Question 1 What is the issue, and why does it matter?
Over a quarter of Karnali's people (26.69 per cent) were below the poverty line in 2022/23, and the 16th Plan reports multidimensional poverty of 39.5 per cent, the highest of any province, and a Human Development Index of 0.538, the lowest.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 (Sch. 5 item 16). Provincial: Health services; higher education (Sch. 6 items 8, 9). Local: Basic and secondary education; basic health and sanitation (Sch. 8 items 8, 9; Sch. 9 items 2, 3).3
Federal: National forest policy, national parks and wildlife reserves (Sch. 5 item 27). Provincial: Agriculture and livestock; use of forests within the province (Sch. 6 items 19, 20); inter-provincial forests and Himalayan areas concurrent (Sch. 7 item 23). Local: Agriculture and agricultural extension (Sch. 8 items 15, 18); forests and biodiversity shared by all levels (Sch. 9 items 4, 7).3
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.4
Question 3 What is known, uncertain or disputed?
Known
Over a quarter of Karnali's people (26.69 per cent) were below the poverty line in 2022/23, and the 16th Plan reports multidimensional poverty of 39.5 per cent, the highest of any province, and a Human Development Index of 0.538, the lowest.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
Target exclusion from existing services12
Map barriers to documentation, benefits, health care, education and market access with communities rather than assigning every resident the provincial average.
Benefits
- Can connect eligible households to services already funded.
Costs
- Needs accessible outreach, case management and protected personal records.
Trade-offs
- Targeting can exclude people with weak documents or create stigma unless appeals and privacy are protected.
What does implementation require?
- Use a clear eligibility test, an appeal route and anonymised inclusion reporting by ward and affected group.
Link livelihoods with essential service investment12
Combine viable livelihoods, transport and skills support with health and education access, rather than treating a grant as a permanent exit from poverty.
Benefits
- Addresses several barriers that reinforce each other.
Costs
- Requires coordination, repeat follow-up and stable funding across programmes.
Trade-offs
- Income effects take time and cannot be inferred from beneficiary counts alone.
What does implementation require?
- Measure earnings, food security and service use with consent and compare against a dated baseline without identifying families publicly.
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
Remote services: health and schoolsFederal: Health policy, standards and specialised hospitals (Sch. 5 item 16). Provincial: Health services; higher education (Sch. 6 items 8, 9). Local: Basic and secondary education; basic health and sanitation (Sch. 8 items 8, 9; Sch. 9 items 2, 3).3
Shared
Apples, herbs and forestsFederal: National forest policy, national parks and wildlife reserves (Sch. 5 item 27). Provincial: Agriculture and livestock; use of forests within the province (Sch. 6 items 19, 20); inter-provincial forests and Himalayan areas concurrent (Sch. 7 item 23). Local: Agriculture and agricultural extension (Sch. 8 items 15, 18); forests and biodiversity shared by all levels (Sch. 9 items 4, 7).3
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.4
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
Eligible households reached and exclusion complaints resolved12
Not established
No official target found
2026-10-20
Household earnings and essential service access measured over time12
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. 6', 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
- 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
- Nepal Living Standards Survey IV 2022-23: Summary Report — National Statistics Office, Office of the Prime Minister and Council of Ministers, Government of Nepal, February 2024. 'Poverty in Provinces and Domains under the New Federal Structure', printed p. 13 (PDF p. 22); Table 11 'Provincial poverty, 2022-23', printed p. 14 (PDF p. 23); national rate, Table 9. Checked 2026-10-11
- सोह्रौं योजना (आ.व. २०८१/८२–२०८५/८६) (The Sixteenth Plan), Chapter 9: provincial and local economies, current situation — National Planning Commission, Government of Nepal, 2081 BS. Section 9.2, items (1) provincial GDP shares, (2) provincial growth rates, (3) per-capita GDP, (5) multidimensional poverty and Human Development Index, printed pp. 180–182 (PDF pp. 194–196). 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.)
