Nepal Pilot Aims to Fuse Fragmented City Data Into One Urban Health Portal

In the sprawling wards of Budhanilkantha Municipality on the northern edge of Kathmandu, a quiet data revolution is taking shape. A team of Nepali and British researchers has published a detailed study protocol describing how they will build an integrated urban health data portal designed to give local officials something they have never had before: a single, coherent, map-based picture of who lives in their city, what risks they face, and where health services are failing to keep up. The project, described in the journal Discover Cities, is a mixed-methods implementation study that will unfold in two wards of the municipality and could become a template for rapidly urbanizing cities across South Asia and beyond.

The urgency behind the effort is rooted in one of the defining demographic shifts of the twenty-first century. The United Nations projects that by 2050 nearly 68 percent of the world’s population will live in urban areas, with the fastest growth concentrated in South Asia and Africa. In low- and middle-income countries, unplanned urban expansion routinely outpaces infrastructure, producing informal settlements with unsafe housing, poor sanitation, unreliable water, and exposure to flooding, waste pollution, and contaminated air. These clustered environmental and social risks drive diarrheal disease, mosquito-borne infections, and respiratory illness. Yet the people most exposed, including migrants, the urban poor, women, and ethnic minorities, are often invisible in official records, which means municipal planners cannot target resources to the neighborhoods that need them most.

The technical problem the researchers set out to solve is fragmentation. In many cities, health, education, water, civil registration, and planning data sit in separate departmental databases with no interoperability, inconsistent coding, and incompatible geographic coverage. Routine health information systems such as clinic records and vital registration are typically designed for national or rural contexts and rarely capture the plurality of providers in urban areas or the granularity needed at ward level. Periodic household surveys offer snapshots but are infrequent and often miss slum settlements entirely. The result is that a slum cluster with high child mortality or no safe water can remain hidden inside favorable city-wide averages, and planning an immunization campaign or a new clinic becomes an exercise in guesswork.

The study will proceed in three sequential phases. From March to November 2025, the team will conduct formative research, including stakeholder interviews and a policy review, alongside a household census and social mapping. From November 2025 to June 2026, they will develop the portal itself, integrating, validating, and visualizing the data. From July to December 2026, the focus shifts to implementation, user engagement, capacity strengthening, and embedding the portal into municipal decision-making. Budhanilkantha was purposively selected because its diverse and rapidly changing population, including dense informal settlements and migratory groups, makes it an ideal proving ground, while remaining manageable for intensive fieldwork.

The formative phase begins with approximately twelve key informant interviews with municipal officials from departments spanning health, education, civil registration, disaster management, animal health, agriculture, environment, infrastructure, information technology, and women, children and inclusion. Semi-structured interviews conducted in Nepali will explore existing data sources and workflows, priority health issues, and barriers to data sharing. Transcripts will be analyzed thematically using NVivo, with two researchers independently coding an initial subset and resolving discrepancies through discussion. Alongside the interviews, the team will review municipal plans, health policies, and census reports, and compile an inventory of routine data sources, including the national Health Management Information System, civil registration records, and education databases, as well as non-routine sources such as past surveys and geographic information system layers.

Three interlinked primary data collection activities will then fill the gaps that routine systems leave. First, GIS-based social mapping will engage community members, youth volunteers, and ward officials in delineating ward boundaries and marking health providers, water sources, schools, markets, transport routes, garbage dumps, and flood zones, along with informal settlements and even shops selling meat, tobacco, and liquor, all of which are relevant to environmental and behavioral health risks. Second, a door-to-door household census will enumerate every household in Wards 4 and 7, capturing household composition, assets, mortality, healthcare access, risk behaviors, maternal and child health, immunization, and HPV vaccination coverage among adolescent girls. Anthropometric measurements, including height, weight, body mass index, blood pressure, and mid-upper arm circumference in children under five, will be recorded, with enumerators using tablets running electronic forms such as Open Data Kit for daily uploads to a secure database.

Third, the team will assess all eleven public health facilities serving the two wards, including one public hospital, six health posts, and four basic health service centers. Structured tools will capture infrastructure, service readiness, equipment, logistics, the availability of eighteen tracer drugs, and the qualifications and training of health care providers. Performance will be benchmarked against Nepal’s Minimum Service Standards, a nationally endorsed framework of the Ministry of Health and Population. GPS coordinates of each facility will enable spatial analysis, and facility data will be linked with household census data to reveal mismatches between where people live, what they need, and what services actually exist. Preliminary findings already illustrate the value of this approach: Ward 7 hosts a high density of informal settlers but is served by only one under-resourced clinic.

The technical architecture of the portal rests on common identifiers and geocoding. Each household receives a unique ID, with individual-level IDs nested within it, allowing records to be linked across datasets where consent permits, or linked spatially through shared geographic identifiers where it does not. Routine government data will be standardized and aligned with ward boundaries using a comprehensive data dictionary, and automated pipelines through APIs or periodic batch uploads will refresh the portal monthly or quarterly. Built on the open-source DHIS2 platform enhanced with GIS modules, the portal will feature interactive dashboards, mapping layers for household density, infrastructure, water and sanitation coverage, and health outcomes, hotspot analytics, custom report generation, and role-based access controls to protect privacy. A user-centered design approach, with participatory workshops, prototype testing, and feedback loops involving municipal officials and community representatives, is intended to ensure usability and long-term adoption.

Data security receives careful attention throughout. All datasets will be stored in password-protected systems with access restricted to a designated municipal focal person and authorized team members, with routine quality checks for missing, duplicate, and out-of-range values, and geospatial information that could identify individual households will never be publicly displayed at an identifiable level. Ethical approval was granted by the Nepal Health Research Council and the University of Leeds, and the study is part of the Community-led Responsive and Effective Urban Health System research consortium funded by UK aid through the Foreign, Commonwealth and Development Office.

The implications extend well beyond two wards in Kathmandu. Because the architecture is built on common identifiers and flexible GIS layers, the framework can be extended to additional wards and municipalities, with indicators tailored to local contexts such as air quality sensors or traffic accident hotspots. The researchers envision future integration of environmental sensors, urban mobility data, and predictive modeling for disease outbreaks, potentially evolving into a community-facing platform with public health alerts and citizen reporting. By demonstrating that participatory mapping, a household census, and facility surveys can be fused with routine administrative data into a living analytical tool, the project offers a proof of concept for equity-focused urban health governance, aligning local action with Sustainable Development Goal 11 on sustainable cities. For the millions of urban residents across low- and middle-income countries whose lives and needs are currently missing from the data, this Nepali pilot suggests that being counted may be the first step toward being served.

Subject of Research: Development of an integrated urban health data portal to strengthen municipal health systems in Nepal

Article Title: Study protocol for developing an integrated urban health data portal to strengthen urban health systems in Nepal

Article References: Kakchapati, S., Sharma, N., Baral, J., Maharjan, S., Mainali, S., Marasini, S., Elsey, H., Lamichhane, B., Karki, S., Bhattarai, A., Sharma, S., Shrestha, G., Karki, S., Ebenso, B., Hicks, J., Dawkins, B., Koirala, B., Dahal, K. P., Lama, A., & Baral, S. C. (2026). Study protocol for developing an integrated urban health data portal to strengthen urban health systems in Nepal. Discover Cities, 3(1), Article 200. https://doi.org/10.1007/s44327-026-00377-y

Image Credits: AI Generated

DOI: 10.1007/s44327-026-00377-y

Keywords: urban health, data integration, Nepal, GIS, health informatics, household census, informal settlements, health equity, DHIS2, municipal governance, Kathmandu, study protocol