Question 1 What is the issue, and why does it matter?
Gandaki's population grew by only 0.25 per cent a year between the 2011 and 2021 censuses, the slowest of the seven provinces. The 2021 census counted 286,593 people from the province living abroad, from about 31 per cent of its households, and the NLSS found 20.8 per cent of the province's population absent from their households (national 16.9 per cent). There are 90 men for every 100 women. Fewer working-age residents can affect farm labour, local businesses and school enrolment.12
The choice is how to improve outcomes in this province, who benefits first, and which institution can act. The figures below belong to the stated reporting period; they are not a real-time measure of today’s conditions.
Question 2 What do current law and policy say?
Federal: Health policy, standards and specialised hospitals; central universities (Sch. 5 items 15, 16). Provincial: Health services; provincial universities and higher education (Sch. 6 items 8, 9). Local: Basic and secondary education; basic health and sanitation (Sch. 8 items 8, 9); education and health shared by all levels (Sch. 9 items 2, 3).3
Federal: Water-resource policy, national transmission lines, large central projects (Sch. 5 items 11, 12, 14). Provincial: Province-level electricity, irrigation and water supply (Sch. 6 item 7). Local: Small hydropower, alternative energy, local irrigation (Sch. 8 items 11, 19); electricity and irrigation services shared by all levels (Sch. 9 item 5).3
Federal: National highways (Sch. 5 item 20); equalization and other grants on the National Natural Resources and Fiscal Commission's recommendation (Art. 60). Provincial: Provincial highways (Sch. 6 item 12); disaster preparedness and response concurrent with the federation (Sch. 7 item 17). Local: Local and rural roads (Sch. 8 item 11); disaster management (Sch. 8 item 20; Sch. 9 item 9).34
Provincial executive power rests with the Council of Ministers. The Chief of Province (governor) performs constitutional and legal functions, generally on the Council’s recommendation and consent; the governor is not the department delivering these services. Provincial revenue and expenditure estimates go to the Provincial Assembly.5
Question 3 What is known, uncertain or disputed?
Known
Gandaki's population grew by only 0.25 per cent a year between the 2011 and 2021 censuses, the slowest of the seven provinces. The 2021 census counted 286,593 people from the province living abroad, from about 31 per cent of its households, and the NLSS found 20.8 per cent of the province's population absent from their households (national 16.9 per cent). There are 90 men for every 100 women. Fewer working-age residents can affect farm labour, local businesses and school enrolment.12
Uncertain
A province-wide number does not identify the worst-served wards or prove the same problem in every municipality. Before spending, establish a current local baseline, service quality, staffing, access barriers and the full operating cost.
Disputed
The policy choice is how to balance universal access, concentrated investment, affordability and fiscal sustainability. The alternatives below are Policy Nepal’s discussion options derived from the problem evidence, not claims that officials or parties have endorsed them.
Questions 4–5 What are the options, and what do they cost and achieve?
Options are listed in no particular order. Policy Nepal does not recommend one; real policies often combine them.
A
Maintain a minimum service network12
Map travel times, seasonal isolation and actual attendance before reallocating schools, clinics or staff. Finance outreach and transport for settlements that cannot sustain a full facility.
Benefits
- Protects access for older people, disabled residents and households unable to move.
Costs
- Outreach staff, transport, communications and recurring maintenance require annual funding.
Trade-offs
- A nearby building is not a functioning service; consolidation can improve quality but lengthen journeys.
What does implementation require?
- Publish settlement-level travel-time maps, a minimum service schedule, responsible teams and a complaints route before changing facilities.
Invest in connected service centres12
Concentrate specialist services in accessible centres while connecting surrounding settlements through reliable transport, referral and digital support.
Benefits
- Can share scarce specialists and equipment across municipalities.
Costs
- Requires safe transport, referral coordination and operating staff, not only construction.
Trade-offs
- Digital access cannot substitute for emergency transport or exclude people without devices.
What does implementation require?
- Pilot a catchment area with neighbouring local governments and compare waiting time, travel cost and service completion before expansion.
Combining options
Start with a verified baseline and maintenance of functioning services, then test additional investment against the same outcomes. Publish who pays for capital costs, recurring costs and any household charges; an unfunded operating plan is not a sustainable solution.
Question 6 Who is responsible?
Shared
Health and educationFederal: Health policy, standards and specialised hospitals; central universities (Sch. 5 items 15, 16). Provincial: Health services; provincial universities and higher education (Sch. 6 items 8, 9). Local: Basic and secondary education; basic health and sanitation (Sch. 8 items 8, 9); education and health shared by all levels (Sch. 9 items 2, 3).3
Shared
Hydropower and irrigationFederal: Water-resource policy, national transmission lines, large central projects (Sch. 5 items 11, 12, 14). Provincial: Province-level electricity, irrigation and water supply (Sch. 6 item 7). Local: Small hydropower, alternative energy, local irrigation (Sch. 8 items 11, 19); electricity and irrigation services shared by all levels (Sch. 9 item 5).3
Shared
Roads, disasters and moneyFederal: National highways (Sch. 5 item 20); equalization and other grants on the National Natural Resources and Fiscal Commission's recommendation (Art. 60). Provincial: Provincial highways (Sch. 6 item 12); disaster preparedness and response concurrent with the federation (Sch. 7 item 17). Local: Local and rural roads (Sch. 8 item 11); disaster management (Sch. 8 item 20; Sch. 9 item 9).34
Provincial
Chief Minister, Council of Ministers and Provincial AssemblyProvincial executive power rests with the Council of Ministers. The Chief of Province (governor) performs constitutional and legal functions, generally on the Council’s recommendation and consent; the governor is not the department delivering these services. Provincial revenue and expenditure estimates go to the Provincial Assembly.5
Question 7 What have parties and leaders said and done?
What was said or promised is shown apart from what was recorded as done. Every entry needs a dated source. A missing entry means the position is not established, not that someone opposes or is neutral.
This dossier presents official evidence and research options. It does not assign a position to a chief minister, governor, mayor or political party without a dated source specific to this issue.
Said or promised
Position not established in reviewed sources.
Recorded actions and outcomes
Position not established in reviewed sources.
Question 8 What would progress look like, and when do we check again?
IndicatorLatest official figureOfficial targetRevisit
Median and worst-case travel time to an operating service, by season12
Not established
No official target found
2026-10-20
Staffed service days and referral completion, by ward12
Not established
No official target found
2026-10-20
Sources
Grouped by type of evidence. Government plans show what government intends; they are not proof of results. Party material shows what a party says.
Constitution & law
- The Constitution of Nepal (English translation, as amended by the Second Amendment, 2020), Schedules 4–9 — Nepal Law Commission, Government of Nepal, Promulgated 20 September 2015; amended 28 February 2016 and 18 June 2020 (as stated in the document). Schedule 4, list for 'Province No. 4', pp. 190–192; Schedule 5 (federal) items 7, 9, 11, 12, 14, 15, 16, 18, 19, 20, 22, 26, 27, 29, 30, 32, 34, pp. 193–195; Schedule 6 (provincial) items 4, 5, 6, 7, 8, 9, 10, 11, 12, 17, 19, 20, pp. 196–197; Schedule 7 (federal–provincial concurrent) items 9, 11, 13, 15, 17, 18, 23, 25, pp. 198–199; Schedule 8 (local) items 4, 8, 9, 10, 11, 15, 17, 18, 19, 20, pp. 200–201; Schedule 9 (all three levels) items 2, 3, 4, 5, 6, 7, 9, 12, p. 202. Checked 2026-10-11
- The Constitution of Nepal (English translation, as amended by the Second Amendment, 2020): Articles 57, 60, 201 and 304 — Nepal Law Commission, Government of Nepal, Promulgated 20 September 2015; amended 2016 and 2020. Art. 57(6), pp. 34–35; Art. 60, pp. 36–37; Art. 201(2)–(4), pp. 102–103; Art. 304(1) and proviso, pp. 179–180. Checked 2026-10-11
- Constitution of Nepal, English translation with first and second amendments — Nepal Law Commission. Articles 162, 166, 207–208; Schedules 6–9. English translation; Nepali text authoritative.. Checked 2026-10-13
Official data
- National Population and Housing Census 2021: National Report — National Statistics Office, Office of the Prime Minister and Council of Ministers, Government of Nepal, 2023 (reprint May 2023, as stated in the document). Major highlights, item 11 (provincial shares of population), printed p. 2; Table 14 (households with absentees and absent population living abroad, by province), printed p. 58 (PDF p. 73); Table 15 (households, population, average household size, sex ratio, density, 2011 population and annual growth rate, by province), printed p. 62 (PDF p. 77). Checked 2026-10-11
- Nepal Living Standards Survey IV 2022/23: Statistical Report — National Statistics Office, Office of the Prime Minister and Council of Ministers, Government of Nepal, June 2024. Table 6.1 'Literacy rates by sex', printed p. 98 (PDF p. 117); Table 9.1 'Distribution and Proportion of absentee population by sex', printed p. 152 (PDF p. 171); Table 16.8 'Remittance receiving households (Percent)', printed p. 279 (PDF p. 298). Checked 2026-10-11
Change history
- 2026-10-13 — Expanded the province challenge into the same eight-question format as national issues. (Regional issues deserve equally accessible evidence, options, responsibilities and tracking. Original dates and sources retained; policy options are editorial proposals.)
