Good Governance to Empower Citizens and Foster Inclusive Decision Making in the Public Health Sector of Nepal.

According to the WHO good governance has been recognized globally as a critical determinant of effective health systems in every sectors (WHO, 2018). Evidences throughout the world shows that participatory governance empowers citizens, enhances accountability, and improves service delivery outcomes in several ways (Brinkerhoff &Bossert, 2014). In the context of Nepal, where socio-political transitions and decentralization have reshaped governance systems, strengthening citizen empowerment and inclusive decision-making is crucial for improving public health outcomes. Governance principles such as participation, transparency, accountability, equity, and responsivenessare integral to ensuring that health policies and programs address the needs of all citizens, particularly marginalized groups. The intersection of governance and health equity is particularly relevant in Nepal, where structural inequalities affect access to services. Evidence suggests that integrating governance reforms with health system strengthening can improve trust, responsiveness, and ultimately, health outcomes (Lewis, 2006; Gurung&Tuladhar, 2013) However, studies highlight persistent governance gaps, particularly in inclusivity and citizen empowerment (Ministry of Health and Population, 2021). Marginalized groups including women, rural poor, dalits, and indigenous populations are often excluded from health-related decision-making processes. Weak governance structures reduce citizens’ trust in the health system and hinder progress toward universal health coverage and equitable health outcomes. Thus there is need of transforming the transparency and accountability by empowering citizens and foster them inclusive decision making especially in Public health sector of Nepal. The objective of this study is to identify barriers and opportunities for fostering inclusive decision-making at the community and institutional levels through discussions with political leaders, stakeholders, educationists and researchers by Interview. Expected outcome will be practical recommendations for strengthening participatory and transparent governance mechanisms. Policy guidance to improve health system accountability, equity, and inclusiveness.