Role of information, education, and communication in enrollment of health insurance: A case of Nepal

Abstract

Background Most of the studies have indicated that various programmes were failing due to lack of appropriate information, education, and communication [IEC] to the target audiences. But still unanswered that which methods or means of communication could be the most powerful for changing behaviour, decision making,and or desired action. The paper aims to assess the effects of IEC on the enrollment of health insurance in Nepal.Methods A cross-sectional study, with randomly selected 810 [405 enrolled and 405 not-enrolled] households, was conducted at Baglung and Kailali districts of Nepal in 2018 using pretested structured interview tool. Background characteristics of family and respondents, and exposure to the means of communication were independent variables; and enrollment of health insurance was the dependent variable. Univariate, bivariate, and multivariate analyses were done to interpret the data.Results Data show that socio-demographics and exposure to communication were associated with the enrollment of health insurance. Demographic characteristics of the respondents and households particularly household head, age, wealth status, ability to feed the family, and presence of chronic diseases in the family were significantly associated with the enrollment of health insurance. Similarly, exposure to communication and media such as knowledge on health insurance and contribution amount of health insurance, having health insurance related books or guidelines, participation in training and workshop, discussion with peers and neighbours, exposure to health insurance related messages from radio and television, seen hoarding board, newspaper, and health insurance related pamphlet, brochure, and posters were significantly associated with enrollment in health insurance. Knowledge about health insurance and contribution amount, having health insurance related books and guidelines, and discussion with peers and neighbours appeared to be the positive and significant predictors for enrollment in health insurance scheme.Conclusion Communication and interaction with peers and neighbours about health insurance scheme of the government could lead to higher participation in health insurance programme. It would be better to incorporate this strategy while planning policies and interventions on health insurance.

Socio-economic factors and management regimes as drivers of tree cover change in Nepal

“…The Terai and Siwalik regions comprise mainly tropical Sal and Mixed Broad-Leaved forest and Hill encompasses Hill Sal forest, Schima-Castanopsis forest, Chir Pine and Chir Pine-Broad Leaved forests whereas High Mountain region has temperate forests such as Cypress, Rhododendron, Spruce, and Oak Forests ( Barnekow Lillesøo et al, 2005 ). From the commercial point of view, Terai and Siwalik regions have forests with maximum market value and are hence highly prone to commercial exploitation ( Acharya et al, 2015 ). In contrast, Terai region has the lowest proportion (7%) of community forests while Hill and mountain have 75% and 16% respectively ( GoN, 2013 ).…”

“…Overgrazing is considered as one of the major drivers of forest loss and degradation in Nepal ( Acharya et al, 2015 ; REDD Implementation Center, 2013 ). Grazing in the forested areas and stripping trees to provide fodder for animals are common in many parts of Nepal.…”

“…The initiation of large-scale monitoring of forest cover change occurred only after 1960 although deforestation has been a major issue in Nepal. From 1964 to 1994, about 2.1 million ha of forests were converted to shrubland or other land uses ( Acharya et al, 2015 ). FAO data showed that the annual loss of forest in the period between 2000 and 2005 was 1.39%, which remained stable during 2005–2010 ( FAO, 2010 ).…”

“…A total of nine major drivers of deforestation and forest degradation: (i) forest fire, (ii) overgrazing, (iii) unsustainable utilization of forest products, (iv) weak forest management practices, (v) infrastructure development, (vi) urbanization and resettlement, (vii) encroachment, (vii) invasive species and (ix) mining were identified ( REDD Implementation Center, 2013 ). Likewise, population distribution, migration, poverty, high dependency in forest products, insecure forest tenure are major underlying causes of deforestation and forest degradation in Nepal ( Acharya et al, 2015 ). We use available data on the drivers and underlying causes of deforestation and analyse: (a) the spatial and temporal patterns of the tree cover change in Nepal from 2001–2016, (b) the socio-economic drivers of forest cover change, and (c) the effectiveness of community forestry programs on the tree cover dynamics.…”

An Ecosystem Services Valuation Research Framework for Policy Integration in Developing Countries: A Case Study from Nepal

“…The country is relatively small, occupying about 0.1 percent of the global area, but ranks 25th in terms of biodiversity [24]. It possesses 3.2 percent and 1.1 percent of the world's known flora and fauna, respectively [26,27]. Similarly, Nepal is renowned for community-based forest management modalities globally, with more than 2.5 million hectares of forests under the community-based forest management (CBFM) system [28].…”