Nepal’s post-conflict constitutional transition from a unitary to a federalist state offers opportunities and challenges for its health systems and other social sectors. Effective, accountable, responsive, and inclusive local governance are essential. Abt’s data-driven strategies support Nepal’s efforts to reduce maternal and newborn morbidity and mortality. We team with Nepalese government at all levels as well as local health partners to increase the quality and uptake of health services while lowering financial and social barriers for historically marginalized people. We also conduct research, analysis, and monitoring, evaluation, and learning (MEL) to guide donor programming to advance Nepal’s National Health Sector Strategy and poverty reduction initiatives. Previously, we have identified cost-efficient water treatment products for child diarrhea prevention and evaluated opportunities to mitigate black carbon emissions from Nepal’s transportation, industrial and residential sectors.