal. Lactating women (n 500), 17-44 years old, randomly selected. The mean usual energy intake was 8464 (sd 1305) kJ/d (2023 (sd 312) kcal/d), while the percentage of energy from protein, fat and carbohydrates was 11 %, 13 % and 76 %, respectively. The mean usual micronutrient intakes were below the estimated average requirements for all micronutrients, with the exception of vitamin C and Zn. The MPA across eleven micronutrients was 0·19 (sd 0·16). The diet was found to be monotonous (MDDS was 3·9 (sd 1·0)) and rice contributed to about 60 % of the energy intake. The multiple regression analyses showed that MPA was positively associated with energy intake, dietary diversity, women's educational level and socio-economic status, and was higher in the winter. The low micronutrient intakes are probably explained by low dietary diversity and a low intake of micronutrient-rich foods.

The Tarai region of Nepal is regarded as the food bowl of Nepal, and yet urban areas have increased in size at an average annual rate of 12% for the 30 years since 1988/1989, largely at the expense of prime agricultural land. Nepal is recognized internationally as highly sensitive to food security with 40% of its population undernourished. To aid future planning and reduce potential further loss of agricultural land and consequent increased food insecurity, we here investigated the previously unknown factors underlying this rapid urban expansion. We achieved this through analyses of land use and land cover (LULC) data, population, and climatic data, in association with focus group discussions and questionnaire surveys. We found that socioeconomic factors were perceived to have made the highest (62%) contribution to urbanization, particularly migration-led population growth and the economic opportunities offered by urban areas, followed by political factors (14.5%), physical factors (12%), and planning and policy factors (11.5%). In addition, climate and physiographic features make the area attractive for urban development along with favorable government plans and policies. Accelerated urban expansion during this period was particularly driven by mass migration due to political upheaval in the country resulting in rapid population and urban center growth. Of the total 293 urban centers in the country, the Tarai region includes 150 (51.2%) of which 77 (26.3%) are located in province 2 alone and accommodate 17.2% of Nepal’s households. This increasing urbanization trend is expected to continue in the future due to current socioeconomic and demographic factors. We hope our results which show what has driven past urbanization will aid future urban planning and management of the Tarai as well as other similar regions elsewhere in the world. We also identified that such rapid urban growth is largely at the cost of populations in rural areas with rural depopulation resulting in agriculture being abandoned in some areas. Given Nepal’s sensitivity to food security and lower food production, this will be an increasing problem for the future.

Understanding the spatiotemporal dynamics of urbanization and predicting future growth is now essential for sustainable urban planning and policy making. This study explores future urban expansion in the rapidly growing region of eastern lowland Nepal. We used the hybrid cellular automata-Markov (CA-Markov) model, which utilizes historical land use and land cover (LULC) maps and several biophysical change driver variables to predict urban expansion for the years 2026 and 2036. Transitional area matrices were generated based on historical LULC data from 1996 to 2006, from 2006 to 2016, and from 1996 to 2016. The approach was validated by cross comparing the actual and simulated maps for 2016. Evaluation gave satisfactory values of Kno (0.89), Kstandard (0.84), and Klocation (0.89) which verifies the accuracy of the model. Hence, the CA-Markov model was utilized to simulate the LULC map for the years 2026 and 2036. The study area experienced rapid peri/urban expansion and sharp decline in area of cultivated land during 1989–2016. Built-up area increased by 110.90 km 2 over a period of 27 years at the loss of 87.59 km 2 cultivated land. Simulation analysis indicates that urban expansion will continue with urban cover increasing to 230 km 2 (8.95%) and 318.51 km 2 (12.45%) by 2026 and 2036, respectively, with corresponding declines in cultivated land to 1453.83 km 2 (56.86%) and 1374.93 km 2 (53.77%) for the same years. The alarming increase in urban areas coupled with loss of cultivated land will have negative implications for food security and environmental equilibrium in the region.

Spatial–temporal analysis of land-use/land-cover (LULC) change as well as the monitoring and modeling of urban expansion are essential for the planning and management of urban environments. Such environments reflect the economic conditions and quality of life of the individual country. Urbanization is generally influenced by national laws, plans and policies and by power, politics and poor governance in many less-developed countries. Remote sensing tools play a vital role in monitoring LULC change and measuring the rate of urbanization at both the local and global levels. The current study evaluated the LULC changes and urban expansion of Jhapa district of Nepal. The spatial–temporal dynamics of LULC were identified using six time-series atmospherically-corrected surface reflectance Landsat images from 1989 to 2016. A hybrid cellular automata Markov chain (CA–Markov) model was used to simulate future urbanization by 2026 and 2036. The analysis shows that the urban area has increased markedly and is expected to continue to grow rapidly in the future, whereas the area for agriculture has decreased. Meanwhile, forest and shrub areas have remained almost constant. Seasonal rainfall and flooding routinely cause predictable transformation of sand, water bodies and cultivated land from one type to another. The results suggest that the use of Landsat time-series archive images and the CA–Markov model are the best options for long-term spatiotemporal analysis and achieving an acceptable level of prediction accuracy. Furthermore, understanding the relationship between the spatiotemporal dynamics of urbanization and LULC change and simulating future landscape change is essential, as they are closely interlinked. These scientific findings of past, present and future land-cover scenarios of the study area will assist planners/decision-makers to formulate sustainable urban development and environmental protection plans and will remain a scientific asset for future generations.

Urban fire scholarship on the global south is scarce. Despite the majority of the 180,000 annual global fire deaths (World Health Organization, 2023) being from low- and middle-income nations we know very little about their characteristics and dynamics. At a time where most current and future urban growth is being experienced in the global south, the need to understand urban fire dynamics has never been more pressing. The current study seeks to empirically capture the antecedent conditions that bring about elevated levels of fire in Kathmandu, Nepal using a spatial analytic approach. Findings reveal elevated levels of fire during winter, weekends, during evening hours and related to extreme weather events. There were strong associations in areas characterised by low socio-economic areas, higher populations of children and locales with no school attendance. Findings are important in their capacity to directly advise both in a strategic capacity (policy design such as a campaign to check electrical equipment before the onset of cold spells) and for operational activities, such as optimal fire resource location based upon the observed patterning in the historical data. Our hope is that the current study acts as a new point of reference to encourage other similar studies of urban fires in the global south through which we can assemble a more complete and robust understanding.

Caesarean section (CS) rates are rising in urban hospitals in Nepal. However, the reasons behind these rising rates are poorly understood. Therefore, this study explores factors contributing to rising CS rates in two urban hospitals as well as strategies to make rational use of CS. This cross-sectional mixed-methods study was conducted in 2021 in two hospitals, one public hospital and one private one in Kathmandu. The quantitative part included a record-based study of 661 births (private hospital = 276 and public hospital = 385) for the fiscal year 2018/19. The qualitative part included semi-structured interviews with 14 health professionals (doctors, nurses & midwives) and five key informants from relevant organisations and four focus group discussions with pregnant women in antenatal clinics in two hospitals. Quantitative data were analysed using SPSS v28. Qualitative data were organised through NVivo v12 and thematically analysed. The overall CS rate was high (50.2%). The CS rate in the private hospital was almost double than that in the public hospital (68.5% vs. 37.1%). Previous CS was the leading indication for performing CS. Non-medical indications were maternal request (2.7%) and CS for non-specified reasons (5.7%). The odds of CS were significantly higher in the private hospital; women aged 25 years and above; having four or more antenatal clinic visits; breech presentation; urban residency; high caste; gestational age 37-40 weeks; spontaneous labour and no labour. Robson group 5 (13.9%) was the largest contributor to overall CS rate, followed by group 1 (13.4%), 2 (8.8%), 3 (4.4%) and 6 (2.9%). Similarly, the risk of undergoing CS was high in Robson groups 2, 5, 6, 7 and 9. The qualitative analysis yielded five key themes affecting rising rates: (1) medical factors (repeated CS, complicated referral cases and breech presentation); (2) socio-demographic factors (advanced age mother, precious baby and defensive CS); (3) financial factors (income for private hospitals); (4) non-medical factors (maternal request); and (5) health service-related factors (lack of awareness/midwives/resources, urban centralised health facilities and lack of appropriate policies and protocols). Four main strategies were identified to stem the rise of CS rates: (1) provide adequate resources to support care in labour and birth (midwives/trained staff & birthing centres); (2) raise awareness on risks and benefits mode of childbirth (antenatal education/counselling and public awareness); (3) reform CS policies/protocols; and (4) promote physiological birth. The high CS rate in the private hospital reflects the medicalisation of childbirth, a public health issue which needs to be urgently addressed for the health benefits of both mother and baby. Multiple factors affecting rising CS rates were identified in urban hospitals. This study provides insights into factors affecting the rising CS rate and suggests that multiple strategies are required to stem the rise of CS rates and to make rational use of CS in urban hospitals.

The developing world is facing pivotal challenges in recent times. Among these, global warming has ominous repercussions on every segment of society, thus tracing its underlying causes is imperative. This research attempts to investigate the impact of urbanization and energy consumption on carbon dioxide emissions (CO2) for a panel of 8 Asian countries (Bangladesh, China, India, Indonesia, Malaysia, Nepal, Pakistan, and Sri Lanka) over the period 1982 to 2017. The analyses are executed using panel co-integration and Granger causality techniques. The main findings of panel co-integration reveal a long-run relationship between urbanization, energy consumption, and CO 2 emissions. Furthermore, the results indicate a positive and significant impact of urbanization and energy consumption on CO 2 emissions, indicating that urban development and high energy consumptions are barriers to improve environmental quality in the long run. The results also highlight bi-directional causality between energy consumption and urbanization, while unidirectional causality exists between energy consumption and CO 2 emissions. Based on the obtained results, this study offers useful policy implications for plummeting carbon emissions.