In the remote districts of Bajura and Achham, where difficult terrain and limited infrastructures constrain access to essential services, undernutrition remains a pressing public health concern. Despite Nepal’s national strides in improving nutrition, these districts continue to grapple with high rates of child stunting, maternal malnutrition, and food insecurity. According to the 2022 Nepal Demographic and Health Survey (NDHS), the prevalence of stunting, wasting, and underweight in Sudurpaschim Province is 27.7%, 4.7%, and 13.5%, respectively, while 43% of women aged 15-49 is anemic. Similarly, the 2022 SMART survey conducted in Bajura District reported significantly higher rates among children aged 6-59 months: 48.8% stunted, 8.6% wasted, and 30.6% underweight. Effectively addressing these crises demands more than food assistance calls for inclusive governance that prioritizes nutrition within local development agendas.
Nutrition is not solely a health issue, it is a matter of equity, dignity, and fundamental human rights. By advancing inclusive governance models, we can empower communities in Nepal’s most isolated regions to take charge of their futures and safeguard the wellbeing of future generations.
Inclusive governance entails ensuring that decisions related to nutrition are shaped through the active participation of diverse local stakeholders including women, youth, marginalized communities, frontline service providers, and elected representatives. By fostering open dialogue and institutional accountability, local governments can lay the foundation for equitable and sustainable progress.
Encouraging developments have begun to surface. Several local governments have incorporated nutrition priorities into their annual development plans, allocated targeted budgets for child nutrition initiatives, and engaged civil society to promote awareness. Nevertheless, significant challenges persist particularly in cross-sector coordination, institutional capacity, and the meaningful involvement of vulnerable groups in decision-making processes.
To build on these initial gains, sustained investment is essential. Youth professionals, development partners, and government actors have a vital role to play. Supporting local capacity-building, promoting evidence-based planning, and facilitating inclusive policy dialogues can cultivate a governance environment where every voice is heard and every child can thrive.
Fostering local leadership and ownership is also critical for long-term impact. When elected officials and community members grasp the consequences of malnutrition and are equipped with the tools to address it, they become agents of transformative change. Youth can serve as dynamic changemakers mobilizing their peers, harnessing technology to amplify community voices, and holding institutions accountable.
Ultimately, sustainable nutrition outcomes depend not on isolated interventions, but on coordinated systems. Institutionalizing multisector collaboration across health, education, agriculture, and social protection is imperative at the local level. The time has come to move from fragmented, reactive programs toward cohesive, inclusive governance that leaves no one behind.
Nepal has made significant progress in reducing child malnutrition over the past decade—for instance, stunting among children under five declined from 41% in 2011 to 25% in 2022. However, malnutrition remains a serious public health challenge, particularly among poor, rural, and marginalized populations. It is a multi-dimensional issue, shaped by interrelated factors such as food insecurity, poor maternal and childcare practices, limited access to health services, inadequate sanitation and hygiene, and low levels of education, especially among women.
Addressing malnutrition requires more than just health sector interventions; single-sector responses are insufficient. Recognizing this, MSNP III (2023–2030) emphasizes joint accountability across seven sectors: health, education, agriculture, WASH, local governance, women and children, and social protection. Building on lessons from MSNP I and II, the third phase highlights the importance of strong local ownership, enhanced institutional capacity, and adequate budget allocation. MSNP III seeks to address these gaps through decentralized planning and budgeting, increased community engagement, and strengthened governance and accountability systems.
Furthermore, MSNP III recognizes the critical role of Community-Based Organizations (CBOs) in both nutrition-sensitive and nutrition-specific planning and implementation. It promotes the active involvement of CBOs to ensure the voices of women, Dalits, and other marginalized groups are reflected in Municipal Nutrition Plans (MNPs). As frontline actors, CBOs play a pivotal role in localizing nutrition efforts, empowering vulnerable communities, and bridging the gap between policy and practice. Their engagement is essential to ensure that nutrition services are inclusive, effective, and accountable. To support in above plan, European Union-supported Better Nutrition Project has recently been launched in 10 municipalities across Bajura and Achham districts of Surdurpaschim province. The project aims to support the effective and efficient implementation of the Multi-Sector Nutrition Plan (MSNP III) in these areas. Its core objective is to ensure that disadvantaged and marginalized groups, who often lack access to nutrition services at the local level, can access quality nutrition services and benefit from the local food system to improve their nutritional status. The consortium is led by LI-BIRD, with technical support from WHH, and is implemented by WAC Nepal in Achham District and by LI-BIRD in Bajura District of Sudurpaschim Province. In Achham, the municipalities are: Sanfebagar Municipality, Mangalsen Municipality, Mellekh Rural Municipality, Chaurpati Rural Municipality, and Bannigadh Jayagadh Rural Municipality. Similarly, in Bajura, the municipalities are: Budhiganga Municipality, Triveni Municipality, Budhinanda Municipality, Swamikartik Khabar Rural Municipality and Himali Rural Municipality. We have successfully completed kick-off meetings in all these municipalities with the participation of key stakeholders such as Mayors/Presidents, Deputy Mayors/Vice Presidents, Chief Executive Officers, Health Section Chiefs, Agriculture Section Chiefs, MSNP focal persons and other relevant representatives. During these meetings, we introduced our program and budget and requested their collaboration and joint efforts to achieve the goals of MSNP III.
During the kickoff meetings, representatives from all participating municipalities expressed a strong commitment to collaborating in addressing malnutrition challenges in remote areas. They demonstrated a positive attitude towards supporting the program and pledged to allocate a dedicated portion of their local budgets to nutrition initiatives, in addition to the central budget provisions for implementing MSNP III. In alignment with federal directives, all municipalities have been encouraged to adopt and apply the Nutrition-Friendly Local Governance (NFLG) indicators. This effort requires close coordination with multisectoral service providers to ensure effective implementation of inclusive governance practices. By emphasizing transparency, accountability, and active participation from diverse community voices as the framework of LNOB, including marginalized groups, the approach aims to foster more responsive planning and budgeting processes. Local plans and budgets are being designed to integrate both nutrition-specific and nutrition-sensitive interventions. To effectively tackle the immediate and underlying causes of malnutrition, strong cross-sector collaboration spanning health, education, agriculture, and social protection is essential.