<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221109141112/636ba77e9c7e80680e073787jpeg.jpg" alt="" width="1728" height="1296"/><figcaption>A woman gets Sayana Press suring the lockdown. Photo: IPAS NEPAL</figcaption></figure>For the past two decades, Basanti Paudel, 41, of Nawalpur had always used Depo-Provera to <a href="https://www.nepalitimes.com/banner/no-conceivable-reason-for-unwanted-pregnancies/" target="_blank" rel="noopener noreferrer">prevent unwanted pregnancies</a>  Then last year, she was given a new choice: Sayana Press.<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/here-now/nepal-far-from-hitting-contraceptive-target/" target="_blank" rel="noopener noreferrer">Sayana Press</a>, a successor to Depo-Provera, was introduced last year in  Nawalparasi and Sindhuli and is a better option because it has a smaller dosage, comes with a small needle, can be stored at room temperature and is injected sub-cutaneously just under the skin rather than in the muscles, making it less painful. Sayana can also be self-injected at home and lasts for three months just like Depo-Provera.Basanti Paudel immediately took to the new contraceptive. “It is a much better, but I worry about its availability during the lockdown, and that I may have to go back to using Depo-Provera,” she says.Pabitra Acharya, 42, of the same neighbourhood also started using Sayana Press after her husband who was working in India came back home following Covid-19 pandemic. She would also like to continue using the injection but is also worried about its availability.“Once we decide on the contraceptive best for us, we should be able to access it each time. Using different methods affects our health,” Acharya says.Both women were at the Rajahar Health Post in Nawalpur this week to express their concern about availability. At the health post, Dev Bahadur Dahal  Nawalpur assured them that they would not have to go back to using Depo Provera.“The drug used in Sayana Press and Depo-Provera is the same, the only difference is the dose, which is 30% lower. We thought why not go for an option that has lower drug but is just as effective and not as painful,” says Lhamo Y Sherpa of Ipas Nepal, adding that depending on the results in the two districts, the new contraceptive would be scaled up to the rest of the country.<a style="font-size: 15px; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/implant-service-providers-take-contraception-to-nepals-poor/" target="_blank" rel="noopener noreferrer">Nepal’s contraceptive prevalence</a> rate at 53% is a dramatic improvement from 20 years ago, but it is still a long way from the government’s target of 75% contraceptive prevalence by 2030.Furthermore, the use of modern family planning methods has plateaued since 2006 <a href="https://www.nepalitimes.com/here-now/migrating-males-and-population-decline/" target="_blank" rel="noopener noreferrer">due to labour migration</a>. But the <a href="https://www.nepalitimes.com/here-now/workers-return-to-jobless-nepal/" target="_blank" rel="noopener noreferrer">return of hundreds of thousands of migrant workers from India</a> and the Gulf following the Covid-19 pandemic is leading to an increase in the demand of contraceptives. Which is why there is a <a href="https://www.nepalitimes.com/here-now/baby-boom-expected-after-lockdown/" target="_blank" rel="noopener noreferrer">fear of shortages</a>  and also a break in the supply chain because of the lockdowns.According to the Nepal Demographic and Health Survey (NDHS) 2016, there is a 24% unmet need for family planning in Nepal — a quarter of women who need contraceptives are not using them.Sayana Press offers a new and easy to use contraceptive that can help meet the country’s unmet needs for family planning. It also gives women agency, especially because their husbands often refuse to use condoms.The new birth control device is already popular with women in Nawalparasi and Sindhuli districts and very few users have complained of side effects normally associated with contraceptives. In fact, users have reported fewer reproductive health complications.“For 20 years, I never got my periods regularly, once I did not have them for two years, and had to resort to medications to force my period,” says Basanti Paudel. “Since using Sayana, it has become more regular. It evevn seems to have brought down my blood pressure, and I don’t have nausea anymore.”Dilmaya Pariyar, 29, has been using contraceptives for 12 years and once every three months she needed to go to a health post to get a Depo-Provera injection, which was always followed by a week of pain in her arms, preventing her from working.“With Sayana Press, I haven’t had any pains. In fact, this has been the most suitable contraceptive for me so far,” she says. The other advantage is that Sayana Press can be injected at home with some basic training.There are some women who have complained of excessive bleeding for up to seven days after switching to Sayana Press, but according to a survey, the new contraceptive appears to have been well accepted in the trials which are conducted by the reproductive health agency Ipas Nepal and the Ministry of Health and Population (MoH) with financial support from the UK’s Department for International Development (DFID). Sayana Press is already used in 40 European countries.Of 1,112 women from 17-49 years of age who participated in the Ipas Nepal comparative study, 12% said they preferred Sayana Press to Depo-Provera. Participants also found the fact that it was self-injectible quite appealing.Says Bhim Singha Tinkaro, head of Family Welfare Division in the Health Ministry: “Given the positive results so far, Sayana Press can now be expanded to other parts of the country, and the ministry is expected to make a decision soon.”

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New contraceptive for increased lockdown demand

<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108141124/636a58c19c7e80680e054852jpeg.jpg" alt="" width="1400" height="933"/><figcaption>WELCOME TO THE WORLD: A child sleeps in a hammock while its parents work in a workshop making idols for the Dasain festival in Kupondol. Photo: GOPEN RAI</figcaption></figure>Giving birth is a life or death issue in Nepal. Even though the maternal mortality rate dropped from 1,000 per 100,000 live births 40 years ago to 239 today, inadequate birthing facilities is still a problem. But attention is now also shifting to preventing pregnancies.There is a big <a href="https://www.nepalitimes.com/banner/implant-service-providers-take-contraception-to-nepals-poor/">unmet need for contraceptives</a>: nearly a quarter of women surveyed nationwide in 2016 said they were not using birth control, even if they need it. Social stigma, patriarchy, ignorance and lack of access were reasons.Nepal’s contraceptive prevalence rate is 52%, but in remote Bajura it is only 34%. Although progress is being made, we are still a long way from the government’s target of raising the rate to 75% by 2030.Read also: <a href="https://www.nepalitimes.com/?p=33714&amp;preview_nonce=033aa12640&amp;preview=true" target="_blank" rel="noopener">Nepal far from hitting contraceptive target,</a> Sewa BhattaraiAs our reports in this edition from Bajura and Chitwan show, there are cultural hurdles. With <a style="background-color: #ffffff; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/here-now/migrating-males-and-population-decline/" target="_blank" rel="noopener">husbands away working for long periods</a>, their wives are reluctant to use contraceptives because of what others will say. The result: women suffer unwanted pregnancies, <a style="background-color: #ffffff; letter-spacing: 0.01em;" href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/globe-rallies-to-aid-nepals-women,3841" target="_blank" rel="noopener">unsafe abortions</a> and ultimately struggle to take care of large families.Almost every woman who visited a hospital in Bajura on a busy day last month had the same story: their husbands were away and they did not use birth control. Some were suffering from botched abortions.More than 800 abortion cases were registered in Bajura last year. Just one hospital in Achham terminated more than 600 pregnancies in one year. Meanwhile, Nepal’s total fertility rate has dropped from 6 in 1960 to near-replacement level at 2.05 today, and the country’s population growth rate is also down from 2.5% in 1990 to 1.1% today. Surveys in Province 2 and Far-western Province have shown a clear correlation between unwanted pregnancies, child marriage and fertility in regions with entrenched patriarchy.Among Nepalis, 21% use injectable contraceptives, 10% are on pills, 10% use condoms, 8% have IUDs and only 3% have implants. Depo-Provera was among the most used injectables, but it was difficult to administer and painful. Now, the government, with donor support, is field-testing in Nawalpur and Sindhuli a lower-dose injectable called Sayana Press, which could make contraceptives more accessible to women.Interventions like these, the government hopes, will reduce unwanted pregnancies, thus preventing unsafe abortions and reducing the number of women who have to take care of larger families.<a href="https://archive.nepalitimes.com/regular-columns/Comment/mothers-in-Nepal-still-dying-at-childbirth,1007" target="_blank" rel="noopener">Complications during pregnancy or at childbirth</a> are the leading causes of death among girls aged 15-19 in low-income countries like Nepal. Unwanted pregnancies also hamper women’s education and economic independence, and impact their family life, fuelling an intergenerational cycle of poverty and poor health.Read also: <a style="background-color: #ffffff; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/implant-service-providers-take-contraception-to-nepals-poor/" target="_blank" rel="noopener">Implant service providers take contraception to Nepal's poor</a>, Rojita Adhikari

Born in Nepal

https://youtu.be/VaSUaALct0oParvati Thapa, 39, looks lost as she wanders into the district hospital in this isolated northwestern corner of Nepal. She and her husband have walked a whole day to get here, and they just found out she is 19 weeks pregnant.Thapa already has three children, and after they were born she lost four sons one after another. After her menstruation stopped, she suspected menopause but now knows she is pregnant for the eighth time.“My husband is away for months at a time, tending cattle in the mountains. Why should I use <a href="https://www.nepalitimes.com/banner/implant-service-providers-take-contraception-to-nepals-poor/" target="_blank" rel="noopener">family planning</a> when we meet so rarely?” asks Thapa, who looks much older than her age.Read also: <a href="https://www.nepalitimes.com/?p=33648&amp;preview_nonce=5c7e9df60a&amp;preview=true" target="_blank" rel="noopener">Born in Nepal</a>, Sewa Bhattarai<a href="https://www.nepalitimes.com/?p=33648&amp;preview_nonce=5c7e9df60a&amp;preview=true" target="_blank" rel="noopener"> </a>Like most women in the remote mountains, Thapa has never used contraceptives. <a style="background-color: #ffffff; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/here-now/migrating-males-and-population-decline/" target="_blank" rel="noopener">Doing so carries a stigma for married women with migrant husbands</a>, and there are misconceptions about the different methods available. The result is that women suffer unwanted pregnancies, <a style="background-color: #ffffff; letter-spacing: 0.01em;" href="https://archive.nepalitimes.com/article/Nepali-Times-Buzz/globe-rallies-to-aid-nepals-women,3841" target="_blank" rel="noopener">unsafe abortions</a> and end up with large families they are  unable to take care of.Nepal’s contraceptive prevalence rate is 53%, but in Bajura it is only 34%. Although this is a dramatic improvement from 20 years ago, it is still a long way from the government’s target of 75% contraceptive prevalence by 2030. The fact that the use of modern family planning methods has plateaued since 2006 points to futher deterrences.“The family planning rate is really low in Bajura because a lot of the men migrate to India for work,” says nurse Dhankala Khadka at Bajura District Hospital. “If the husband is away and the wife wants to use birth control, she is often questioned about fidelity and may be ostracised by her community. Even husbands do not support them.”<figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108141124/636a58de9c7e80680e054862jpeg.jpg" alt="" width="1400" height="970"/><figcaption>Parvati Thapa went to Bajura district hospital suspecting menopause, but found out it was her eighth pregnancy. Photo: MONIKA DEUPALA</figcaption></figure>Almost every woman who visited nurse Khadka on a busy day last month had the same story: their husbands were away and they did not use birth control.There were 804 abortions in Bajura in the past year, which Rohit Giri of Bajura District Hospital says is very high: “Most who come to us are married women with children, and the abortions are due to the lack of birth control, which leads to unwanted pregnancies.”<a style="background-color: #ffffff; letter-spacing: 0.15px;" href="https://www.nepalitimes.com/banner/this-is-how-to-upgrade-nepals-rural-health/" target="_blank" rel="noopener">In Bayalpata Hospital</a> in neighbouring Achham district, the story is much the same — it performed 660 abortions in the past year. Bhawana Rawal, 33, has had two abortions at the hospital in the past five years and admits she does not used birth control.Read also: <a href="https://www.nepalitimes.com/here-now/migrating-males-and-population-decline/" target="_blank" rel="noopener">Migrating males and population decline</a>, Om Astha Rai“I already have two children, and do not need any more, but I got pregnant twice by accident,” she says. “I still do not want to use contraceptives in future.” Rawal did try a Depo-Provera injection once but says it made her bleed too much. Other women have the same complaint. For those who do not want to use a permanent contraception, many felt pills were a hassle to acquire and take every day, and IUDs hurt.“Unwanted pregnancies often lead to anaemia because women lose so much blood,” says Kalawati Setthi, a nurse at Bayalpata Hospital. Nearly 40% of women in Far-western Nepal were found in a survey to be anaemic — most of them pregnant and <a href="https://www.nepalitimes.com/banner/back-to-the-nipple-in-nepal/" target="_blank" rel="noopener">breastfeeding</a>.The government has put up posters in rural hospitals to encourage contraceptive use but at this rate, it is unlikely that the target of 75% contraceptive use will be reached.<h2>Demand, but no supply</h2>According to the Nepal Demographic and Health Survey (NDHS) 2016, there is a 24% unmet need for family planning in Nepal — a quarter of women who need contraceptives are not using them. A report by Population Services international (PSI) Nepal found that unmarried youth aged 15-24 and married women aged 20-24 are the groups that use contraceptives the least.Married women like Parvati Thapa at a clinic in Bajura last month (left), normally tended to use contraceptives after their first child, and exposure to information about family planning through health workers and current users of family planning, as well as talking about it with husbands or relatives.Unmarried youth were likely to discuss family planning only with their sexual partners and most used condoms over other methods, which were bought and kept by the male partner. In contrast, married women visited health facilities themselves and chose the type of method they wanted.Unmarried youth, especially adolescents, had a higher unmet need and were more vulnerable to stigma associated with family planning. The report argues that the term ‘family planning’ only applies to married women and their plan to have children, whereas there are many contraceptive users who have no intention of having children, or use contraceptives to prevent sexually-transmitted diseases (STDs).Read also: <a href="https://www.nepalitimes.com/banner/child-marriage-in-nepal-eloped-at-13-mother-by-17/" target="_blank" rel="noopener">Child marriage in Nepal, eloped at 13, mother by 17</a>, Sewa BhattaraiWhen a woman goes to a public health facility for contraceptives, a register is filled out, which includes a column for ‘husband’s name’, which is another deterrent for unmarried women. Though the husband’s name is optional, there is no column for the wife’s name when it comes to male contraceptives like condoms or a vasectomy.A report by the UN Population Fund (UNFPA) about sexual and reproductive health says complications in pregnancy and childbirth are the leading cause of death among girls aged 15-19 in low-income countries like Nepal. Unwanted pregnancies also hamper women’s education and economic independence, and impact their family life, fuelling an intergenerational cycle of poverty and poor health.<h2>More choice for family planning</h2><figure><img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108141124/636a58e19c7e80680e054863jpeg.jpg" alt="" width="1400" height="1029"><figcaption> </figcaption></figure>Although Nepal’s contraceptive prevalence rate has increased dramatically, from 7% in 1981 to nearly 60% today, social taboos, patriarchy and unavailability mean that many women still do not have access to birth control.It usually falls on women to take the initiative, since many men refuse to use condoms or get a vasectomy. Popular contraceptives used to be the pill or Depo-Provera, an injectable that needs refrigeration and must be taken at a clinic, but the dosage is high and the injection painful.Now, women like Shanti Adhikari, 43, in Chitwan, (pictured, right) who have always used Depo-provera for short-term contraception, have a new choice: Sayana Press.Read also: <a style="background-color: #ffffff; letter-spacing: 0.01em;" href="https://www.nepalitimes.com/banner/implant-service-providers-take-contraception-to-nepals-poor/" target="_blank" rel="noopener">Implant service providers take contraception to Nepal's poor</a>, Rojita Adhikari<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108141124/636a58e49c7e80680e054864jpeg.jpg" alt="" width="524" height="531">Adhikari’s husband, who works as a security guard in India, will be coming home for Dasain, so she is at the health post in Nawalpur for her Depo-Provera progesterone hormone injection, which prevents pregnancy for three months.But auxiliary nurse midwife Sharada Rimal (pictured, left) tells her about Sayana Press. Its advantages over Depo-Provera are that it comes with its own small needle, the dosage is much smaller, it is less painful and can be self-injected.“Everyone in my neighbourhood comes to this health post for contraceptives, but no one told me about this new injection. The needle looks much smaller, I think I will go with this one,” says Adhikari, 43, as Rimal proceeded to inject her in the thigh.Sayana Press, a successor to Depo-Provera, is being launched in Nepal in two districts: Nawalpur and Sindhuli, by the reproductive health agency Ipas Nepal in coordination with the UK’s Department for International Development (DFID) and the Ministry of Health and Population (MoH). The drug has already been tried and approved, and is available for use in 40 European countries.What sets Sayana apart from Depo-Provera is the smaller dosage (104 mg compared to 150), it comes with its own needle, it can be stored at room temperature and is injected sub-cutaneously (just under the skin), rather than in the muscles like <a href="https://archive.nepalitimes.com/article/from-nepali-press/Ftnp-the-curse-of-the-contraceptive,493" target="_blank" rel="noopener">Depo-Provera</a>.Injectable contraceptives are the most popular reversible contraceptive among women, for a variety of reasons. Adhikari says she does not like pills because she has to remember to take them every day, and, because of her age, she wants to be discreet about using them.While most other methods, like IUCDs, implants, condoms and pills, are visible and can be discovered by others, an injection leaves no traces. 52% married couples use contraceptives in Nepal: 8.9% use injectables, 4.6% are on pills, 4.2% use condoms, 1.4% use IUDs and only 3.3% use implants. 9.8% use other traditional methods. Some have gone for permanent contraception, with 14.7% preferring female Sterilization and 5.5% male Sterilization.“Depo-Provera has been in use for 50 years, but it was so popular and effective not much further research was done on it,” explains Lhamo Yangchen Sherpa of Ipas. “But WHO studies found that a much lower dosage was enough.”<img src="https://superdesk-pro-c.s3.amazonaws.com/sd-nepalitimes/20221108141124/636a58e69c7e80680e054865jpeg.jpg" alt="" width="478" height="531">Health workers like Rimal confirm that Sayana Press is much easier to inject, more portable and less painful. Though it is self-injectable in some countries, in Nepal, where it has been undergoing trials in 14 health facilities of Nawalpur and Sindhuli since 5 September, it will only be administered by health professionals.Bhim Singh Tinkari of the MoH Family Welfare Division says that since 7% of pregnant women still die from unsafe abortions, making contraceptives easily accessible can save lives. Binod Bindu Sharma of the MoH links contraceptives to women’s choice and empowerment. “The availability of contraceptives is important for women’s rights, since it lets women choose when and how many children to have,” says Sharma, adding that the ministry is making Sayana Press available for free in health facilities.Lisa Honan, head of DFID Nepal, links contraceptives with women’s economic potential, adding that the country can make better use of women in the workforce if they have better choices of contraceptives. “DFID is committed to providing Sayana in any volume in Nepal until 2022 through UNFPA (the UN Population Fund), and would help Nepal scale it up all over the country if the results of the feasibility study are positive.”

Nepal far from hitting contraceptive target

Imagine a high-end fair trade tea brand from Nepal that has done everything right, with ethical sourcing practices and international certifications. It has built a loyal base of socially conscious, premium customers in an export market and focuses on quality over quantity. Then one day, a government in the export market introduces a new ‘listing criteria’ that requires exporting a certain amount of tea to at least three countries in the past five years. But this was never a numbers game, it was about a niche market of socially responsible tea lovers. Suddenly, fair trade tea companies are restricted from exporting tea to that country. Pretty unfair for the company, for consumers, for the tea sector. More importantly, for tea farmers and families benefiting from fair standards. The overseas labour industry is facing a similar risk as recruiters, including those that have adopted ethical standards, may soon be barred from finding workers for Malaysia. On 27 October, the Malaysian Ministry of Foreign Affairs sent letters to five countries including Nepal, Bangladesh, Burma, Pakistan and India to ‘rationalise the number of licensed private recruitment agencies permitted to facilitate recruitment and placement of workers to Malaysia’.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251030141040_050274dddc6cf10224b0ad9283eec7b3bc3c0acd650543a808a8ea473ecf40db.jpg" data-media-id="editor_0" data-image-id="20251030141040_050274dddc6cf10224b0ad9283eec7b3bc3c0acd650543a808a8ea473ecf40db" data-rendition-name="original" width="961" height="1135" loading="lazy" alt="Malaysia recruitment"></figure>  The letter includes 10 criteria for private recruiting agencies including at least five years of operating experience, deployment of 3,000 workers in the past three years of operation, experience sending workers to at least three countries, a 10,000 sq m office maintained for three years, valid licenses and good conduct certificates, five employer testimonials, and operating their own training and accommodation centres. Two conditions stand out as potentially harmful to Nepal’s ethical recruitment movement. First, although the letter cites a minimum of 3,000 workers, it says three years in the heading and five in the body text. A big enough difference to affect a significant number of recruiters from making the cut, but problematic regardless. Second, the requirement to send workers to at least three countries disproportionately impacts responsible recruiters in Nepal and elsewhere. Turning the selection of workers into a numbers game is dehumanising. Responsible recruiters deprioritise volume, focus on quality of jobs even when business sustainability comes under threat as ethical opportunities that do not require workers to pay any feed and ensure greater transparency are difficult to come by. Sending workers is further impacted by a series of external shocks. For example, in the Malaysian context Nepal banned emigration to Malaysia for two years followed by the Covid pandemic, and then Malaysia’s decision to stop the intake of foreign workers for the last two years.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251030141040_b1b88b3ae2e94c6bc077529ac6f2a4e380a385ee9a22219edfed25067c9d25a1.jpg" data-media-id="editor_1" data-image-id="20251030141040_b1b88b3ae2e94c6bc077529ac6f2a4e380a385ee9a22219edfed25067c9d25a1" data-rendition-name="original" width="595" height="841" loading="lazy" alt="Malaysia recruitment"></figure>   <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251030141040_2cf252908d18aaf09c875002eef2d92ab45897a56b560addd2dc02311725c8a7.jpg" data-media-id="editor_2" data-image-id="20251030141040_2cf252908d18aaf09c875002eef2d92ab45897a56b560addd2dc02311725c8a7" data-rendition-name="original" width="590" height="238" loading="lazy" alt="Malaysia recruitment"></figure>  Many ethical recruiters have focused on Malaysia because it is a more common labour market for responsible recruitment than other destinations like the Gulf. There is no credible justification to why responsible recruiters well regarded by scores of Malaysia-based multinational companies and with decades of experience should be ‘disqualified’ for not diversifying. Finding jobs for Nepalis in new markets is difficult given fierce competition, challenges identifying companies which follow the employer-pays principle, lack of networks and shortcomings in marketing strategies. These factors hit responsible recruiters harder because profit-motivated employers are often unwilling to cover the costs and fees associated with workers’ recruitment. “The volume of deployment does not determine a recruiter’s capability or the quality of services provided,” says Sujit Shrestha of the Nepal Association of Foreign Employment Agencies (NAFEA). Nepal recently scrapped the licensing renewal requirement that mandated sending at least 100 workers a year as it was impractical. The new Malaysian criteria is similar in nature, he added. The ball is now in Nepal’s court at a time when the interim government does not even have designated heads in the Foreign Ministry and the Ministry of Labour, Employment Employment and Social Security. When rumours about the Malaysian action started circulating, NAFEA had raised the issue, but was assured that this was not an attempt to set up a syndicate.  <figure><img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251030141044_83c8a174ef116603f747d1cd254c4d353e8b855a41fb99feec54e701f5fc4c3f.jpg" data-media-id="editor_3" data-image-id="20251030141044_83c8a174ef116603f747d1cd254c4d353e8b855a41fb99feec54e701f5fc4c3f" data-rendition-name="original" width="3456" height="5184" loading="lazy" alt="Malaysia recruitment"></figure>  How will governments and recruiters in other origin countries now respond? There is precedence from Bangladesh. Dhaka-based journalist at the Daily Star, Porimol Palma who says, “Earlier, the Malaysian authorities had selected 101 Bangladeshi recruiters unilaterally, despite Bangladesh’s call for a syndicate-free recruitment mechanism.” Between 2022-2024, 450,000 Bangladeshis were recruited under this system with workers paying between $4,500 and $6,000, even though the legal limit was $750. Palma attributes part of the high fees workers had to pay were for commissions or bribes to recruitment syndicates. Adrian Pereira heads the North South Initiative in Malaysia says: “The criteria seems a bit fishy, as they do not appear to address the actual problems in the the recruitment of foreign workers. Some of the criteria seem to encourage a system of monopoly or syndicate rather than a rights-based approach. Every government has the right to set criteria for recruiters, but conventions and ILO (International Labour Organization) standards on recruitment exist. It looks like we’re back to square one.” Whether migrant origin countries including Bangladesh and Nepal accept the terms sent without reservations or push back in good faith remains to be seen. In an ideal world, a collective stance should put workers’ needs and welfare at the centre. How rational is the proposed ‘rationalising strategy’? What aspects of it are promising to curb recruitment abuse and what merits serious reconsideration? Even if the move from the Malaysian side is well-intentioned to address rampant malpractices migrant workers face, Nepal should deliberate on the conditions set, the collateral damage especially on the responsible actors and small but capable recruiters. Alternate options that might serve everyone better before rushing to respond with a chosen list by 15 November. If the proposal is accepted, how would it be done in a transparent and accountable way? It is noteworthy that Indonesia was not listed even though it has the most workers in Malaysia among the 16 countries that send migrants to Malaysia. The Responsible Business Alliance (RBA), the ILO, the International Organization for Migration (IOM), and certification programs like On the Level (OTL) also need to use their leverage to ensure that recruiters, including those they have trained or certified on ethical recruitment principles, are not penalised. This is more than just about protecting the ethical recruitment movement, but raising even more basic questions: Who can legally be a recruiter in Nepal? There are already obligations like hefty security deposit and minimum office requirements. But requirements to have building facilities with ‘accommodations’ or ‘testing centres’ are not among them. There are 1,150 plus players in Nepal’s recruitment sector, with a few hundred engaged in the Malaysian market. A unilateral selection criteria could risk foul play, or lead to unintended, unfavourable consequences. To be sure, overseas recruitment in Nepal is known for ‘settings’, corruption, dog-eat-dog competition, and collusion. The profiteering is out of control, often at the expense of workers. But the solution does not lie in stifling the industry with criteria like deployment volume, building worker accommodations or expanding office floors. The focus should instead be on enforcing rules and laws in both countries that govern the industry, and the Malaysian labour agreement that has not been renewed since October 2023. Meddling in the industry in ways that harms fair competition and ethical actors means workers suffer. The only issue that should be taking precedence is: how will Malaysia’s 10-point criteria and planned arrangement affect migrant workers? We have seen how for identical Malaysia-based jobs, one worker might pay zero while another pays up to Rs400,000, depending on the employer and recruiter. It is unclear if the 10-point selection criteria rewards the employer. As a longstanding host country for Nepali migrants, Malaysia deserves credit for nurturing the small but growing ethical recruitment industry here. Export-oriented companies in Malaysia need responsible recruitment partners and have mentored recruiters to strengthen their practices and move away from worker-paid models. The business case for ethical recruitment standards has led many recruiters in Nepal to pivot with many now in various stages of transition from traditional to hybrid or purely ethical practices. This progress needs to be acknowledged and built upon. Large, well-networked recruiters with large physical assets and high volume of workers seem to be the winners of Malaysia’s 10-point criteria after two years of waiting for the Malaysian market to reopen. Responsible recruiters endure long periods of minimal or no deployments that threatens their survival. The letter now sitting on the desk of the interim government in Nepal deepens the concern: rather than just failing to recognise or reward responsible recruiters, does the international recruitment market actually punish them? Upasana Khadka heads Migration Lab, a social enterprise aimed at making migration outcomes better for workers and their families. Labour Mobility is a regular column in Nepali Times.

Who gets to recruit for Malaysia?

Public anxiety about immigration has become a powerful political currency across many liberal democracies. In Australia, as elsewhere, legitimate concerns about housing and economic fairness can be, and increasingly are exploited by anti-democratic actors who frame migration not as a policy issue but as a cultural threat.&nbsp;
When these narratives move from online spaces to public rallies, they do more than divide opinion; they erode the social trust and pluralism on which democracy depends. Understanding how populist and far-right movements weaponise migration debates is crucial to recognising the early challenging signs of liberal democracy.
Immigration has become one of the most politically charged issues in Australia, not only because of the numbers but because of its entanglement with cost-of-living pressures, housing shortages, and rent spikes.&nbsp;
The latest Household, Income and Labour Dynamics in Australia (HILDA) <a href="https://www.unimelb.edu.au/newsroom/news/2025/september/how-we-live-latest-hilda-data-gives-insight-into-a-changing-australia">data</a> shows rising household financial stress as Australian households spending more on rent and income tax. These changes likely reflect a mix of economic and policy factors but create a lot of room for people to hold inaccurate and occasionally contradictory attitudes on these issues.&nbsp;
While net overseas migration has started to decline from its post-pandemic peak, public concern remains high, amplified by populist rhetoric. Some surveys have <a href="https://www.theguardian.com/australia-news/2025/feb/04/australians-want-less-migration-but-oppose-cutting-international-student-numbers-study-finds">revealed</a> a nuanced picture: most Australians want lower migration overall but oppose cutting international student numbers, and support targeted skilled migration to address workforce gaps.&nbsp;
As former Home Affairs Minister Clare O’Neil <a href="https://minister.homeaffairs.gov.au/ClareONeil/Pages/how-australia-broke-its-migration-system.aspx">argued</a> in 2023, Australia’s migration system is “broken and un-strategic”, not delivering for business, for migrants, or for the larger population. This is a situation that frustrates both sides of the debate and makes immigration an easy political flashpoint.
The recent <a href="https://marchforaustralia.org/">March for Australia</a> rallies turned these anxieties into street-level mobilisation. Tens of thousands <a href="https://www.bbc.com/news/articles/czjmre371l1o">protested</a> at what they called ‘mass immigration’, while far-right groups seized the opportunity to inject xenophobic slogans and calls for ‘remigration’ into the public space. These demonstrations were not only about visa caps or housing and jobs; they became performances of who is entitled to belong.&nbsp;
When immigration is framed not as a policy question but as a cultural test of Australianness, it risks shrinking the demos, the very community that democracy is meant to represent.
What made the March for Australia so striking was not only its size but its composition. Recent investigative reporting <a href="https://www.theage.com.au/politics/victoria/don-t-mention-hitler-and-you-re-sweet-the-great-march-for-australia-deception-20250909-p5mtlc.html">revealed</a> that neo-Nazi groups were not merely present at the March for Australia rallies but played a role in covertly organising them. They amplified messaging online, coordinated attendance, and sought to mask their involvement to broaden appeal.&nbsp;
This highlights that democratic erosion is rarely spontaneous; it requires actors who deliberately exploit social grievances, mistrust, and polarisation to mobilise anger for their anti-democratic ends. The banners reading ‘<a href="https://www.theguardian.com/commentisfree/2025/sep/01/how-do-i-feel-safe-after-march-for-australia-anti-immigration-protest-ntwnfb">Stop Immigration</a>’ revealed that public hostility towards migrants, <a href="https://www.afr.com/politics/federal/pressure-mounts-for-price-to-apologise-to-indian-australians-20250908-p5mt7x">particularly</a> from the Indo-Pacific, is growing.
For many migrants, these displays are more than conceptual debates about white national identity. They are experienced emotionally. Writing shortly after the rallies, Melbourne-based writer Jafrin Kabir <a href="https://www.theguardian.com/commentisfree/2025/sep/01/how-do-i-feel-safe-after-march-for-australia-anti-immigration-protest-ntwnfb">reflected</a> that she had never felt so foreign on Australian soil. She pays taxes and inflated rents, contributes skills in the national interest, cheers for the Tillies and calls Melbourne “home”, yet suddenly felt unsafe because of the origin and colour of her skin.&nbsp;
Similarly, Chinese national interviewed by media outlet <a href="https://www.scmp.com/news/china/diplomacy/article/3325127/i-feel-insecure-chinese-nationals-australia-blindsided-anti-immigration-marches">reported</a> cancelling weekend plans and feeling “blindsided” by the scale of the marches.
Scapegoating migrants especially in times of economic stress is an age-old phenomenon and is not just limited to Australia. Across the democratic world, from the United States to the UK and parts of Europe, hostility toward migrants and minorities has become a route for anti-democratic forces. Populist actors often <a href="https://www.theguardian.com/australia-news/2025/mar/27/peter-dutton-keeps-blaming-migration-for-the-housing-crisis-but-can-it-really-be-that-simple">use</a> cultural anxiety and demographic change to justify illiberal and undemocratic measures, claiming to restore order while actually dismantling checks and balances.
By analysing democratic decay, scholars like Lydia Khalil at the Lowy Institute, <a href="https://interactives.lowyinstitute.org/features/democratic-erosion/">argue</a> that democracies rarely break down at once. Instead, they incrementally weaken through vicious cycles: declining trust in institutions, entrenched division based on hate, the normalisation of political violence, and the bit by bit removal of norms and guardrails.&nbsp;
Though some of the conditions are present in Australia to be exploited by anti-democratic actors, for example, almost two-thirds of Australians believe their leaders intentionally mislead them, according to the <a href="https://www.edelman.com/au/trust/2025/trust-barometer">2025 Edelman Trust Barometer</a>, &nbsp;but their presence is not determinative.
Australia’s democratic guardrails remain strong: independent courts, transparent elections run by the AEC, and a free press continue to hold power to account. Federalism and active civil society further diffuse power and create space for contestation.&nbsp;
But if public trust continues to erode and social divisions deepen, these safeguards will come under strain. Early recognition and action are crucial to ensure that today’s street-level hostilities do not translate into institutional regression.
Preventing such outcome requires a socially embedded understanding of migration, an understanding that goes beyond simplistic optimistic and pessimistic views. Policy makers should go beyond Push-Pull models, functionalist and neoclassical and historical-structural theories.&nbsp;
Consulting the work done by <a href="https://www.guilford.com/books/The-Age-of-Migration/Haas-Castles-Miller/9781462542895#:~:text=International%20Population%20Movements%20in%20the%20Modern%20World,-Hein%20de%20Haas">Hein de Haas</a> et-el, migration should be conceptualised as an intrinsic part of broader processes of development, social transformation and globalisation rather than a 'problem to be solved'. We need more nuanced views that have an eye for the complexity of migration processes and the diversity of its causes and impacts.
Sohail Akhtar is a Melbourne- based researcher focusing on governance, public policy, and migration. He contributes to Lowy Institute Sydney.
This article was issued by the Toda Peace Institute and is being republished from <a href="https://toda.org/global-outlook/2025/is-street-level-hostility-a-challenge-to-liberal-democracy-reflections-from-australia.html">the original</a> with their permission.

Is street-level hostility a challenge to liberal democracy?

Intricately painted Buddha, Aryatara, Krishna, and Parvati gaze serenely at visitors at the Kathmandu Art Gallery under muted amber lights. Moving from one artful devotion to the next, a quiet, profound connection to the divine envelopes the visitor. This transcends art to the realm of the spiritual. &nbsp; The gallery’s latest exhibition, Masters of Devotion, features art by 22 artists all from Bhaktapur. They also include Ajay Karmacharya, Purna Prasad Hyoju, Nhuche Kaji Bajracharya, Rajani Sinkhwal, Shashi Dhar Sainju, Surya Bahadur Chitrakar and Sundar Sinkhwal from the Khowpa Paubha Chowmi Pucha. Paubha are religious and devotional art depicting deities and mandala that date back to the 7th century, when Newa artists began to paint images of the gods on cloth. For the artists who practice this craft, the art form is as meditative as it is meticulous.&nbsp;  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251025041028_de34b51d48bcee50ae391301e2ff1890be7ecba3df7e563537c273818825aad5.jpg" data-media-id="editor_0" data-image-id="20251025041028_de34b51d48bcee50ae391301e2ff1890be7ecba3df7e563537c273818825aad5" data-rendition-name="original" width="1280" height="960" loading="lazy" alt="art review "> </figure>  The exhibition at the newly-opened space Kathmandu Art Gallery coincides with the festival season and is a collection of extravagant works done in mineral and stone colour, sakura and gouache. The vintage art space is located at Babar Mahal Revisited and is a fitting accompaniment to the paubha featured in the exhibit.&nbsp; Sundar Sinkhwal’s vividly painted Harihara is among the more eye-catching works. “Half of the painting is Shiva and half is Vishnu, hence the name Harihar,”explains Sinkhwal. “Together with their consorts Parvati and Laxmi, I have painted Uma-Maheswor and Laxmi-Narayan.” Nandi and Garuda, the vehicles of the two gods, complete the vibrant painting.&nbsp; In contrast, for his piece titled Lakshmi, Sinkhwal shrouds his canvas in dark colours to paint Kuber, the deity revered as the custodian to the wealth in the Hindu pantheon, accompanied by two khyak apparitions —one black, the other white— both mythical creatures in Newari folklore.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251025041032_1bde6de442b742c300bb8c9278ea8886445aa8df47076fd9aa362ce1f8bef903.jpg" data-media-id="editor_1" data-image-id="20251025041032_1bde6de442b742c300bb8c9278ea8886445aa8df47076fd9aa362ce1f8bef903" data-rendition-name="original" width="1280" height="960" loading="lazy" alt="art exhibition"> </figure>  “The black khyak is considered inauspicious, while white ones are a symbol of good luck,” explains Sinkhwal. Purna Prasad Hyoju has used mineral paint on canvas for a powerful depiction of Ardhanareswar, the composite form of Shiva and his consort Parvati.&nbsp; “I drew inspiration from the Newari Swasthani story about the separation of Shiva and Satidevi,” says Hyoju. Legend has it that Shiva, unwilling to part from his consort, reincarnated as a unified dual gender form of himself and Parvati. Hyoju has painted goddess Parvati in bright yellow, in homage to one of her other manifestations, Gauri, which means radiant.&nbsp; Meanwhile, Ratna Gopal Sinkhwal’s Kurkula Devi, done in stone pigment, is radiant on the cotton canvas. “Kurkula Devi is a tantric goddess whose traces are found in the Sadhana Mala,” says Sinkhwal. “The stone pigment is what makes the goddess look like she is gleaming.” One of Sinkhwal’s other works draws from stories in the Mahabharat to depict Bhimsen, Draupadi, Dushasan and Akash Bhairav in confrontation, expressions fierce.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251025041028_72eea52c8504eccb8b3be7cd4cef616dfb8efd821e8b1e1ae8f440f10782be11.jpg" data-media-id="editor_2" data-image-id="20251025041028_72eea52c8504eccb8b3be7cd4cef616dfb8efd821e8b1e1ae8f440f10782be11" data-rendition-name="original" width="1280" height="854" loading="lazy" alt="art exhibition"> </figure>  The opening of the exhibition last week also featured a music session, during which some of the artists sang traditional songs. Their voices joined the rhythm of the madal and melody of the harmonium, adding warmth to the crisp autumn evening.&nbsp; Each painstakingly detailed paubha reflects the artists’ devotion to divinity and mythology, as well as their heritage. Masters of Devotion showcases the work of veritable masters of their craft, and is a must-visit for art connoisseurs and devotees alike. Says the gallery’s Sangeeta Rana Thapa: “It is our honour to celebrate the artists’ work—to stand among pieces that embody both devotion and mastery, and to witness a tradition that continues to inspire us.” Masters of Devotion Kathmandu Art Gallery Baber Mahal Revisited Until 22 November

Artful devotion

<a href="https://myrepublica.nagariknetwork.com/news/dhm-forecasts-above-average-rainfall-and-temperatures-for-2025-monsoon-28-10.html">This year, </a>Madhes Province received less rainfall than was forecast by the &nbsp;Department of Hydrology and Meteorology (DHM), reducing groundwater recharge of shallow aquifers which are the lifeline for domestic use and irrigation.&nbsp; The crisis was serious enough for the government to officially declare a drought emergency during the monsoon, with the province declared a '<a href="https://kathmandupost.com/national/2025/07/23/cabinet-declares-madhesh-province-a-disaster-crisis-zone?">disaster-hit zone</a>' in July.&nbsp; The monsoon scarcity hit farmers hardest, a majority of whom depend on rainfall for agriculture. Data from Dhanusa’s <a href="https://add.madhesh.gov.np/noticefiles/%E0%A4%A7%E0%A4%BE%E0%A4%A8-%E0%A4%B0%E0%A5%8B%E0%A4%AA%E0%A4%BE%E0%A4%87%E0%A4%95%E0%A5%8B-%E0%A4%B5%E0%A4%BF%E0%A4%B5%E0%A4%B0%E0%A4%A3-%E0%A5%A4-1752227917.pdf">Agriculture Development Directorate</a> shows that only 33% paddy plantation was completed by mid July, in comparison to <a href="https://kathmandupost.com/money/2024/07/31/fastest-transplantation-rate-sows-hope-for-bumper-paddy-harvest?">92% planting the same time last year</a>. Only 49% of agricultural land in Nepal is irrigated — farmers in the rest of the arable land rely on rainfall, private wells and groundwater extraction. During the dry seasons and droughts, water insufficient groundwater recharge worsens the water crisis.&nbsp; Nearly 88% of households depend on groundwater in Madhes Province which has about 100,780 shallow tube wells and 60,660 deep tube wells. But in recent times, the tube wells and hand pumps have dried up every year.&nbsp; This shortage disproportionately impacts low income families and small-scale farmers, who have no other alternative to irrigate their land. And because paddy accounts for up to 7% of Nepal’s economy, Madhes’ water crisis is not confined to within the province, but has serious implications on the national economy.&nbsp; Underground water Groundwater extraction for irrigation began in the <a href="https://jvs-nwp.org.np/wp-content/uploads/2018/09/Water-Nepal-A-historical-Perspective.pdf">1970s, </a>shallow and deep tube wells for irrigation were introduced with support from development partners. By the 2021 agriculture census, <a href="https://agricensusnepal.gov.np/upload_file/files/post/1731650149_1221316497_Agriculture%20Census%202021_District%20Summary%20Report_by%20Province.pdf">groundwater irrigated land had increased </a>to 41.7%, up from &nbsp;<a href="https://agricensusnepal.gov.np/upload_file/files/post/1694250757_1312300734_National%20Sample%20Census%20of%20Agriculture%202021_22%20(National%20Report).indd.pdf">29.8% in 2011.</a>&nbsp; A lack of strong policies and regulation to monitor unchecked extraction has meant that with the exception of some parts of Kathmandu Valley, domestic users, subsistence and commercial farmers, restaurants, hotels and industries across Nepal can draw any quantity of groundwater from desired depths and location. While the dependence on drilling for water has risen due to limited expansion of surface water infrastructure, there has been little attention to groundwater recharge. This competing use of groundwater threatens the fundamental right to drinking water.&nbsp; The ecologically sensitive Chure and Bhawar watershed play a crucial role in groundwater recharge. However, deforestation and indiscriminate riverbed mining has severely reduced its recharge potential over the years. In addition, widespread monoculture plantation of fast-growing non-native eucalyptus trees, replacing native sissoo and sal trees has compounded the crisis. Eucalyptus, a water intensive species indigenous to Australia, was introduced in the Bhawar region in 1978 for supplying wood. The Tarai’s recurring water crisis is not only climatic. Years of fragmented planning, inadequate budget allocation for groundwater management, as well as limited intra- and inter-government policies and coordination have contributed to the disaster just as much as droughts and floods caused by changing weather patterns. The United Nations said decades ago disasters are not natural, and they occur when we fail to prepare.&nbsp; Groundwater management is <a href="https://www.opmcm.gov.np/download/%e0%a4%86%e0%a4%af%e0%a5%8b%e0%a4%9c%e0%a4%a8%e0%a4%be-%e0%a4%b5%e0%a4%b0%e0%a5%8d%e0%a4%97%e0%a5%80%e0%a4%95%e0%a4%b0%e0%a4%a3%e0%a4%95%e0%a5%8b-%e0%a4%86%e0%a4%a7%e0%a4%be%e0%a4%b0-%e0%a4%a4/?wpdmdl=8990&amp;refresh=683b8df54ffef1748733429">the shared responsibility of federal, provincial and local</a> governments, but there is a lack of <a href="https://www.iwmi.org/blogs/stakeholders-in-nepal-work-together-to-enhance-collective-action-for-municipal-groundwater-management/">integrated planning, &nbsp;budgeting, data sharing</a>, and collective action for groundwater extraction and recharge.&nbsp; Sustainable groundwater use in the plains requires inclusive and equitable practices that combine water science-informed interventions with a long-term cross-disciplinary approach.&nbsp; Groundwater is mainly available either in shallow unconfined aquifers that are close to the surface and directly linked to rainfall and rivers, and deep confined aquifers between semi permeable or impermeable ground layers. Locating and mapping such aquifers would help us find what depth they lie at, how much water they hold, what we can do to recharge them and how much time recharging would take—enabling sustainable use of groundwater. Construction of surface water projects such as the Sun Kosi Marine Diversion Multipurpose Project, which serves a dual purpose of expanding irrigation and recharging groundwater, must be expedited.  <figure> <img src="https://publisher-publish.s3.eu-central-1.amazonaws.com/pb-nepalitimes/swp/asv65r/media/20251027071020_a9442084bc412998d3e7417cf0d057cae8a2b98f5e47ac1a8cc0630612ff2a55.jpg" data-media-id="editor_9" data-image-id="20251027071020_a9442084bc412998d3e7417cf0d057cae8a2b98f5e47ac1a8cc0630612ff2a55" data-rendition-name="original" width="1778" height="1000" loading="lazy" alt="Mitigating the Madhes water crisis NT"> <figcaption>Photo: ONION FILMS / IWMI</figcaption> </figure>  Such infrastructure have a conjunctive use recognised by the National Irrigation Master Plan 2019 and the National Irrigation Policy 2023, wherein farmers can rely on canals for irrigation during monsoon and groundwater during dry seasons.&nbsp; Nature-based solutions such as rainwater harvesting, managed aquifer recharge techniques, restoration of wetlands and retention ponds, and floodwater reservoirs, particularly in ecologically sensitive regions like the Chure Bhaban, should be explored. &nbsp; The management of green water — the water stored in soil and vegetation — is equally as critical as that of blue water (rivers, canals, and groundwater). Green water is lost through evapotranspiration, which contributes to nearly half of the rainfall on land. Deforestation, soil degradation, poor land use practices, and loss of wetlands contribute to the disruption of the evapotranspiration cycle, affecting rainfall patterns and groundwater recharge. Solutions Rising temperatures compound this situation by increasing evapotranspiration. Soil water conservation, vegetation cover, wetland restoration, and nature friendly land use practices must therefore be prioritised. Water-efficient technologies and practices including drip irrigation use of sprinklers, mulching, and soil fertility improvement should be scaled up.&nbsp; At the same time, we must promote irrigation techniques and technologies along with crop choices and cropping patterns that give more yield per drop of water so that food production and water conservation go hand in hand. &nbsp; The government provides subsidised electricity for irrigation starting at Rs2.3/unit, some local governments are even supplying power for free. While such subsidies support farmers and increase productivity, &nbsp;it also poses serious risk of over extraction of groundwater.&nbsp; Flat subsidies in electricity or solar irrigation must be replaced by targeted subsidies in order to balance domestic and agricultural needs with ecological conservation. The 2015 <a href="https://kvwsmb.gov.np/public/uploads/board_act_&amp;_rules/rule-1.pdf">directive for groundwater licensing</a> developed per the Drinking Water Management Board Act 2006 for Kathmandu valley prohibits groundwater extraction from shallow aquifers for commercial and industrial uses. The directive also has provisions for licensing, and renewals, and mandates for license holders to contribute to groundwater recharge. The Madhes needs similar context-specific policies to address its groundwater crisis and safeguard water rights. Shallow aquifers in the region should be prioritised for domestic use while <a href="https://link.springer.com/chapter/10.1007/978-981-10-3889-1_11">deep aquifers, which are still underutilised, should be tapped</a> in a sustainable manner for commercial, industrial and large scale irrigation and drinking water projects.&nbsp; While <a href="https://www.frontiersin.org/journals/human-dynamics/articles/10.3389/fhumd.2023.1181734/full">technical solutions</a> are important, they are not enough to solve Madhes’ water crisis. Nepal’s Constitution and the Local Governance Operation Act 2017 empower local governments for water management in their constituencies. But beyond the letter of the law, local units require community tailored groundwater policies, regular groundwater monitoring and up-to-date data, and investment in local recharge initiatives such as retention ponds, restoration of wetlands, and rainwater harvesting. Coordination between all three tiers of government is crucial, particularly among agencies that pertain to drinking water, water resources, irrigation, agriculture, land use, environment, climate change, and urban development. &nbsp; Heeding indigenous knowledge will be crucial to understanding the water crisis in Madhes and initiating solutions that will fit the context and needs of the region. Local engagement in groundwater monitoring can help to create self -aware, accountable, cost effective and participatory groundwater management practices.&nbsp; To ensure water security in Madhes, we thus need inclusive governance, coherent policies, active engagement of citizens, integration of local and indigenous knowledge and a principle of equity that puts people at the centre. &nbsp; Sumitra KC, a policy and governance researcher in natural resources management, is the National Researcher at the International Water Management Institute (IWMI), Nepal. Manohara Khadka, PhD, an expert in natural resources management, gender equality, and social inclusion, is the Country Representative of IWMI, Nepal.