Background Many studies indicate that various health programmes have been failed because of the lack of appropriate information, education, and communication [IEC] for the target audiences. It is still unanswered which methods/means of communication could be the most powerful for changing behaviour or decision-making capacity. The paper aims to assess the effects of IEC on family enrolment in health insurance programme [HIP] in Nepal. Methods We employed a household-based observational study with a control group. Altogether 810 household interviews were conducted in Baglung and Kailali districts of Nepal in 2018. The study used a validated structured interview schedule. Background characteristics of the family and respondents and their exposure to the means of communication were the independent variables while enrolment in health insurance [HI] was the dependent variable. Results Data showed that 72% of the respondents heard about the HI and 66% knew the contribution amount for enrolment in HI. In the total enrolled households, 53% were household heads, 59% belonged to the age group 41–60 and 68% were above 60 years. More than half (56%) of rich compared to 46 and 49% of middle and poor (p < 0.05); 60% of the family member suffering from the chronic disease were enrolled in the HI. Similarly, 68% of those who heard about HI compared to 4 % who did not hear were enrolled (p < 0.001). A vast majority (69%) of those knowing contribution amount, 73% who interact with peer neighbour compared to 39% who did not, and 62% of those who listened to the radio and 63% of those who watched TV were enrolled in HI (p < 0.001). However, heard about HI (aOR = 21.18, 95%CI: 10.17–44.13, p < 0.001), knowledge about contribution amount (aOR = 5.13, 95%CI: 3.09–8.52, p < 0.001), having HI related books or guidelines (aOR = 4.84, 95%CI: 2.61–8.98, p < 0.001), and interact with peer or neighbours (aOR = 1.74, 95%CI: 1.34–2.65, p < 0.01) were appeared to be positive and significant predictors for enrolment in HI. Conclusion Knowledge about HI and interaction with peers and neighbours about the HI scheme of the government could lead to higher participation in the HIP. It would be better to incorporate this strategy while planning interventions for increasing enrolment in the HIP.

Background Most of the studies have indicated that various programmes were failing due to lack of appropriate information, education, and communication [IEC] to the target audiences. But still unanswered that which methods or means of communication could be the most powerful for changing behaviour, decision making,and or desired action. The paper aims to assess the effects of IEC on the enrollment of health insurance in Nepal.Methods A cross-sectional study, with randomly selected 810 [405 enrolled and 405 not-enrolled] households, was conducted at Baglung and Kailali districts of Nepal in 2018 using pretested structured interview tool. Background characteristics of family and respondents, and exposure to the means of communication were independent variables; and enrollment of health insurance was the dependent variable. Univariate, bivariate, and multivariate analyses were done to interpret the data.Results Data show that socio-demographics and exposure to communication were associated with the enrollment of health insurance. Demographic characteristics of the respondents and households particularly household head, age, wealth status, ability to feed the family, and presence of chronic diseases in the family were significantly associated with the enrollment of health insurance. Similarly, exposure to communication and media such as knowledge on health insurance and contribution amount of health insurance, having health insurance related books or guidelines, participation in training and workshop, discussion with peers and neighbours, exposure to health insurance related messages from radio and television, seen hoarding board, newspaper, and health insurance related pamphlet, brochure, and posters were significantly associated with enrollment in health insurance. Knowledge about health insurance and contribution amount, having health insurance related books and guidelines, and discussion with peers and neighbours appeared to be the positive and significant predictors for enrollment in health insurance scheme.Conclusion Communication and interaction with peers and neighbours about health insurance scheme of the government could lead to higher participation in health insurance programme. It would be better to incorporate this strategy while planning policies and interventions on health insurance.

Background Most of the studies have indicated that various programmes were failing due to lack of appropriate information, education, and communication [IEC] to the target audiences. But still unanswered that which methods or means of communication could be the most powerful for changing behaviour, decision making, and or desired action. The paper aims to assess the effects of IEC on the enrollment of health insurance [HI] in Nepal.Methods A cross-sectional study, with randomly selected 810 [405 enrolled and 405 not-enrolled] households, was conducted at Baglung and Kailali districts of Nepal in 2018 using pretested structured interview tool. Background characteristics of family and respondents, and exposure to the means of communication were independent variables; and enrollment of HI was the dependent variable. Univariate, bivariate, and multivariate analyses were done to interpret the data.Results Data show that socio-demographics and exposure to HI related information were associated with the enrollment of HI. Demographic characteristics of the respondents and households particularly age, wealth status, and presence of chronic diseases in the family were significantly associated with the enrollment of HI. Similarly, exposure to communication and media such as heard about HI and knowledge of contribution amount of HI, having HI related books or guidelines, participation in training and workshop, discussion with peers and neighbours, exposure to HI related messages from radio and television, seen hoarding board, newspaper, and HI related pamphlet, brochure, and posters were significantly associated with enrollment in HI. Heard about HI and knowledge of contribution amount, having HI related books and guidelines, and discussion with peers and neighbours appeared to be the positive and significant predictors for enrollment in HI.Conclusion Communication and interaction with peers and neighbours about HI scheme of the government could lead to higher participation in HI programme. It would be better to incorporate this strategy while planning policies and interventions on HI.

The Government of Nepal has introduced a health insurance programme since 2016. The main essence of the program is to reduce the gap in the utilization of health services between poor and rich, to reduce the out-of pocket expenditure while receiving the healthcare services, and to protect the family from poverty due to catastrophic healthcare expenditure. Researchers review the policy, programme and existing practice Data from Health Insurance Board shows that the programme appears not so effective in many districts but it looks successful in some districts where private healthcare providers are existing as a referral hospital. It is still unanswered whether the HIP is going to boost industrialists in the name of basic rights, health equity and social justice. The paper studies socio-economic and political perspectives of healthcare and health insurance with reference to Nepal and concludes that the healthcare system needs to reform for real welfare, social justice, and citizens' access and right to healthcare.

The Government of Nepal introduced the health insurance [HI] program in three districts, in 2016 and now has been expanded almost all districts. Since it was a new initiative, there was no clear evidence on people's attitude, perception, and awareness, which continues until now.  This study, therefore, intended to assess the perception and attitude of household heads towards enrollment in HI. The descriptive research design was used and 810 households in Baglung and Kailali Districts of Nepal were selected randomly. The interview schedule used for data collection comprised positive and negative statements at a three-point scale as independent variables to explore the perception and attitude of people towards HI and enrollment in HI as a dependent variable. Most of the respondents agreed with the statement where attitude and perception were significantly associated with the enrollment in HI. Among the 16 statements, 13 statements were observed statistically significant. Among them: 'anyone can enroll easily in HI', 'primary service point is appropriate', 'contribution amount is appropriate', 'coverage amount is appropriate', 'HI may solve the problem',  'proper dissemination of information, education, communication [IEC] materials may help to enroll', 'health services quality has not been improved after enrollment', 'IEC materials are not appropriate', 'HI related queries are addressed timely', 'relatives/neighbors do/did not request me to enroll', 'complaints are not addressed timely', and 'information is not adequate' were the significantly associated for enrollment in HI. The perception and attitude of the household heads were significantly associated with the enrollment in HI. The study recommends an appropriate IEC campaign for positive perception and attitudes that leads to better participation in HI. The policymaker may consider the findings while planning the program intervention.