Nepal in a Warming World: Strengthening Heat-Health Action

REPORT

Living with Heat in Nepal

Heat-Health Risks, Vulnerability and Emerging Responses

08 October, 2026 | Climate Resilience

Anushka Goswami, Shruti Nikhar, Shravan Prabhu, and Dr Vishwas Chitale

Suggested Citation: Global Heat Health Information Network South Asia Hub. 2026. Living with Heat in Nepal: Heat-Health Risks, Vulnerability and Emerging Responses

Download Study

Overview

This country synthesis report examines Nepal’s growing exposure to extreme heat, the populations and places most at risk, emerging policy and institutional responses, and locally grounded approaches to strengthening heat resilience. The report assesses Nepal’s response to the evolving risk of extreme heat, identifies gaps in heat-health surveillance, early warning, implementation, and consolidates priorities for strengthening long-term heat resilience. It also highlights emerging approaches and considers how evidence can inform practical, scalable and context-specific responses to reducing the health impacts of extreme heat.

The report examines four interconnected dimensions: historical and projected heat trends and the spatial distribution of risk; evidence on heat-health impacts and socioeconomic vulnerabilities to heat exposure; Nepal’s heat governance landscape, including heat action planning, health-system preparedness, early warning and forecasting, and heat-health surveillance; and the role of non-governmental and community-based initiatives in strengthening heat resilience. It then identifies priorities for strengthening long-term heat resilience, including integrating heat-health surveillance with early warning systems, strengthening local capacity and coordination, mainstreaming heat risk across sectors, and applying a differential vulnerability lens to heat-health action.

Key highlights

Annual average maximum temperatures exceeded 30°C across the southern Terai in 2024, but remained below 9°C in the north. In 2025, Lahan station in Siraha recorded the country’s highest annual average maximum temperature, at 32.6°C.
Nepal’s National Adaptation Plan (NAP) projects a 1.5–1.6°C increase in mean annual temperature for 2021–40, 2.0–2.4°C for 2041–60, and 2.7–4.4°C for 2081–2100. More recent DHM scenarios model temperature increases of up to 4.5°C under SSP2-4.5 and up to 7°C in some areas under SSP5-8.5.
In Kathmandu Valley and Terai cities such as Nepalgunj, Chitwan and Biratnagar, the urban heat island effect intensifies and prolongs heatwaves. Its impacts extend beyond public health, reducing labour productivity, worsening air quality and deepening socioeconomic inequalities.
In Nepalgunj, more than 60 per cent of surveyed residents reported heat-related symptoms, but only 14.3 per cent sought care at a health facility.
Heat-health risks in Nepal reflect differential vulnerability shaped by gender. In Dhangadhi, women from marginalised and low-income communities reported heat exposure during both paid and domestic work, and nearly half did not receive heat alerts.
Nepal's Early Warning and Reporting System (EWARS) currently covers six communicable diseases and syndromes. Heat-related illnesses are not yet systematically recorded, which presents an opportunity to strengthen the evidence base for heat-health action
The NDRRMA issued the country’s first federal heat plan in 2024 and a broader, anticipatory national plan covering extreme heat and drought in 2026. The DHM operates numerical forecasting models and issues heatwave alerts and special bulletins.
Organisations such as Nepal Red Cross Society, Zurich Climate Resilience Alliance and the RAIN programme in Nepal have implemented heat-risk initiatives such as public awareness and risk communication campaigns, installation of hydration stations, cool roofs, and technical support to local governments.
Nepal has made important progress through national heat plans and established forecasting capacity. The next step is to establish local warning thresholds, dedicated financing for heat action, and systematic heat-health data.

HAVE A QUERY?

Anushka Goswami

Research Analyst

[email protected]

Nepal’s warming climate is changing patterns of heat exposure across its diverse geography. While the Terai continues to face the highest levels of extreme heat, rising temperatures are also increasing exposure in higher-altitude regions of the country. As communities in these areas have historically experienced cooler conditions, targeted measures will be needed to strengthen preparedness and reduce emerging heat-health risks. Community-led action, supported by stronger climate information, health preparedness and locally relevant early warning systems, will be critical to ensuring that Nepal’s heat response reflects this changing risk landscape.”

Executive summary

The increasing frequency, intensity and duration of extreme heat events have emerged as a global climate, health and development challenge, with impacts shaped by levels of exposure, socioeconomic conditions and access to health and social protection. This global warming trend provides important context for understanding Nepal’s changing climate risks: the World Meteorological Organization confirms that 2015–2025 were the 11 warmest years on record, with 2025 approximately 1.43°C above the 1850– 1900 average (WMO 2026). Against this backdrop, Nepal is experiencing rising temperatures and more frequent episodes of extreme heat, with risks varying across its diverse climatic zones and populations. In the high mountains, warming is also contributing to glacier retreat and the expansion of glacial lakes (Khadka et al. 2023). Understanding these changing patterns of climate risk, and the factors shaping vulnerability across populations and places, is therefore critical to strengthening climate and heat- health action in Nepal.

As part of GHHIN South Asia Hub’s knowledge products, this country synthesis examines heat risks in Nepal through four interconnected dimensions. It first assesses historical and projected heat trends and the spatial distribution of heat risk across the country. It then examines how socioeconomic conditions shape vulnerability to heat, before reviewing Nepal’s policy and institutional mechanisms for addressing heat risk. Finally, it highlights non-government and community- oriented solutions being implemented on the ground, offering insights into emerging approaches to strengthen heat resilience.

Key findings

Nepal is facing both chronic and acute heat stress.
Across 46 meteorological stations in Nepal, maximum temperatures rose by roughly 0.04°C per year between 1980 and 2016, while minimum temperatures rose by 0.02°C per year, with the strongest warming observed in the mountains and during the pre-monsoon season. The number of warm days increased by 13 per decade and warm nights by 4 per decade (Karki et al. 2020).
Nepal also experiences a pronounced north–south temperature gradient: annual average maximum temperatures exceeded 30°C across the southern Terai in 2024, but remained below 9°C in the north. In 2025, Lahan station in Siraha recorded the country’s highest annual average maximum temperature, at 32.6°C (DHM 2024b; DHM 2026a). Recent data also indicate an increase in the frequency and duration of extreme heat events. In 2024, the Terai recorded 50 extremely hot days with temperatures above 40°C, with heatwave spells lasting 5–17 days. In 2025, it recorded 22 such days and heatwave spells lasting 3–6 days (DHM 2025; DHM 2026a). The trends highlight that Nepal, once a country affected largely by hydrometeorological disasters, is also facing heat related hazards in recent decades.
Projections show increasing heat risk.
Nepal’s National Adaptation Plan (NAP) projects a 1.5– 1.6°C increase in mean annual temperature for 2021–40, 2.0–2.4°C for 2041–60, and 2.7–4.4°C for 2081–2100, depending on the emissions pathway (MoAFE 2021). More recent Department of Hydrology and Meteorology (DHM) scenarios model temperature increases of up to 4.5°C under SSP2-4.5 and up to 7°C in some areas under SSP5-8.5, with the high Himalaya experiencing the fastest warming (DHM 2024c). Projected increases in monsoon rainfall, combined with higher temperatures, could increase humidity and compound heat stress in regions such as the Terai, where exposure is already high.
Vulnerability is determined by more than temperature.
In 2021, just 53.1 per cent of Nepali households owned an electric fan, 23.7 per cent a refrigerator, and 37.7 per cent had internet access, 4.5 per cent of households had no access to a toilet(NSO 2023). About 66 per cent of the population is engaged in agriculture, which accounts for roughly a third of the country’s gross domestic product (GDP) (FAO 2026). The sector is also projected to experience significant heat-related productivity losses: ILO projects productivity losses equivalent to 391,000 full- time jobs by 2030, up from 106,000 in 1995 (ILO 2019). Outdoor workers routinely work in ambient temperatures of 36–39°C with high humidity. This results in increasing the risk of heat-related illness two- to threefold (Venugopal et al. 2021; Sharma et al. 2025). Residents of informal settlements, marginalised communities, and households without access to water, healthcare, or cooling bear the heaviest burden (Giri et al. 2021).
The health burden of heat stress is high.
In Nepalgunj, where the maximum heat index remained in the ‘Danger’ category (41–54°C) from May to September 2019, more than 60 per cent of surveyed residents reported heat-related symptoms, ranging from headaches and cramps to hyperthermia, unconsciousness, and seizures. However, only 14.3 per cent sought care at a health facility (Bhatta and Pahari 2021). Nepal’s principal sentinel surveillance system, the Early Warning, Alert and Response System (EWARS), covers six communicable diseases and syndromes but does not monitor heat-related illnesses. There is also no established system for recording heat-related mortality (Dhimal et al. 2018). Consequently, facility-based data alone may underestimate the overall burden of heat-related illness and mortality in Nepal. Strengthening heat-health surveillance is therefore important to capture cases that may not reach health facilities, identify populations and locations experiencing disproportionate impacts, and generate timely evidence to inform heat-health action plans, early warning systems and targeted public health interventions.
Institutions are responding with plans and policies, but implementation remains uneven.
Nepal has made progress in developing institutional responses to extreme heat: the National Disaster Risk Reduction and Management Authority (NDRRMA) issued the country’s first federal heat plan in 2024 and a broader, more anticipatory national plan covering extreme heat and drought in 2026 (NDRRMA 2024, 2026a). The DHM operates a forecasting system based on the Weather Research and Forecasting (WRF) numerical weather prediction model, initialised four times daily, which features tiered heatwave alerts and special bulletins for extreme heat (DHM n.d.c.). However, this forecasting capacity is not complemented by corresponding health surveillance and local response systems. Nepal’s routine health surveillance does not systematically capture heat-related illness, and no systematic heat early warning system reaching all vulnerable groups is yet in place (Dhimal et al. 2018; Khan et al. 2026). This gap between forecasting capacity and downstream health and local response systems presents a key challenge for heat governance in Nepal. Technical expertise, financing, and access to climate finance remain concentrated at the federal level, limiting what the 7 provincial and 753 local governments can deliver (Khatri et al. 2022).
Heat responses are being implemented at the ground level. Three documented initiatives of locally grounded heat response include:
- The Nepal Red Cross Society (NRCS) works across Nepalgunj, Siddharthanagar, Biratnagar, and Dhangadhi, reaching about 880,000 people through public awareness campaigns and around 4,400 through household visits, health checks, and drinking water stations. As part of its heat-risk reduction interventions, NRCS supported the installation of cool roofs in 14 households and two schools, and technical support underpinned heat action plans (HAPs) in three cities (NRCS 2025).
- The Zurich Climate Resilience Alliance (ZCRA), through Practical Action and Mercy Corps, supported Madhesh Province and five municipalities in committing 5 per cent of sectoral budgets to adaptation and disaster risk reduction, informed by resilience assessments conducted in 57 communities in 13 municipalities. A 2025 Mercy Corps study covering 347 public schools in Madhesh provided evidence of heat impacts in Nepali schools. It identified 202 schools as highly vulnerable and documented existing coping measures and preparedness gaps, providing evidence to inform targeted interventions in school infrastructure, heat preparedness and local planning (ZCRA 2025; Mercy Corps 2025)
- The Resilience, Adaptation, and Inclusion (RAIN) programme in Nepal piloted a heat early action standard operating procedure (SOP) in Gaur, Jaleshwor, and Siraha in June 2025, using locally derived 95th-percentile temperature thresholds of 38.5°C, 38.1°C, and 36.5°C. It provided hydration stations for more than 17,500 outdoor workers and door-to-door health advice to over 1,800 people through female community health volunteers, as well as risk communication via local-language radio and mural art (Neupane 2025; People in Need 2025).

What Nepal needs next to be heat resilient

Nepal needs to shift from a largely reactive response to extreme heat to a more proactive, integrated and inclusive approach to heat-health action. This requires strengthening institutional preparedness across levels of government while ensuring that interventions respond to the differing risks faced by populations and places. The brief highlights four priorities.

Strengthen heat-health surveillance
The Ministry of Health and Population, working with the DHM, can strengthen routine reporting of heat-related morbidity and mortality, beginning with the mandatory recording of heat-related admissions at Terai district hospitals during the pre-monsoon and monsoon months. Systematic reporting will help identify populations and locations experiencing higher health impacts and generate evidence to guide targeted interventions
Integrate heat-health surveillance into the early warning system
Heat-health surveillance data can be linked with meteorological forecasts and locally derived heat-health thresholds to strengthen Nepal’s early warning system. This integration can enable authorities to assess emerging health risks, identify hotspots, and trigger timely, evidence-based public health interventions.
Strengthen local capacity and coordination for heat action
As local governments play a critical role in disaster risk management and service delivery, building their technical and institutional capacity is essential. Establishing clear roles and coordination mechanisms across meteorological, health, disaster management, and local government agencies can support the development and implementation of locally tailored heat-health action plans.
Mainstream heat risk across sectors
Heat health considerations need to be extended beyond seasonal heatwave responses and be integrated into health-system preparedness, urban planning, workplace safety, and disaster risk management. This can help address the underlying drivers of heat exposure and reduce risks through measures such as improved access to cooling, heat-resilient public spaces, and safer working conditions.
Apply a differential vulnerability lens to heat-health action
Heat impacts are not experienced uniformly. Policies and interventions should prioritise groups facing higher exposure or limited capacity to adapt, including outdoor and informal sector workers, low-income households, and communities in heat-prone areas. Nepal’s Female Community Health Volunteers (FCHVs) network, with over 50,000 volunteers in every ward, offers an effective channel for reaching households and generating evidence on gender, livelihoods, and access to resources at the local level (MoHP 2025).

The GHHIN South Asia Hub can support these priorities by convening stakeholders, strengthening the regional evidence base, facilitating knowledge exchange, and building capacity for heat-health action. This can help Nepal translate emerging evidence into practical, scalable, and context-specific approaches to reducing the health, livelihood, and socioeconomic impacts of extreme heat.

FAQs

Where are Nepal's heat-risk hotspots

The southern Terai is Nepal's main heat hotspot. Average maximum temperatures there exceeded 30°C in 2024, and the region recorded 50 extremely hot days above 40°C. The urban heat island effect intensifies heatwaves in Kathmandu Valley and Terai cities such as Nepalgunj, Chitwan and Biratnagar, and rising humidity is extending heat risk to higher-elevation areas.
What heat policies and institutional measures are being implemented in Nepal?

The NDRRMA issued the country’s first federal heat plan in 2024 and a broader national plan covering extreme heat and drought in 2026. The country also has heat action planning at a local level, including Nepalgunj 2023 HAP. The DHM operates forecasting models and issues heatwave alerts.
What solutions does the report propose for long-term heat resilience in Nepal?

The report sets out five priorities for long-term heat resilience in Nepal: strengthening heat-health surveillance, integrating it into the early warning system, building local capacity and coordination, mainstreaming heat risk across sectors, and applying a differential vulnerability lens. Together, these would help Nepal move from a largely reactive response to a proactive approach that protects those most at risk.
How are communities and NGOs driving heat action in Nepal?

Community organisations and NGOs are complementing national efforts with locally grounded heat action. The Nepal Red Cross Society has reached about 880,000 people through awareness campaigns and supported heat action plans in three cities. Community assessments under the Zurich Climate Resilience Alliance helped Madhesh Province commit budgets to adaptation. The RAIN programme piloted local heat thresholds and hydration stations for more than 17,500 outdoor workers. These efforts show how local partnerships can turn national guidance into practical protection.