Picture Credit: Nepali times EFFECTIVENESS OF LOCAL GOVERNMENTS IN NEPAL TO ADDRESS THE COVID-19 CRISIS ASSESSMENT REPORT Prepared under Contract No. GS-10F-0033M / Order No. AID-OAA-M-13-00013, Tasking N083 This publication was produced for review by the United States Agency for International Development. It was prepared by NORC at the University of Chicago. The authors’ views expressed in this publication do not necessarily reflect the views of the United States Agency for International Development or the United States Government. DRG LEARNING, EVALUATION, AND RESEARCH ACTIVITY EFFECTIVENESS OF LOCAL GOVERNMENTS IN NEPAL TO ADDRESS THE COVID-19 CRISIS ASSESSMENT REPORT APRIL 2021 Prepared under Contract No.: GS-10F-0033M / AID-OAA-M-13-00013, Tasking N083 Submitted to: Mousumi Sarkar, USAID COR Submitted by: Ritu Nayyar-Stone, Team Lead Jagadish Pokharel, Local Government Specialist Samantha Downey, Qualitative Specialist Alex Rigaux, Quantitative Specialist Contractor: NORC at the University of Chicago 4350 East West Highway, 8th Floor Bethesda, MD 20814 Attention: Renée Hendley Tel: 301- 634-9489; E-mail: [email protected] DISCLAIMER The authors’ views expressed in this publication do not necessarily reflect the views of the United States Agency for International Development or the United States Government. CONTRACT NO.: GS-10F-0033M / AID-OAA-M-13-00013 / DRG-LER TASKING N083 TABLE OF CONTENTS TABLE OF CONTENTS I TABLES II FIGURES II ACRONYMS III EXECUTIVE SUMMARY 1 FINDINGS 2 CONCLUSIONS 5 LESSONS LEARNED AND RECOMMENDATIONS 6 RESEARCH PURPOSE AND RESEARCH QUESTIONS 7 BACKGROUND 8 METHODS AND LIMITATIONS 9 QUALITATIVE DATA COLLECTION – KEY INFORMANT INTERVIEWS 9 QUALITATIVE DATA COLLECTION – FOCUS GROUP DISCUSSIONS 10 QUANTITATIVE DATA COLLECTION 11 QUANTITATIVE DATA COLLECTION – MUNICIPAL OFFICIALS SURVEY 12 LIMITATIONS 13 FINDINGS AND CONCLUSIONS 14 FINDINGS 14 CONCLUSIONS 42 LESSONS LEARNED AND RECOMMENDATIONS 44 ANNEX A: ASSESSMENT STATEMENT OF WORK 46 ANNEX B: ASSESSMENT METHODS AND LIMITATIONS 49 ANNEX C: DATA COLLECTION INSTRUMENTS 57 ANNEX D: SOURCES OF INFORMATION 89 KEY INFORMANTS 89 DOCUMENTS REVIEWED 90 ANNEX E: DISCLOSURE CONFLICTS OF INTEREST 96 USAID.GOV EFFECTIVENESS OF LOCAL GOVERNMENT IN NEPAL TO ADDRESS COVID-19 | i CONTRACT NO.: GS-10F-0033M / AID-OAA-M-13-00013 / DRG-LER TASKING N083 TABLES Table 1: KIIs in Kathmandu, Province 2 and Sudurpaschim 9 Table 2: FGD Participants in Province 2 and Sudurpaschim 10 Table 3: Quantitative data and gender breakdown Province 2 and Sudurpaschim 12 Table 4: Citizen’s Satisfaction with Assistance Received from Non-Governmental Organizations, Counts 32 Table 5: Municipal Response and Challenges dealing with COVID-19 40 FIGURES Figure 1: Coordination with other levels of government 18 Figure 2: Type of assistance and collaboration with other levels of government 18 Figure 3: Greatest challenges in meeting the health and humanitarian needs of the people 19 Figure 4: Migration of citizens in the sample 21 Figure 5: Hiring during the COVID-19 Crisis by Municipalities 22 Figure 6: Regular municipal service delivery during the COVID-19 crisis 23 Figure 7: Citizens’ Awareness of services or resources provided by the federal, provincial, or municipal government to this community in response to COVID-19 crisis 25 Figure 8: Citizens Perception of their municipality’s response to COVID-19 26 Figure 9: Feedback on Municipality’s handling of the COVID-19 crisis by various sources 27 Figure 10: Cooperation with the private sector, NGOs and other entities 30 Figure 11: Percent of citizens who received assistance from NGOs and other entities during the COVID-19 crisis and were satisfied with the assistance 32 Figure 12: Citizen feedback on assistance received from the government during COVID-19 41 USAID.GOV EFFECTIVENESS OF LOCAL GOVERNMENT IN NEPAL TO ADDRESS COVID-19 | ii CONTRACT NO.: GS-10F-0033M / AID-OAA-M-13-00013 / DRG-LER TASKING N083 ACRONYMS CATI Computer-Assisted Telephone Interview CCMC COVID-19 Crisis Management Center CSO Civil Society Organization CDCS Country Development Cooperation Strategy COVID-19 Coronavirus Disease of 2019 CN Concept Note DMF Disaster Management Fund DRMF Disaster Risk Management Fund DRG-LER Democracy, Human Rights, and Governance – Learning, Evaluation, and Research Activity EQ Evaluation Question FCHV Female Community Health Volunteers FGD Focus Group Discussion GoN Government of Nepal ICU Intensive Care Unit IP Implementing Partner KII Key Informant Interview LG Local Government MoD Ministry of Defense (Nepal) MoF Ministry of Finance (Nepal) MoFAGA Ministry of Federal Affairs and General Administration (Nepal) MoFA Ministry of Foreign Affairs (Nepal) MoHP Ministry of Health and Population (Nepal) MoHA Ministry of Home Affairs (Nepal) MSD Ministry of Social Development NORC NORC at the University of Chicago NGO Non-Governmental Organization PI Principal Investigator PM Prime Minister USAID United States Agency for International Development USG United States Government WHO World Health Organization USAID.GOV EFFECTIVENESS OF LOCAL GOVERNMENT IN NEPAL TO ADDRESS COVID-19 | iii CONTRACT NO.: GS-10F-0033M / AID-OAA-M-13-00013 / DRG-LER TASKING N083 EXECUTIVE SUMMARY Just a few months into the first half of 2020, the unprecedented COVID-19 pandemic infected millions across nearly every country in the world, killing hundreds of thousands as it inundated existing health care infrastructures, prompting widespread lockdowns resulting in mass unemployment, halting international travel as borders closed, and crippling local and global economies alike in the process. As of August 28, 2020 Nepal had 36,456 cases with 195 deaths. By April 4, 2021 this figure had increased to 277,944 cases with 3,032 deaths. Under the DRG-LER Contract, USAID asked NORC to design and undertake research on the Nepali local governments’ (LGs) response to COVID-19. The primary goal of this research is to explore the effectiveness of local governments in addressing the COVID-19 crisis across four key research questions at the local level, specifically in Province 2 and Province 7 (Sudurpaschim). RESEARCH QUESTION 1 deals with LGs’ functions with respect to COVID-19 response, the roles and responsibilities for municipalities (Palikas) and wards (both urban and rural), and their cooperation and/or coordination with other levels of government in providing this response. RESEARCH QUESTION 2 focuses on the capacity of LGs to deliver COVID-19 related services; if the provision of COVID-19 services affects the delivery of other government services; and the perception of the public towards LGs as they continue to respond to COVID-19. RESEARCH QUESTION 3 examines if LGs developed partnerships with other entities, specifically CSOs and the private sector, in the provision of COVID-19 related services and the ways in which they did so; how LGs engaged the private sector to address the effect on supply-chains; and the short-term and long-term repercussions on the economy and household livelihoods. RESEARCH QUESTION 4 describes the funds that were mobilized and provided for COVID-19 response; the systems of control and transparency that were established; how funds were used; the current local planning process (April-June 2020) of municipalities to deal with COVID-19, and if the plans target the most vulnerable groups of the communities. In Nepal, the provision of various health and economic services at the municipal (Palika) level related to the COVID-19 response is exacerbated by challenges in implementing a constitutionally mandated transition to a more decentralized form of government that began in 2017 with the formation of The Federal Parliament of Nepal. Thus clear functional responsibilities, coordination and collaboration between the federal, provincial and local levels of government in providing these services are critical, especially for the COVID-19 response. NORC collected data from both the supply side (entities providing the COVID-19 response) and the demand side (citizens, nongovernmental organizations and private sector actors requesting a response due to the pandemic). On the supply side, NORC conducted key informant interviews (KIIs) with LG officials at the provincial and municipal level, federal government officials from ministries engaged in COVID-19 decision-making, USAID implementing partners (IPs), and Donor staff. On the demand side, NORC conducted focus group discussions (FGDs) with citizen beneficiaries of COVID-19 services, with a particular focus on migrant workers returning from India and vulnerable (low income) populations. NORC also conducted FGDs with civil society organizations (CSOs) and private sector representatives as they sought economic relief from the government and also collaborated with the municipal government in responding to the pandemic. Based on the initial findings from KIIs with municipal officials, NORC drafted a short computer assisted telephone interview (CATI) survey for additional municipal officials in Province 2 and USAID.GOV EFFECTIVENESS OF LOCAL GOVERNMENT IN NEPAL TO ADDRESS COVID-19 | 1 CONTRACT NO.: GS-10F-0033M / AID-OAA-M-13-00013 / DRG-LER TASKING N083 Sudurpaschim. NORC also developed a short CATI survey for citizens. The primary data collected for this assessment is shown in the table below. Federal Government Agencies and Officials 11 in Kathmandu Key Informant Implementing Partners 9 in Province 2 Interviews Donors 9 in Sudurpaschim Provincial officers, Mayors/Deputy mayor 11 total, 5 in province 2 and 6 in