A year after a magnitude 7.8 earthquake devastated Nepal, rebuilding efforts are lagging and three million people still live in temporary shelters, according to reports from Save the Children, CARE International, and other aid organizations.

Following the April 25, 2015, earthquake that killed nine thousand people, injured more than twenty-two thousand others, and destroyed nearly a million houses, international donors pledged more than $4.1 billion for reconstruction efforts in the country, but those efforts have been delayed — in part, by internal political upheaval, Reuters reports. According to data collected by #quakeHelpDesk, an initiative led by Accountability Lab and the UK-based Local Interventions Group, four out of five Nepalese quake survivors report their reconstruction needs are not being addressed.

"Millions of families are still living in the temporary shelter supplied by aid agencies months ago, having already braved a very cold winter and are now facing the prospect of another monsoon season, which will start in June," said Delailah Borja, Save the Children's country director for Nepal.

In a recent report, Did the Humanitarian Response to the Nepal Earthquake Ensure No One Was Left Behind? (26 pages, PDF), Save the Children also noted that during the emergency response phase of the relief effort, many of the most marginalized and vulnerable communities missed out on critical aid such as cash distributions. Challenges to an effective response included the government's decision to use "blanket," rather than targeted, distributions of aid; poor communication with isolated communities and elderly or disabled people; and a lack of thorough assessment to identify families most in need.

CARE International has voiced concern that women and girls have suffered disproportionately since the quake. According to UN Women, unmarried, widowed, and divorced women have had only limited access to relief measures, while the United Nations has reported an increase in domestic violence against women.

"Landless women and girls are the most vulnerable in this situation," said Lora Wuennenberg, CARE's country director for Nepal.