“Coming from a community where girls are often discouraged from voicing their opinions, facilitating discussions on sensitive topics helped me break my own barriers.” – Aarati Patel, National Volunteer
This impact story was published on The United Nations Collaborative on Citizen Data (The Collaborative) on 19 May 2026.
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Across Nepal’s Madhesh Province, rural women are increasingly asserting their rights to equal pay, participation in local decision-making, and timely, dignified maternal health care. Through a citizen data-driven process, women have begun to document their lived realities, transforming longstanding challenges into evidence and strengthening their collective voice for social justice and accountability.
These efforts were supported through the Leave No One Behind (LNOB) Consortium in Nepal, a coalition of eleven organizations working to advance evidence-based advocacy within marginalised communities. In Madhesh Province—particularly in Bara and Rautahat districts—the Consortium supported locally driven, systematic data collection and analysis that helped translate lived experience into credible evidence to be taken seriously by decision-makers.
Nepal faces deep social and economic inequalities shaped by gender, caste, class, disability, and geography. These disparities are particularly acute for rural Madheshi women, who experience intersecting forms of discrimination—manifesting in lower wages, limited access to maternal health services, and restricted participation in decision-making spaces.
Madhesh Province, located in the southernmost part of the country, is home to a significant proportion of the population living below the poverty line, where low literacy rates and entrenched discriminatory social norms further restrict access to public services. In districts like Bara, weak infrastructure and environmental vulnerabilities further complicate access to essential services.
In this context, citizen data offers a pathway for women’s lived experiences to be translated into evidence that clarifies responsibilities, makes expectations visible, and opens new entry points for accountability within local governance systems.
From Citizen Data to Accountability
For women’s lived experiences to influence decisions, they had to be documented in ways that could not be dismissed.
During one interface dialogue in Basatpur community of Bara district, discussions on progress toward gender and wage equality (SDG Indicator 5.1.1) revealed starkly different accounts of women’s labor conditions. A local health facility in-charge asserted that wages were equal for men and women, noting that “for rice planting, both men and women receive 3 kg of rice.”
But this claim was immediately challenged by Nainab Devi Chamaen, a Dalit woman from the community, who responded: “For hourly labour, wages are different. If a man works, he gets 550 rupees, but a woman gets 250 rupees for the same work. Isn’t this discrimination? We have even held Panchayat discussions in the community, but the unequal wages still persist.”
Moments like this illustrate why structured citizen data processes matter. Without a facilitated, evidence-based platform, unequal wages could continue to be dismissed as anecdotal or isolated complaints. By bringing these experiences into a formal dialogue with local authorities, women’s testimonies gained weight and visibility.
Central to this citizen data process is the use of social accountability tools such as community score cards (CSC)— a participatory process through which community members collectively assess services and translate their experiences into evidence. By aggregating individual experiences into collectively validated indicators, CSCs transform lived realities into evidence that carries weight with decision-makers. Through CSCs, the LNOB Consortium facilitated eleven preparatory community dialogues and structured interface meetings between right-holders—women and other marginalized groups—and duty-bearers, including local authorities and municipal representatives, enabling direct and constructive communication between communities and authorities.
Because the process is inclusive and systematic and often mediated by trusted community facilitators supported by experienced civil society organisations, women who previously felt voiceless or intimidated were able to stand up and speak their concerns and lived realities. Reflecting on the process, one national volunteer, Aarati Patel, said, “I still remember my first CSC event. I was nervous, unsure of myself, and had never led a session before. It was frightening to stand in front of duty-bearers and right-holders and guide the entire process. But stepping into that space and completing the session became a turning point that started building my confidence and reshaping my belief in my own abilities.”
Making Safe Motherhood a Local Priority
For marginalised women in Madhesh, the citizen data process became a pathway to safer motherhood by strengthening women’s engagement in local health governance. Through the community score card process, women brought long-standing gaps in maternal care into direct dialogue with health authorities and local governments across 11 health facilities and seven municipalities, creating structured spaces where community members and duty-bearers could confront these issues together.
That shift became visible in a single moment. During one such interface meeting in Bara district—where health facilities are expected to be within a 30-minute walk, yet poor road conditions and seasonal flooding often make access far more difficult—a woman stood before government representatives and stated:
“Pregnant women do not have any choice but to walk long distances for safe delivery. Sometimes women have to deliver on the road. We don’t even have a stretcher so people can carry pregnant women to the health facility.”
The room fell silent.
The evidence and testimony were so compelling that the mayor ordered a stretcher for the health facility the very next day. What had long been dismissed as “women’s issues” was, in that moment, recognized as an urgent local priority driven by citizen data.
Turning Community Priorities into Health System Change
Health Facility Operation and Management Committees (HFOMCs) are formally mandated local governance bodies responsible for overseeing the management of public health facilities. While national guidelines clarify their roles and responsibilities, their operationalization has been uneven in practice. In this context, the LNOB Consortium in Nepal used community score cards (CSCs) to support communities in engaging with HFOMCs and strengthening oversight of local health services
Through the CSC process, indicators and action plans were developed in consultation with local health authorities, mother’s groups, Female Community Health Volunteers, and civil society organisations. Separate consultations with right-holders and duty bearers, followed by joint interface meetings, created structured spaces for finalising the scores and improving the action plans.
Concrete improvements followed. As part of CSC action plans, health posts have printed and displayed citizen charters, begun sharing annual plans and budget information in periodic meetings and interactions with citizens, improved the regularity of mothers’ group meetings by conducting them on a monthly basis, and allocated resources to strengthen adolescent-friendly services. Together, these actions demonstrate how citizen data can reinforce accountability and support the effective functioning of existing health governance mechanisms. For instance, in the span of two months after conducting the CSC, progress on service delivery increased by 5 per cent in the Urban Health Promotion Center of Dumarwana Bara.
Beyond improving accountability and service delivery, the citizen data process also contributed to the empowerment of women as active participants in local governance. National volunteer Aarati Patel described how women who were previously unaware of local planning processes, accountability tools, or essential health services are now informed and actively participating. As she observed, “even female ward representatives who previously remained silent now speak up, make decisions, and advocate for others in their communities.”
Taken together, these changes show that the process not only improved services but also helped rebalance local power dynamics, demonstrating how citizen data can support marginalised women to exercise their agency more fully as decision-makers influencing local policy.
References
- Ministry of Health and Population, Nepal; New ERA; and ICF. (2022). Nepal Demographic and Health Survey 2022: Key Indicators Report. Kathmandu, Nepal: Ministry of Health and Population, Nepal. https://dhsprogram.com/pubs/pdf/FR379/FR379.pdf
- National Statistical Office. (2021). National Population Census. https://nsonepal.gov.np/content/10391/10391-national-population-and-hous/.
- National Planning Commission. (2021). Nepal’s Roadmap for Peaceful, Just and Inclusive Societies: A SDG 16 Plus Report. https://npc.gov.np/content/5098/5098-a-sdg-16-plus-report-peaceful/.
- VSO Nepal. (2023). A Guide to Implementing the Community Scorecard for Enhanced Dialogue and Mutual Accountability between Right Holders and Duty Bearers. https://nepal.tracking-progress.org/community-scorecard-guideline/.
- VSO Nepal. (2021). Monitoring Report of Joint Monitoring Visit of VSO and Health Facility, ACTIVE Project, 2021.
