Title:
National Social Health Insurance in Nepal: What Will It Take to Make It Work?
Authors:
Rai, Devika
Place:
Amsterdam
Publisher:
KIT - Royal Tropical Institute [etc.]
Year:
2017
PAGE:
xi, 53
Language:
En
Subject:
Health and Poverty
Keywords:
National Health Insurance Policy, Social Health Security Programme, Social Health Insurance, Universal Health Coverage, Policy Analysis
Abstract:
Background: With an overarching objective of ensuring Universal Health Coverage, Nepal adopted National Health Insurance Policy (NHIP) in 2013. The policy is currently being operationalized by Social Health Security Development Committee (SHSDC), in the form of Social Health Security Programme (SHSP). But considering Nepal’s current socio-economic, political and health system context, how effective can this policy be in achieving its objective? And, what are the possible implementation issues? Answers of these questions can help facilitate scaling up SHSP effectively. Methods: The NHIP document was assessed. Relevant literature from Nepal and selected low-and lower-middle-income countries (LLMICs) was reviewed. For analysis, Florence Morestin’s healthy policy analysis framework was used. Findings: First, the NHIP has several shortcomings. It fails to address the policy’s wider implementation context. Second, Nepal’s evidence base on the policy and SHSP is weak. Third, a range of findings from LLMICs provide critical insights vis-à-vis social health insurance (SHI) implementation in Nepal. For instance- low enrolment persists in most countries. SHI increases service utilization but its impact on preventing catastrophic expenditure is inconclusive. SHI can jeopardize equity and quality of care by inducing negative supply and demand-side behaviors. Stakeholders’ role is central in the entire SHI development processes. Conclusion: The apparent gap in NHIP and prevailing socio-economic, political and health sector challenges raise concerns over the effectiveness and sustainability of SHSP. The Government should strengthen an entire health system rather than solely focusing on the insurance scheme. The SHSDC should take evidence-informed decisions to avoid pitfalls during the policy’s implementation.
Organization:
KIT - Royal Tropical Institute
,
VU - Vrije Universiteit Amsterdam
Institute:
KIT (Royal Tropical Institute)
Country:
Nepal
Region:
South Asia
Training:
Master of Public Health
Category:
Research
Right:
© 2017 Rai
Document type:
Thesis/dissertation
File:
DCcvHoPQaL_20180404105721705.pdf