Nepal, a landlocked country in the Himalayas, exhibits significant geographical diversity, from the fertile Terai plains to the lofty mountain ranges. This varied terrain poses considerable challenges for development and health service accessibility, particularly for remote and isolated communities. To address these issues, the proposed project aims to implement large-scale telemedicine across 100 health facilities in Koshi province from 2025. This initiative seeks to provide cost-effective healthcare solutions, improving access and outcomes for underserved populations, especially vulnerable groups like women and the elderly. Key health focus areas include Sexual and Reproductive Health, Primary Health Care, Skin Diseases, and Maternal and Child Health, targeting the general population, rural communities, women, and individuals aged 65 and older. Current status of the project: 107 sites equipped to use telemedicine, 1509 teleconsultations conducted (~60% women), 231 FCHVs trained for advocacy, 10 sites co-financed with municipalities. The project is still ongoing and more detailed information related to the implementation process and the impact of telemedicine will be shared in the coming months.