Universal health coverage in a regional Nepali hospital: who is exempted from payment? [Short communication]

Basnet, Rajendra; Shrestha, Bikash; Nagaraja, Sharath Burugina; Basnet, Binamra; Satyanarayana, Srinath; Zachariah, Rony

doi:10.5588/pha.12.0082

Cited by 6 publications

(8 citation statements)

References 5 publications

(4 reference statements)

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“…The study by Basnet et al showed that 83.3% of patients using free services were from the geographical district where the hospital was situated, 17 while the percentages in the present study were 51.8% for WRH and 56.4% for LZH. This shows that access to these hospitals is comparatively easier than access to the regional hospital in Surkhet for people from outside the geographical districts of WRH and LZH.…”

Section: Discussioncontrasting

confidence: 40%

“…21 A similar study by Basnet et al in 2013 in a regional hospital of Surkhet district also did not differentiate between the poor and ultrapoor; that study showed that the poor used free health care in the highest numbers (71.9%). 17 The present study showed that most of the groups using the free services were upper-caste patients and poor patients, and also some nontarget groups. Similar to the present study, there are reports showing an increasing demand for free services because of unnecessary use of health care by nontarget groups, thus leading to a fall in the quality of the services and increasing health-care costs.…”

Section: Discussionmentioning

confidence: 87%

“…A similar study by Basnet et al in 2013 in a regional hospital in the midwestern region of Nepal showed that 10.8% of patients were exempted from payment. 17 The percentage of patients receiving free services was very low at LZH and moderately low at WRH, although the population census report of 2011 showed the population of Rupandehi district to be much larger (880 196) than that of Kaski (492 098). 19 The poor educational programme provided by the hospitals to inform the target groups on the availability of free health-care services contributed to the low number of patients receiving free services at LZH.…”

Section: Discussionmentioning

confidence: 99%

“…15 Some studies have evaluated the implementation of the free health-care policy in health posts and subhealth posts, and in hospitals up to district level; however, there is limited information available on the effectiveness of this policy for access to the health-care system, especially for the marginalized and poor. [15][16][17] A study conducted in a regional hospital in the midwestern region of Nepal attempted to evaluate the situation regarding financial protection for patients and access to free services available at that facility. 17 However, there is no such evidence available for the tertiary-level hospitals of the western region of Nepal.…”

Section: Introductionmentioning

confidence: 99%

“…[15][16][17] A study conducted in a regional hospital in the midwestern region of Nepal attempted to evaluate the situation regarding financial protection for patients and access to free services available at that facility. 17 However, there is no such evidence available for the tertiary-level hospitals of the western region of Nepal. Therefore, the aim of this study was to assess the access to, and the state of, free heath-care services for the target population in two tertiary-level hospitals in western Nepal.…”

Section: Introductionmentioning

confidence: 99%

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Access to free health-care services for the poor in tertiary hospitals of western Nepal: a descriptive study

Mahato

Paudel

2015

WHO South-East Asia J Public Health

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background:Nepal is an underdeveloped country in which half of the total health expenditure is from out-of-pocket payments. Thus, the Government of Nepal introduced universal free health-care services up to the level of district hospitals, and targeted these services to poor and marginalized people in regional and subregional hospitals. The aim of this descriptive study was to explore the implementation and utilization of free health-care services by the target population (poor and marginalized people) in two tertiary-care hospitals in western Nepal, one with a social care unit (Western Regional Hospital) and one without a social care unit (Lumbini Zonal Hospital). Methods:Medical records maintained by the two hospitals for one Nepali calendar year were collected and analysed, along with information from key informant interviews with staff from each hospital and patient exit interviews.results: Utilization of free health-care services by poor and marginalized people in the two tertiary-care hospitals was suboptimal: only 8.4% of patients using services were exempted from payment in Western Regional Hospital, whereas it was even fewer, at 2.7%, in Lumbini Zonal Hospital. There was also unintended use of services by nontarget people. Qualitative analysis indicated a lack of awareness of free health-care services among clients, and lack of awareness regarding target groups among staff at the hospitals. Importantly, many services were utilized by people from rural areas adjoining the district in which the hospital was situated.conclusion: Utilization of free health-care services by the target population in the two tertiary-care hospitals was very low. This was the result of poor dissemination of information about the free health-care programme by the hospitals to the target population, and also a lack of knowledge regarding free services and target groups among staff working in these hospitals. Thus, it is imperative to implement educational programmes for hospital staff and for poor and marginalized people. Unintended use of free services was also seen by nontarget groups; this suggests that there should further simplification of the process to identify target groups.

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Section: Discussioncontrasting

confidence: 40%

Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Access to free health-care services for the poor in tertiary hospitals of western Nepal: a descriptive study

Mahato

Paudel

2015

WHO South-East Asia J Public Health

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Availability, Price, and Affordability of Essential Medicines to Manage Noncommunicable Diseases: A National Survey From Nepal

Khanal

Veerman

Ewen

et al. 2019

INQUIRY

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The aim of this study was to evaluate the availability, price, and affordability of essential noncommunicable disease (NCD) medicines in Nepal. A cross-sectional survey was conducted in Nepal in 2015 using World Health Organization/Health Action International (WHO/HAI) methodology. We collected data on the availability and price of 60 essential NCD medicines from medicine distribution outlets in both the public and private health care sectors in 6 regions. Essential NCD medicines were more available in the private sector (78%) than the public sector (60%). Furosemide tablets were the cheapest (NPR 0.6/10 tablets) and streptokinase injections were the most expensive (NPR 2200/vial) drugs. There was no significant difference (P > .05) in availability and affordability of essential NCD medicines across the 6 survey areas. Treating selected NCD conditions with medicines was generally affordable, with 1 month of treatment costing no more than a day’s wage of the lowest paid unskilled government worker. The lower availability of NCD medicines in the public sector limits the effectiveness of the government’s policy of providing free health services at public facilities. Although NCD medicines were generally affordable, future health policy should aim to ensure improved equitable access to NCD medicines, particularly in public facilities.

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Shift in disease burden from communicable to non-communicable diseases: aiming to achieve Universal Health Coverage in Nepal

Khanal¹,

Veerman²,

Hollingworth³

et al. 2015

Perspect Public Health

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Universal health coverage in a regional Nepali hospital: who is exempted from payment? [Short communication]

Cited by 6 publications

References 5 publications

Access to free health-care services for the poor in tertiary hospitals of western Nepal: a descriptive study

Access to free health-care services for the poor in tertiary hospitals of western Nepal: a descriptive study

Availability, Price, and Affordability of Essential Medicines to Manage Noncommunicable Diseases: A National Survey From Nepal

Shift in disease burden from communicable to non-communicable diseases: aiming to achieve Universal Health Coverage in Nepal

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