Nepal formally adopted federalism with the promulgation of a new Constitution in 2015, subsequently restructuring the state into a federal government, seven provincial governments and 753 local governments comprising 293 urban municipalities and 460 rural municipalities. The Constitution has established health as a fundamental right and stipulated public health as a concurrent function amongst all three levels of government. The Constitution has also designated specific public health responsibilities and authorities to each level of government. For example, it is solely the local government’s task to deliver basic health care services while functions such as setting national-level goals and standards are under the jurisdiction of the federal government. The exclusive authorities of the local governments and their concurrent authorities with the federal and provincial governments with regards to health are defined in the Local Government Operations Act 2074.