Lack of Resources
Years of armed conflict and poor governance have slowed development. The Hindu Caste system, while declining in influence, continues to have a strong effect on the culture of inequality of rural Nepalese. This creates greater political and social isolation, and slows steps towards equality.
There is a deadly shortage of health care workers in these areas, which only exacerbate poorly-resourced clinics. Only 36% of births in Nepal are attended by skilled health personnel.
Many times, non-governmental organizations fail to reach the poorest and most isolated communities--so, those most in need of support are dramatically under-served.