In Nepal, “disaggregated monitoring” (i.e. breaking down results from statistical monitoring by sex, caste, ethnic and other social groups) has helped to strengthen results-based management; support better evidence-based decision making and better targeting of health services; and to counter social exclusion and discrimination. Nepal’s society is highly unequal, with huge differences in opportunities and access to basic services; the difficulties are particularly severe for women, and indigenous (Janajati) and lower caste groups (Dalits).
The Gender and Social Exclusion Assessment (GSEA) – a joint undertaking of the National Planning Commission, the United Kingdom’s Department for International Development (DFID) and The World Bank – was completed in June 2005. It documented what has been generally accepted as one of the root causes of Nepal’s internal conflict: the fact that certain social groups – defined in terms of their gender, caste, ethnicity, region and religion – have shown persistently higher levels of poverty, lower education and health outcomes and less political voice. The Assessment summary Unequal Citizens: Gender, Caste and Ethnic Exclusion in Nepal (2006) highlighted empirical evidence of the patterns of social disparity that are indeed well-known, but rarely documented or the focus of policy analysis.
The evidence demonstrates that identity (gender, class, ethnicity, caste) predetermines access to services as well as the quality of services received. For example, almost half of Newar (advantaged ethnic group) women give birth in hospitals or other institutions, compared to only one-tenth of Dalit women. Almost 80% of Muslim and 85% of Terai (southern plains) Dalit women still have no education, compared to a national average of 53%. Girls are 1.5 times more likely than their brothers to die before the age of five, and twice as likely to be malnourished.
Nepal’s 10th National Development Plan for the first time acknowledged that marginalised groups are not only “poor” in economic terms, but also in terms of their lack of representation and empowerment. Subsequent plans (the Three Year Interim Plan and the Nepal Development Strategy Paper) have made provisions for women and a range of excluded caste, ethnic, religious and geographically defined groups – with quantitative targets and budgets. The Interim Constitution has also made a number of provisions that address discrimination against women and excluded caste and ethnic groups. Donors have aligned behind the National Development Plan to provide support in critical areas, such as health and education. Civil society organisations have conducted research and used qualitative and quantitative data – broken down by ethnicity, sex and caste – to tell the stories behind the figures, and to show how and where people are facing barriers to health and education services.
The Monitoring and Information Systems of the Ministry of Education and the Ministry of Health and Population are being improved so that they can better collect and analyse data for different social groups, supporting evidence-based policy making. A number of immediate actions have also been taken. For example, the government is addressing social and cultural barriers to health by providing training in midwifery for Dalit and Janajati women and reserving places for women on the management committees of local health facilities. The government has also increased its budget allocation to primary health care clinics in the 25 poorest districts. Indigenous and lower caste women are now more likely to seek medical care, which is helping to reduce maternal mortality. In the education sector, reforms have lead to a dramatic increase in the access of girls and children from excluded groups to school. The new school sector reform programme will continue to build on this progress, and will provide scholarships and other incentives to enable the poorest children and those from excluded groups to attend school.
The original version of this case study was used in the 2009 OECD Development Co-operation Report.