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

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  • Rajani Pokharel
  • Pushkar Raj Silwal

Abstract

The World Health Organization has identified universal health coverage (UHC) as a key approach in reducing equity gaps in a country, and the social health insurance (SHI) has been recommended as an important strategy toward it. This article aims to analyze the design, expected benefits and challenges of realizing the goals of UHC through the recently launched SHI in Nepal. On top of the earlier free health‐care policy and several other vertical schemes, the SHI scheme was implemented in 2016 and has reached population coverage of 5% in the implemented districts in just within a year of implementation. However, to achieve UHC in Nepal, in addition to operationalizing the scheme, several other requirements must be dealt simultaneously such as efficient health‐care delivery system, adequate human resources for health, a strong information system, improved transparency and accountability, and a balanced mix of the preventive, health promotion, curative, and rehabilitative services including actions to address the social determinants of health. The article notes that strong political commitment and persistent efforts are the key lessons learnt from countries achieving progressive UHC through SHI.

Suggested Citation

  • Rajani Pokharel & Pushkar Raj Silwal, 2018. "Social health insurance in Nepal: A health system departure toward the universal health coverage," International Journal of Health Planning and Management, Wiley Blackwell, vol. 33(3), pages 573-580, July.
    • Handle: RePEc:bla:ijhplm:v:33:y:2018:i:3:p:573-580
    DOI: 10.1002/hpm.2530
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    Cited by:

    1. Nguyen Thi Thu Thuong & Yme Van Den Berg & Tran Quang Huy & Do Anh Tai & Bui Nu Hoang Anh, 2021. "Determinants of catastrophic health expenditure in Vietnam," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(2), pages 316-333, March.
    2. Gaj Bahadur Gurung & Alessio Panza, 2022. "Implementation bottlenecks of the National Health Insurance program in Nepal: Paving the path towards Universal Health Coverage: A qualitative study," International Journal of Health Planning and Management, Wiley Blackwell, vol. 37(1), pages 171-188, January.

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