Cultural factors affecting the demographic structure of a high altitude nepalese population

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Abstract
This study concerns the fertility of Sherpa and Tibetan women living at altitudes over 3,400 meters in Nepal. The average completed fertility (4.77 live births) and estimated crude birth rate (31 to 33 per 1,000) are low relative to low altitude peasant populations as well as to high altitude Andean peasants. Environmental phenomena (hypoxia, iodine deficiency) may be associated with retarded menarchial age and high infant mortality; but the major factors causing the low fertility appear to be cultural rather than environmental. Traditional ceremonial requirements delay the age at marriage until the mid or late twenties. Religious practices promote male and female celibacy. Migrant females and women married to migrant males report reduced fertility, probably because of poor nutrition and health care. Nonmigrant women living in villages that participate extensively in the cash economy have greater access to the growing market economy, health care, and education and report higher numbers of live births and fewer child deaths.