Nepal is one of the world's poorest countries where nearly 85% of the people live in villages in remote and difficult to access terrain.  The population is predominately children and the growth rate is high.  While the decline in fertility has been slow, it has started to accelerate in recent years. Total fertility is currently three times higher than the lowest rate in the world. Under-nutrition is widespread, particularly among children. HIV is emerging as a problem and tuberculosis continues to be a major threat. Nearly a quarter of all deaths occur in children less than five years old.  Major causes of death for adults are asthma/bronchitis, tuberculosis and cancer for men and asthma/bronchitis, cancer, and complications of pregnancy and delivery for women. For children, infections are the leading cause of death. Nepal is also one of the few countries where leprosy has yet to be eliminated.
     

The high incidence of low birth-weight and under-weight and stunted children underscores the need to substantially increase the emphasis on nutrition to prevent morbidity and mortality in Nepal.  Seasonal “hunger gaps” during winter, drought and monsoon in select rural areas are issues that also threaten food security.