key: cord-0814109-d2jdarlu
authors: Mainali, Raju; Tosun, Mehmet S.; Yilmaz, Serdar
title: Local response to the COVID‐19 pandemic: The case of Nepal
date: 2021-06-25
journal: Public Adm Dev
DOI: 10.1002/pad.1953
sha: 85ae4d7991a812620517681080bfa0fed046fe99
doc_id: 814109
cord_uid: d2jdarlu

Outbreak of the coronavirus pandemic is testing governments' capacity. Generally, considerable attention is paid to the capacity and response of the central or national governments; however, COVID‐19 pandemic is local in nature. Although central authorities have important roles to play in COVID‐19 response, local governments, being closer to people, are best‐positioned to form the first line of defense.

In Nepal, the outbreak of coronavirus pandemic has put the fledgling federal system to a test. Nepal's federal system was put in place with the adoption of the 2015 Constitution. After embarking on a fullfledged federal system after years of conflict, the country has made significant progress in establishing key institutional structures, such as provincial and local governments before the coronavirus pandemic. These newly established subnational governments have joined the efforts of the federal government to contain the spread of the disease and limit the number of causalities.

In Nepal, the crisis highlights glaring weaknesses in the intergovernmental system. Initial research highlights an alarming pattern of high levels of cases and mortality among the younger cohorts of the population (Banerjee et al., 2020) . The recent upward trend in the number of COVID-19 cases is worrisome. However, the uptick in the COVID-19 cases is in localized clusters and there is a big variation across provinces. For instance, there has been a flattening of cases in Provinces 6 (Karnali) and 7 (Sudupashchim), whereas in Provinces 3 (Bagmati) and 5 there is an upward trend. Interestingly, there is an increase in the number of women who have tested positive compared to the initial period of the pandemic.

Nepal is one of the most diverse countries in the world. There are 126 ethnic groups and castes speaking 123 languages as mother The findings, interpretations, and conclusions are entirely those of authors and do not represent the views of the World Bank, its executive directors, or countries they represent. 1 The upper caste people from Himalaya and hill regions dominate the political system, administrative machine, and business society of the country. While public health policy is the main responsibility of federal and provincial governments, local governments are exclusively responsible for primary healthcare and sanitation (Dhrubaraj, 2020) .

However, the constitution does not specifically mention pandemic management and response in relation to the distribution of powers among the three levels of government. Nonetheless, the constitutional mandate for primary healthcare responsibility gives the legal basis to local governments to enact local healthcare and sanitation act to fight against the pandemic. Many local governments enacted these local laws based on powers enumerated in the constitution and national legislations for primary healthcare service provision. In addition, local governments declared public health emergency and activated their disaster management committees 3 to ensure that citizens receive emergency services at any healthcare institution within the municipality.

Notwithstanding the progress in the implementation of federalism, Nepal's federal system is still fragile and incomplete. Although much has been accomplished, there is still much to be done (Government of Nepal, 2019). There are overlapping mandates and coordination failures in addition to weaknesses in institutional capabilities. In order to achieve better coordination across levels of government, the parliament needs to update legislative framework to reflect federalism principles in the assignment responsibilities. In that context, the most pressing issue is updating sector legislations and enactment of a modern pandemic act to improve coordination between levels of government. Currently, an outdated legislation, the Panchayat-era Infectious Disease Act of 1964, empowers the central government and its deconcentrated structures in an epidemic situation, ignoring provincial and local governments established after transition to federal system. The Supreme Court of Nepal has recently instructed the government to evaluate the existing legislations related to health emergencies and enact a new pandemic act. 4

In its ruling, the high court clearly stated that the existing laws are insufficient to address important health and social issues surrounding coronavirus pandemic, different levels of government setting different standards and issuing conflicting orders. A good example of conflict between different levels of governments is mobility restrictions introduced by district authorities and opposed by the municipal government in Kathmandu (Ojha, 2020) .

The coronavirus pandemic has presented a defining challenge to the nation's nascent federal system. Although initially the majority of the COVID-19 cases had been imported from other countries (Chalise, 2020), they began to spread to all seven provinces. The first major community outbreaks were observed in the eastern (Udaypur), western (Banke), and central (Bitguni) regions (Chalise, 2021) . Afterward the epicenter of the pandemic shifted to Kathmandu, where half of the national cases are reported (Chalise, 2021) .

Initially, the public health measures-social distancing, lockdowns, personal hygiene, and border controls-helped in preventing the spread. However, the effectiveness of these measures has not been observed and the number of cases surged (Dhakal & Karki, 2020) . A contributing factor had been the return of daily wage migrant workers from India, where Nepal shares open border with.

Nepalese, desperate to return home, evaded border controls by swimming across the Mahakali River (Badu, 2020) . All three tiers of government struggled to cope with the influx of people returning home from India. In addition, there was a significant volume of incountry movement as workers returned to their hometown after employment opportunities dwindled in urban centers due to lockdowns (Dhakal & Karki, 2020) . The government came under criticism for its slow response (Koirala et al., 2020; Shakya, 2020) . 

As local governments take a prominent role in responding to coronavirus pandemic, we analyze the relationship between Figure 1 shows total COVID-19 cases in the Nepalese districts.

We see a clear pattern with cases clustered in those districts in the Plains region that are close to the border with India, which is a country that has so far experienced one of the largest COVID-19

outbreaks in the world. The map shows that while the majority of the districts don't show any serious virus transmission, there are 49 districts, mainly along the border with India, with more than 1000 cases. Figure 2 shows that the case fatality rate is also high (greater than 1%) in 31 districts, including some along the border with India and others in the Hills region and the Mountain region along the border with China.

We see in Table 1 that while the case fatality rate is less than 1% for the country, there is significant variation across provinces.

There is also a significant variation in the survey variables. We find it interesting that those provinces with higher share of local gov- ince also has some of the highest indicators of women's participation in local governance as seen by the share of female members in the local assembly, social inclusion mechanism for gender, and the framework for women's participation in local government activities.

In Nepal, the response to the COVID-19 pandemic is impacted by the lack of test kits, medical supplies, personal protective equipment, and well-trained healthcare personnel. Initial failures in coordination mechanisms among stakeholders and poor reporting and documentation of cases hampered the progress in government's response. The pandemic highlighted the importance of a robust healthcare and the government is preparing a strategy to enhance health service in the country (Pant, 2020).

The case of Nepal highlights the importance of coordination and cooperation across levels of government. All-of-government, federalprovincial-local, response is a critical factor in the success of the fight against the COVID-19 pandemic. Despite the fact that newly established subnational governments face capacity constraints, they are at the forefront of the fight against the coronavirus pandemic. A recent assessment of subnational governments' response highlights that they were able to mobilize resources for localized solutions (Foundation for Development Management and Nepal Institute for Policy

Research, 2020). Local governments, for example, rapidly enacted their own local healthcare and sanitation acts even though the national legislation to manage a pandemic is lacking. In fact, local governments with inclusive structures, such as social inclusion mechanism for gender as well as a framework for women's participation in local government activities, handled the pandemic better than others.

A word of caution about data is that the situation on the ground is still changing rapidly as the pandemic rages on in the region, particularly in neighboring India. We would like to note that we are not making any causal claims based on these findings. With more data in the future, we expect more empirical research on COVID-19 and local government response in Nepal.

The data used in this article are available from the corresponding author upon reasonable request.

Serdar Yilmaz https://orcid.org/0000-0003-4105-709X

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