How will Nepal develop in the next decade?

Nepal is recognised as the only low-income country to have made rapid progress cutting poverty and boosting public health and education in recent decades. But can these achievements be sustained in the 2020-2030 decade?

The country’s maternal mortality rate decreased from 539 deaths per 100,000 live births to 239 deaths between 1996 and 2016. The adult literacy rate rose from 20% in the 1980s to 67% in 2018, and the proportion of Nepalis living below the poverty line dropped from 42% to 21% in two decades.

Yet the poorest still do not have access to affordable healthcare. The school dropout rate is as high as the enrolment rate. In urban centres, people breathe some of the foulest air in the world, reducing their life expectancy by up to four years. Many lack safe drinking water.

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Local elections in 2017, after a gap of 20 years, were supposed to close these gaps by delivering accountable, elected leaders. Two years later, the euphoria has evaporated. The state of the state remains stagnant.

“The elections helped us rebuild grassroots democracy and decentralise power, but the lack of accountability at all levels of government continues to be a major challenge,” says Min Bahadur Shahi of the National Planning Commission (NPC). “This is why the primary agenda of the NPC’s 15th periodic plan is governance reform, controlling corruption and promoting transparency.”

As we step into the new decade, there are questions about Nepal’s progress in human development, including whether we are on track to meet the UN’s Sustainable Development Goals (SDGs) and achieve double-digit growth. Reaching these targets will require huge investments in healthcare, schools and nutrition. With the emergence of non-communicable diseases, Nepal now faces a double burden: rising rates of diabetes, cardiovascular diseases and cancer, which are expensive to treat, while the poor continue to die of easily curable infections.

Said Sanjib Sharma, doctor at the BP Koirala Institute for Health Sciences in Dharan: “Our efforts now should be on strengthening primary health care and prevention and early detection of diseases using existing tools, as well as new technologies such as artificial intelligence for virtual expert consultation and drug delivery.”

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Despite poverty falling by half, one-third of Nepali children are still malnourished. Anaemia among women has actually increased in recent years. The government’s Multi-sectoral Nutrition Plan, developed in 2012, works to improve maternal and child health, vaccination rates and malnutrition.

“Development in Nepal is still synonymous with roads, but investing in early childhood development is equally important, it is a component of development,” said Kiran Rupakheti of the NPC, which wants nutrition programs to reach the grassroots.

Even as literacy rates rise, gender disparity is expected to continue in the coming decade. As female literacy improves, for instance, child marriage and girls’ dropout rates will persist. Experts say improving the quality of instruction at community schools, encouraging female students in technical fields and promoting applied education should be priority areas in the 10 years ahead.

Nepal is expected to graduate from lower-middle-income country status by 2030, but that is unlikely if the SDGs goals are not met. For this, the government will need to spend $1billion a year in infrastructure alone. Nepal is hoping to sustain double-digit growth of above 10% and achieve per capita income of $1,595 by the end of the decade.

“I’m hopeful about our prospects but if we uplift the economic status of women, who make up more than half of the population, we will get there sooner,” said Saru Joshi, gender and development expert.

A 2017 World Bank report, however, stated that if present trends continue Nepal will not reach its middle-income target. It pointed out that despite rapid reduction in the poverty rate, the country’s development path has not led to economic growth but perpetuated a shortage of jobs at home, which in turn is fuelling further outmigration. And while remittance accounts for one-third of the national GDP, it is a symptom of deep-seated, chronic problems.

Planners say that a slew of new hydropower and large infrastructure projects planned for the next 10 years, a boom in tourism and the service sector, and better connectivity will create jobs at home, discouraging youth from seeking employment elsewhere.

“We know our targets are ambitious but we also have the most favourable environment to achieve it. There is finally stability, the present growth is already at 7%, some major hydropower projects are taking off and we have made huge investments in information technology,” said Rupakheti.

Shahi forecasts optimistically: “The 2020s will be a progressive decade of sustainable and just development. There will be prosperity along with social justice. There will be double-digit growth, increased investment from the government and the focus will be on quality, not quantity.”