Nepal’s transition to a federal health system is currently hampered several factors such as poor transparency and shortage of health workforce, leading to a significant decline in public trust despite the constitutional guarantee of basic health services. With the 2026 elections approaching, the Government of Nepal has a crucial four-month window to demonstrate decisive leadership and restore public faith.

This proposed strategy is built on four interconnected pillars: Election-Focused Health Support for safety and participation; Rapid Health Workforce Support and Retention to address migration and motivation issues; Community-Based Service Delivery and Equity Promotion to reach vulnerable populations; and Transparency and Accountability through measures like e-procurement and a free public reporting hotline. The brief calls for a Four-Month National Health System Strengthening Task Force to oversee these 15 short-term actions, ensuring they are implemented with a Gender Equality, Disability, and Social Inclusion lens. Successful implementation will improve health outcomes and reinforce the legitimacy of Nepal’s democratic institutions.