Social health insurance in Nepal: A health system departure toward the universal health coverage

Pokharel, Rameshwar Prasad; Silwal, Pushkar Raj

doi:10.1002/hpm.2530

Cited by 35 publications

(38 citation statements)

References 7 publications

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“…For addressing the financial constraint in health services, Nepal's Government implemented the Social Health Insurance Program (SHIP) in 2016. However, the program has been facing many challenges and only small portions of the population are enrolled under this scheme [13,14]. Despite the fact that research on CHE has been substantially studied around the world, very few research papers have been published in the context of Nepal.…”

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confidence: 99%

Catastrophic Health Expenditure: An Experience from Health Insurance Program in Nepal

Paudel

2019

Emerg Sci J

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High expenditure due to health care is a noted public health concern in Nepal and such expenditure is expected to reduce through the access to health insurance. This study determines the factors affecting household’s catastrophic health care expenditure in Kailali district, where the government health insurance program was first piloted in Nepal. A cross-sectional survey was conducted from January to February 2018 among 1048 households (6480 individuals) after 21 months of the execution of the social health insurance program. For the sample selection, wards were selected in the first stage followed by the selection of the households. Overall, 17.8% of the households reported catastrophic health expenditure using a threshold of more than 10% of out-of-pocket payment to total household expenditure. The study found that households without having health insurance, low economic status, and head with low level of education were more likely to face catastrophic spending. The findings suggest a policy guideline in the ongoing national health insurance debate in Nepal. The government health insurance program is currently at expansion stage, so, increase in insurance coverage, could financially help vulnerable households by reducing catastrophic health expenditure.

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confidence: 99%

Catastrophic Health Expenditure: An Experience from Health Insurance Program in Nepal

Paudel

2019

Emerg Sci J

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“…interventions in countries such as Nepal [82,90], Ugunda [117,118] Rwanda [75], Tanzania [50,77], Ethiopia [119], Afghanistan [62] and…”

Section: Discussionmentioning

confidence: 99%

“…Considering the economic conditions of countries, the results of the present study show that most of the interventions have performed in the eld of nancing or nancial protection functions. Thus, most interventions in these countries have focused on the insurance system and targeted the poor people or speci c groups of society [67,75,78,[80][81][82]120]. Also one of the issues that mostly reformed by countries is the payment and premium systems [60,65,99,121].…”

Section: Discussionmentioning

confidence: 99%

Best Practices in Achieving Universal Health Coverage: A Scoping Review

Koohpayehzadeh

Azami-Aghdash

Derakhshani

et al. 2020

Preprint

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Background: Universal health coverage (UHC) is a very important and effective policy in the health system of countries worldwide. Using the experiences and learning from the best practices of successful countries in the UHC can be very helpful. Therefore, the aim of the present study is to provide a scoping review of successful global interventions and practices in achieving UHC. Methods:The present study is a scoping review study has conducted using the Arkesy and O'Malley framework. To gather information the databases of Embase, PubMed, The Cochrane Library, Scopus, SID and MagIran have searched using the keywords of Universal health coverage, Universal healthcare coverage, Universal health care coverage, Strength*, Transfer*, interventions, improve*, program*, innovations, initiative, Financing, "Service delivery", Stewardship, "Resource generation", from 2000 to 2019. Content-Analysis was also used to analyze the data.Results: Out of 4257 articles, 57 evidence finally included in the study. The results showed that of the 40 countries that had successful interventions, most were Asian. The interventions were financial protection (40 interventions that categorized to 14 items), service coverage (31 interventions that categorized to 7 items), population coverage (36 interventions that categorized to 9 items) and quality (18 interventions that categorized to 7 items) respectively. Also, the successful result were conducted financial protection (14 items), service coverage (7 items), population coverage (9 items) and quality (7 items)) respectively. Conclusion:This study provides a comprehensive and clear view of successful interventions in achieving to UHC. Therefore, with consideration to lessons learned from successful interventions, policymakers can be designing appropriate interventions to their country. a significant impact on health promotion, easier access to health care for those in need, and improved public health, especially for the poor [12].Given the importance of achieving UHC for high-and middle-income countries, the number of countries trying to achieve this has increased in the last two decades [13, 14]. In addition, nowadays countries by increasing their knowledge and awareness of strategies and applying the experiences of successful countries, as well as acquiring the necessary capabilities to meet their urgent needs, are trying to take the path of achieving UHC [15][16][17]. Like other high-income countries that have achieved UHC, low and middle-income countries, with taking into account the structure and resources that they have, on the path to UHC, undertake measures such as mobilizing resources, fulfilling the political commitments necessary to implement health-related policies, and implementing effective reforms and interventions in macro-national policies [1, 18, 19]. The UHC can be one of the most challenging political processes that require the support of various stakeholders, including health system policymakers [4]. Although all countries pursue the same goal of achieving UHC, the path...

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“…The government pays hospital a xed amount for providing haemodialysis and transplant service for the destitute through its impoverishment citizen fund established in 2016 [19,31]. However, in the absence of renal registry and fully viable health insurance system to cover expenses associated with the treatment, patients with ESRD face a major setback in living a quality life [31,37].Importantly, the government subsidy through the impoverished citizen fund does not cover all treatment expenses and moreover, there is a low enrollment and limited ceiling in bene t package (NPR 100,000) in health insurance [38]. In our study, even after transplant, QOL in environment domain was found comparatively lower than other domains in renal transplant.…”

Section: Discussionmentioning

confidence: 99%

Health related quality of life among end stage renal disease patients from low income country, Nepal: a cross sectional study using WHOQOL-BREF

Ranabhat¹,

Khanal²,

Mishra³

et al. 2020

Preprint

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Abstract Background Little is known about the health-related quality of life (HRQOL) among end stage renal diseases (ESRD) patients in Nepal. This study examined the health-related quality of life of among the dialysis and transplant patients in Nepal. Methods Nepali Version of WHOQOL-BREF questionnaire was administered using face to face interviews among ESRD patients, from two large national referral centers in Nepal. The differences in socio-demographic characteristics among ESRD patients were examined using Chi-square test. The group differences in QOL were examined using Mann-Whitney U test and Kruskal-wallis tests. Results Of the 161 participants, 92 (57.1%) were transplant patients and 62 (42.9%) were dialysis patients. Hypertension (70.9%) was the commonest co-morbidity among ESRD patients. Dialysis patients scored significantly lower than the transplant patients in all the four domains as well as in overall perception of quality of life and general health. Ethnicity (p = 0.020), socio-economic status (p < 0.001), educational status (p < 0.001) and employment status (p = 0.009) was significantly associated with the overall QOL in ESRD patients. Across patient groups, educational status (p = 0.012) was positively significant with the QOL in dialysis patients while residence (p = 0.023), socio-economic status (p < 0.001), educational status (p = 0.004) and diabetes status (p = 0.010) was significantly associated with the QOL in transplant patients. Conclusion The overall QOL of the renal transplant recipient was higher than those of the patients on maintenance hemodialysis; this was true in all the four domains of the WHOQOL-BREF. ESRD patient with low HRQOL should be prioritized for risk modification intervention.

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Social health insurance in Nepal: A health system departure toward the universal health coverage

Cited by 35 publications

References 7 publications

Catastrophic Health Expenditure: An Experience from Health Insurance Program in Nepal

Catastrophic Health Expenditure: An Experience from Health Insurance Program in Nepal

Best Practices in Achieving Universal Health Coverage: A Scoping Review

Health related quality of life among end stage renal disease patients from low income country, Nepal: a cross sectional study using WHOQOL-BREF

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