Governance and Purchasing Function under Social Health Insurance in Nepal: Looking Back and Moving Forward

Abstract

Nepal is pursuing Social Health Insurance as a way of mobilizing revenues to achieve Universal Health Coverage. The Social Health Insurance governance encourages service providers to maintain quality and efficiency in services provision by practicing strategic purchasing. Social Health Security Programme is a social protection program which aspires to achieve the goals of Social Health Insurance. Social Health Security Development Committee needs to consider following experiences to function as a strategic purchaser. The Social Health Security Development Committee need to be an independent body instead of falling under Ministry of Health. Similarly, purchasing of health services needs to be made strategic, i.e., Social Health Security Development Committee should use its financial power to guide the provider behavior that will eventually contribute to achieving the goals of quality and efficiency in service provision. The other social health security funds should be merged with Social Health Security Development Committee and develop a single national fund. Finally, the state has to regulate and monitor the performance of the SHI agency.

Successes and obstacles in implementing social health insurance in developing and middle-income countries: A scoping review of 5-year recent literatures

“…In structure, purchasing systems should guide consumer behavior and ensure quality and efficiency while purchasing services to guide provider behavior. Multiple funds should be integrated into one single pool covering both formal and informal sectors ( 45 ). Appointing a third party by an SHI authority as an agency for strategic purchasing may pose severe issues.…”

Strategic Health Purchasing Progress Mapping in Cameroon: A Scoping Review

“…Our results are consistent with the increasingly common view in international health financing circles that a clear legislative mandate and formally defined objectives for the purchasing agency are the foundations on which other elements of governance-particularly accountability and transparency-are built. 28,29,76,77 Strategic health purchasing goes beyond the simple notion of contract and encompasses power issues and stakeholders' dynamics. 78 Our findings suggest that the governance function of strategic health purchasing is very challenging in Cameroon, due to the multiple purchaser markets and the resulting fragmentation of the health financing system.…”

“…Furthermore, it has been widely recognized that the increased interest in research in SHP is largely attributable to the needs to move beyond concepts and theory to practical application, as researchers are urged to produce evidence that adequately inform policy debate and actions. 10,[26][27][28][29] We aimed to fill these gaps by conducting a scoping review to describe the SHP functions, capacities and governance arrangements in Cameroon.…”

Adoption of Improved Management Practices of Sugarcane in Bara and Nawalparasi Districts

“…. Compared to the global average, Nepal's sugarcane yield is very low, most probably due to poor varietal selection (Sapkota et al, 2019). selection of poor-quality sets are also major causes for low productivity of sugarcane in Nepal (Neupane et al, 2017;NSMA, 2018).…”

“…selection of poor-quality sets are also major causes for low productivity of sugarcane in Nepal (Neupane et al, 2017;NSMA, 2018). The average yield of sugarcane in the NARC research center with improved practices is Sapkota et al, 2019). The productivity of sugarcane for Nepal is 49.48 t/ha and that of Nawalparasi and Bara district is 47.20 t/ha and 46.73 t/ha respectively (MoALD, 2022) whereas the productivity of India is 78.57 t/ha (FAOSTAT, 2021).…”