National Health Policy of Nepal-Time to Revisit and Reform

Magar, Angel

doi:10.31729/jnma.2110

Cited by 4 publications

(3 citation statements)

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“…The National Health Policy of Nepal was adopted in 1991 to bring about improvement in the health conditions of the people of Nepal, with the primary objective of extending the healthcare system to rural areas. 4 Since 2005, the Ministry of Health and Population (MoHP) initiated two five-year strategic plans with a priority on universal health care coverage. Despite these priorities, there continues to be inequity in health service deliveries and outcomes.…”

Section: Description Of Supporting Evidencementioning

confidence: 99%

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Abstracts: Scientific papers, education sessions to be presented at the May 26–28, 2016 Victoria, BC

2016

Physiotherapy Canada

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Section: Description Of Supporting Evidencementioning

confidence: 99%

“…Despite these priorities, there continues to be inequity in health service deliveries and outcomes. 4 Disability policy is essential to ensure equal access and accessibility to health care services for the entire population.…”

Section: Description Of Supporting Evidencementioning

confidence: 99%

Abstracts: Scientific papers, education sessions to be presented at the May 26–28, 2016 Victoria, BC

2016

Physiotherapy Canada

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“…Nepal's health sector strategy(2015-2020) is assembled on four strategic principles: equitable access to health services, quality health services, health systems reform, and multi-sectoral approach [10]. This was the core theme of the national health sector strategies under the focused area of Nepal's community based primary health care as the foundation of universal health coverage (UHC) [11][12][13]. Family planning with maternal and child health service delivery integration shows potential in improving various outcomes [14].…”

Section: Introductionmentioning

confidence: 99%

Health facility readiness to provide integrated Family Planning, Maternal and Child Health (FPMCH) services in Nepal: Evidence from the comprehensive health facility survey

Acharya¹,

Subedi

Acharya

2022

PLoS ONE

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Introduction This study aimed to build the emergent body of evidence of family planning and maternal and child health (FPMCH) service integration benefits that can be useful in reaching the target of sustainable development goals (SDGs). Methods We utilized data from the 2015 Nepal Health Facility Survey and used the World Health Organization service readiness manual for defining the service readiness indicator score of all services related to FPMCH integration. Composite readiness index for all services including family planning, antenatal care service, delivery and newborn service readiness index, and curative child care service readiness index was considered for the integration of all services (i.e. readiness for FPMCH). Multivariable linear regression models were fitted to examine the association between covariates and readiness score to provide integrated services. Results The mean readiness score of integrated services in health facilities in Nepal was 52.1%. The services in private hospitals and peripheral health facilities had significantly lower readiness scores of integrated services compared to government hospitals. Compared to Province 3(Province 3 holds the national capital), Province 2 had significantly lower and Province 7 had significantly higher readiness scores. There is a marginally significantly higher readiness score of integrated services in the facilities where management meetings are held compared to where management meetings are never conducted. Interestingly, health facilities where external supervision occurred in the last 4 months had better service readiness of integrated services compared with those facilities with no external supervision. Similarly, the facilities that performed the routine quality assurance activities and facilities having a system for collecting opinion and being reviewed had a higher integrated services readiness score than their counterparts. Conclusion This study found a scope of improvement in management practices in the health sector of Nepal especially for supportive supervision, quality assurance (QA) activities, monthly management meetings, and a system of collecting and reviewing opinions from the clients. Strengthening management practices especially, promoting supportive supervision and adhering to QA protocols may improve HF readiness to implement integrated FPMCH in Nepal. Being low readiness, there is an urgent need for policy reform to improve the integrated service readiness, particularly in Province 2.

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Evaluation of the National Health Insurance Program of Nepal: are political promises translated into actions?

Khanal¹,

Bharadwaj

Upadhyay

et al. 2023

Health Res Policy Sys

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Background Despite political promise to reduce out-of-pocket (OOP) expenditure on healthcare through the National Health Insurance Program (NHIP) of Nepal, its implementation is challenging with low enrolment and high drop-out rates. Program performance can often be linked with political economy considerations and interests of stakeholders. This study aimed to develop an in-depth understanding of organizational and systemic challenges in implementing NHIP. Methods We conducted a structured narrative review of available literature on the NHIP in Nepal. We analysed data using a political economy analysis for health financing reform framework. The findings were explained under six broad categories: interest groups, bureaucracy, budgets, leadership, beneficiary and external actors. In addition, we triangulated and further presented the literature review findings using expert opinions (views expressed in public forums). Results Nepal has formulated acts, rules, regulations, and policies to implement NHIP. Under this program, the Health Insurance Board (HIB) is the purchaser of health services, and health facilities under the Ministry of Health and Population (MoHP) are the providers. The NHIP has been rolled out in all 77 districts. Several challenges have hindered the performance of NHIP at the policy and implementation levels. Challenges under interest groups included inadequate or delayed reimbursement and drop-out of hospitals in implementing the programme. Bureaucracy-related challenges were hegemony of provider over the purchaser, and inadequate staff (delay in the approval of organogram of HIB). There was inadequate monitoring of premium collection, and claim reimbursement was higher than collected premium. Challenges under leadership included high political commitments but weak translation into action, consideration of health insurance as poor return on investment, and intention of leaders to privatize the NHIP. Beneficiaries experienced compromised quality of care or lack of services when needed, high drop-out rates and low interest in renewal of premiums. External actors provided technical assistance in policy design but limited support in implementation. Conclusions Despite enabling a policy environment, the NHIP faced many challenges in implementation. There is an urgent need for institutional arrangements (e.g. digitalization of claims and reimbursement, endorsement of organogram of HIB and recruitment of staff), increased coverage of financial protection and service (increased benefit package and introduction of cost-sharing/co-payment model), legislative reforms (e.g. legal provision for cost-sharing mechanism, integration of fragmented schemes, tripartite agreement to reimburse claims and accreditation of health facilities to ensure quality healthcare), and leveraging technical support from the external actors. High levels of commitment and accountability among political leaders and bureaucrats are required to strengthen financial sustainability and implementation.

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National Health Policy of Nepal-Time to Revisit and Reform

Abstract: Abstract

Cited by 4 publications

References 0 publications

Abstracts: Scientific papers, education sessions to be presented at the May 26–28, 2016 Victoria, BC

Abstracts: Scientific papers, education sessions to be presented at the May 26–28, 2016 Victoria, BC

Health facility readiness to provide integrated Family Planning, Maternal and Child Health (FPMCH) services in Nepal: Evidence from the comprehensive health facility survey

Evaluation of the National Health Insurance Program of Nepal: are political promises translated into actions?

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