Karnali leads the way

Sixteen-year-old Gita starts every morning with a cup of ginger tea made by her grandfather and barley flatbread made by her mother. Lunch is usually lentil and bean curry with more flatbreads, and dinner includes rice, daal (lentil soup), and green leafy vegetables, such as mustard greens. 

Meals like these - simple, wholesome, cost-effective, and homegrown- are quietly helping to transform women’s and girls’ health across Karnali, Nepal’s largest province, located in the western part of the country. 

Gita’s family live in Dullu municipality in Dailekh District of Karnali. Like many others in the region, they rely on local, seasonal and forest foods. Their meals include iron-rich staples such as millet, amaranth leaves, soybeans, nettles, mustard greens, and wild ferns, along with turmeric, chillies, timmur (Nepali pepper), and fruits like guava, mangoes, figs, and mulberries.

For women and children especially, these locally grown, iron-rich ingredients are doing more than feeding families; they’re steadily pushing back against anaemia, one meal at a time. 

Anaemia occurs when the body lacks sufficient healthy red blood cells to carry oxygen, often due to poor diets. This results in people feeling weak, tired, and more susceptible to illness. For girls and women, anaemia can make it more challenging to stay in school, work or care for their families, particularly because of heavy periods. Lastly, anaemia during pregnancy poses a risk to both mother and baby.

Progress against anaemia has been slow nationwide.

However, Karnali is turning things around.  

Between 2016 and 2022, anaemia rates in Nepal decreased by 75 per cent, and Karnali, despite being one of the poorest regions in the country, is leading the way. 

So, what made the difference? A powerful mix of nutrition sourced from the neighbourhood, local leadership, and community-led health and education programmes.

Locally known as latte or matye marse, Amaranth leaves are rich in iron and folate and are the most widely eaten greens in Dailekh. 

Efforts to preserve traditional foods and farming have been combined with health programmes organised in schools. At Gita’s school, students attend sessions on nutrition, the harms of junk food, and the importance of iron, especially for girls.

When she was in Grade 8, Gita began receiving weekly Iron-Folic Acid tablets at school.  

We take the tablets every week. Hari sir makes sure we take them. He says it helps increase our blood cells.

Gita recently finished her Grade 10 exam. She spends her days helping at home, feeding the cows and goats and gathering firewood. In her free time, she studies, writes poems, and dreams about her future.

On Saturdays, she participates in UNICEF’s Rupantaran programme, where boys and girls learn about child marriage, caste-discrimination, menstrual hygiene, and financial nutrition. “Rupantaran” means “transformation’ and that’s exactly what it is helping young people do.

From time to time, Gita accompanies her mother, Radha, to the Pragatisheel Swasthya Aama Samuha (Progressive Health Mother’s Group). This group focuses on supporting pregnant and breastfeeding mothers.

Female Community Health Volunteer Shyama Upadhyaya leads the sessions with Radha and other mothers in Dullu Municipality.

These groups have become a lifeline for many women. They offer support, information, and practical solutions, such as the Poshan Nanglo (tray of food), used to teach families about the importance of eating a variety of local foods.

But old habits die hard. Many cultural beliefs and food myths still hamper progress. New mothers are sometimes told to avoid salt, garlic, peanuts, or eggs, fearing it might harm the baby.