Mid-Western Development Region
Nepal's second-poorest region with 45% multidimensional poverty, limited roads and electricity, substantial untapped hydropower potential on the Karnali River.
The Mid-Western Development Region ranks as Nepal's second-poorest territory, with 45% of the population in multidimensional poverty—marginally better than the Far-Western Region's 46%. This 1970s planning designation now corresponds to portions of Karnali Province and other administrative units. Infrastructure remains sparse: road access is limited, electrification incomplete, and basic services concentrated in district headquarters rather than villages. The Karnali River system offers substantial hydropower potential, and recent years have seen Nepal's electricity production increase, but transmission infrastructure to bring power to remote areas lags. Agriculture operates at subsistence levels on terraced hillsides, vulnerable to monsoon variability. The region's remoteness historically preserved cultural traditions but also limited educational and economic opportunities, driving emigration—though workers from this region typically earn less abroad than their counterparts from wealthier regions. The Maoist insurgency (1996-2006) found fertile ground in this neglected territory. Federal restructuring promised resources for provincial governments, but implementation has been uneven. By 2026, the Mid-Western Development Region's trajectory depends on whether hydropower development reaches local communities, whether road construction improves connectivity, and whether any economic activity beyond subsistence agriculture emerges in a region that Kathmandu's development model consistently bypassed.