Nepal is grappling with significant obstacles in its pursuit of universal health coverage (UHC), as the nation experiences a surge in non-communicable diseases and injuries. Recent studies highlight the financial strain on households and the inefficiencies within the health financing system, signaling a pressing need for comprehensive reforms.
Fragmented Health Protection Schemes Undermine Efficiency
The current landscape of health protection in Nepal is marked by multiple overlapping schemes that fail to pool risks effectively. This fragmentation leads to high out-of-pocket expenditures, with over half of healthcare costs being directly borne by individuals. Consequently, about 10% of the population faces catastrophic health expenses, particularly those affected by injuries and chronic illnesses.
National Health Insurance Program Struggles with Low Coverage
Nepal’s National Health Insurance Program (NHIP) covers only 28% of the population and suffers from a mere 54% renewal rate. Financial sustainability remains a concern as provider payments surpass revenue collection. Despite efforts to enhance financial risk protection, the UHC service coverage index remains limited, reflecting the system’s inadequate capacity to address evolving health challenges.
Key inferences from the study include:
- High out-of-pocket expenses burden low-income households.
- Fragmented health schemes reduce overall efficiency.
- Low NHIP enrollment hampers financial sustainability.
- Chronic diseases significantly contribute to healthcare costs.
To address these issues, the study recommends structural reforms that encompass legal, institutional, and policy frameworks. Merging existing health protection schemes could enhance risk pooling and purchasing efficiency. Increasing domestic health funding through diverse revenue streams and making NHIP enrollment mandatory are also critical steps. Additionally, improving policy implementation and ensuring equitable public financing can help allocate resources based on need, responding effectively to demographic and epidemiological shifts.
Reforming Nepal’s health financing system is essential for achieving equitable and sustainable healthcare access. By consolidating social health protection schemes and boosting domestic funding, Nepal can reduce the financial burden on its population. Mandatory NHIP enrollment and enhanced policy execution will likely increase coverage and financial protection, paving the way towards a more resilient and inclusive health system. These measures, coupled with strategic resource allocation, can significantly improve Nepal’s ability to meet the health needs of its diverse population.
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