Question 1 What is the issue, and why does it matter?
Between the 2011 and 2021 censuses, 10 of Koshi's 14 districts lost population: Taplejung (-0.53 per cent a year), Sankhuwasabha (-0.04), Solukhumbu (-0.09), Okhaldhunga (-0.56), Khotang (-1.56), Bhojpur (-1.39), Dhankuta (-0.78), Tehrathum (-1.30), Panchthar (-1.02) and Ilam (-0.36). Jhapa (1.97), Morang (1.66), Sunsari (1.86) and Udayapur (0.68) grew.1
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.
This means services have to keep reaching smaller, older and more scattered hill populations while towns in the Tarai need more schools, water and roads. Where to put new money is therefore partly a choice between places.
Question 2 What do current law and policy say?
Basic and secondary education and basic health are local powers (Schedule 8, items 8 and 9); provincial universities, higher education and health services are provincial (Schedule 6, items 8 and 9); education and health are concurrent for all three levels (Schedule 9, items 2 and 3).2
Large central projects and inter-province transmission are federal (Schedule 5, items 12 and 14); province-level electricity is provincial (Schedule 6, item 7); small hydropower is local (Schedule 8, item 19); electricity services and natural-resource royalties are concurrent for all three levels (Schedule 9, items 5, 6 and 14).2
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.3
Question 3 What is known, uncertain or disputed?
Known
Between the 2011 and 2021 censuses, 10 of Koshi's 14 districts lost population: Taplejung (-0.53 per cent a year), Sankhuwasabha (-0.04), Solukhumbu (-0.09), Okhaldhunga (-0.56), Khotang (-1.56), Bhojpur (-1.39), Dhankuta (-0.78), Tehrathum (-1.30), Panchthar (-1.02) and Ilam (-0.36). Jhapa (1.97), Morang (1.66), Sunsari (1.86) and Udayapur (0.68) grew.1
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 network1
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.
B
Invest in connected service centres1
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
Schools and healthBasic and secondary education and basic health are local powers (Schedule 8, items 8 and 9); provincial universities, higher education and health services are provincial (Schedule 6, items 8 and 9); education and health are concurrent for all three levels (Schedule 9, items 2 and 3).2
Shared
Hydropower and transmissionLarge central projects and inter-province transmission are federal (Schedule 5, items 12 and 14); province-level electricity is provincial (Schedule 6, item 7); small hydropower is local (Schedule 8, item 19); electricity services and natural-resource royalties are concurrent for all three levels (Schedule 9, items 5, 6 and 14).2
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.3
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 season1
Not established
No official target found
2026-10-20
Staffed service days and referral completion, by ward1
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, incl. first and second amendments), Schedules 5–9 — Nepal Law Commission, Government of Nepal, Gazette publication 20 September 2015 (2072/06/03); amended 2016 and 2020. Schedule 5 (federal powers), pp. 193–195; Schedule 6 (provincial powers), pp. 196–197; Schedule 7 (federal–provincial concurrent powers), pp. 198–199; Schedule 8 (local powers), pp. 200–201; Schedule 9 (concurrent powers of all three levels), p. 202. Item numbers are given in each statement that cites this source.. 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 (NPHC 2021): National Report — National Statistics Office, Government of Nepal, 2023 (census day 25 November 2021). Part I key results 3, 4, 9 and 11, pp. 1–2; Table 14 (households and population; absentees abroad), p. 58 (PDF p. 73); Table 15 (households, average household size, sex ratio, density, 2011 population and annual growth rate, by province and district), pp. 62–64 (PDF pp. 77–79); Table 24 (population aged 5+ by literacy status), p. 199 (PDF p. 214). 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.)