JNMA I VOL 51 I NO. 1 I ISSUE 181 I JAN-MARCH, 2011 28 ABSTRACT Introduction: Gender equality has been a priority area of demographic research. One of the major reasons for high fertility and low acceptance of family planning is the prevalence of gender preference among couples. The objectives of this study were to identify the determinants and examine the extent of gender preference on fertility. Methods: This is a cross-sectional study carried from June 2008 to July 2009 in Duhavi VDC of Sunsari district of Nepal. Three hundred and five randomly selected ever-married women of 15 - 49 years, who had at least one child were the subjects of the study. A questionnaire covering the areas on gender and fertility preference and methods and use of contraception was given and filled up. Results: The study showed that 42.6 % of the ever-married women belonged to the 25 - 29 years age group. Around 92 % of women whose last child was a male were using family planning methods whereas only 40 % of women whose last child was a female were using family planning methods. This difference was statistically significant (P < 0.0001). Conclusions: The contraception use among the women having a female child was low, showing a desire for a male child which is one of the factors in the increase of family size in our society. Due to the patrilineal society, women are discouraged in the practice of contraception. Effective intervention programs need to be planned and conducted to rectify this situation. Keywords: Determinants, Duhavi VDC, gender preference, impact, Nepal Impact and Determinants of Gender Preference in Duhavi VDC of Eastern Nepal Uprety S, 1 Jha N, 1 Poudel IS, 1 Pokharel PK, 1 Poudel M, 2 Niraula SR 1 1 School of Public Health and Community Medicine, 2 Department of General Practices and Emergency Medicine, BP Koirala Institute of Health Science, Ghopa, Dharan Correspondence: Dr. Samyog Uprety School of Public Health and Community Medicine B. P. Koirala Institute of Health Sciences, Dharan, Nepal. Phone: +977255125555 (ext. 2626) Mobile: No:-9802714123 E-Mail: samyoguprety@gmail.com ORIGINAL ARTICLE J Nepal Med Assoc 2011;51(181):28-33 INTRODUCTION One of the major reasons for high fertility and low acceptance of family planning is the prevalence of gender preference among couples. This is believed to have powerful effects on the numbers of additional children desired by the couples. Desired gender preference thus is an important factor in population growth. 1, 2 As sons are believed to be the carriers of lineage, women tend to stop childbearing only after they have given birth to the desired number of sons. 3 It was revealed from the study of Malhi P et al. from India that the percent of women, at each parity, using contraception tends to increase with the number of living sons, suggesting a preference for sons. 4 According to a rural and urban survey data from 1979, the ideal family size among all respondents was, on