Paving Way Towards Universal Health Coverage: Health Insurance, Priority Setting and Packaging Safety Nets in Nepal

Authors

  • Ambika Thapa Pachya Daayitwa Nepal Public Policy Fellow, Daayitwa, Lalitpur, Nepal; Editor, Journal of Karnali Academy of Health Sciences (JKAHS)
  • Uttam Pachya Senior Medical Generalist, Dept. of General Practice & Emergency Medicine, Bir Hospital, NAMS, Kathmandu
  • Kapil Amgain Editor-in-Chief, Journal of Karnali Academy of Health Sciences (JKAHS)
  • Madan Kumar Upadhyaya Chief, Quality Standards and Regulation Division, Ministry of Health and Population, Kathmandu, Nepal
  • Krishna Kumar Aryal Researcher, Department of Global Public Health and Primary Care, Bergen Center for Ethics and Priority Settings (BCEPS), University of Bergen, Norway

Keywords:

Universal Health Coverage, Sustainable Development Goals, Priority Setting Safety Nets, Health Insurance, Priority Setting, Safety Nets, Health Insurance

Abstract

Universal Health Coverage (UHC) is instrumental for achieving sustainable development goals (SDGs) and its agenda of leaving no one behind (LNOB). For resource poor setting, the frictions between free health services, priority programs and health insurance schemes are not unlikely. Asynchronous safety nets - free health services, subsidized or targeted free programs, with existing health insurance schemes fail to protect the population from catastrophic out of pocket expenditure in health. Multiple scientific publications and media narratives have declared health insurance to be failing in Nepal, they either recommend or report government of Nepal (GoN) to restructure health insurance program. The answers on how to restructure are catered in the scope of coverage of health insurance schemes, application of contextual evidence for ethical priority setting and appropriate packaging of safety nets. Evidences clearly show that uptake of insurance schemes have multiple supply and demand side factors and they are contextual, thus one size fit for all approach will not be effective. It is high time government reconsiders rigorous and ethical priority setting for packaging of safety nets synchronous with health insurance program, committed and transparent governance, vigilant civil societies and commitment of political leadership for paving path towards universal health coverage.  

Published

2023-08-31

How to Cite

1.
Pachya AT, Pachya U, Amgain K, Upadhyaya MK, Aryal KK. Paving Way Towards Universal Health Coverage: Health Insurance, Priority Setting and Packaging Safety Nets in Nepal. Journal of Karnali Academy of Health Sciences [Internet]. 2023Aug.31 [cited 2024May2];6(2). Available from: http://jkahs.org.np/jkahs/index.php/jkahs/article/view/852

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