Nepal Health Insurance Bill: Possible Challenges and Way Forwards

Kandel, Nirmal

doi:10.31729/jnma.3600

Cited by 5 publications

(5 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To increase access to care and minimise excessive health expenditures, different health system financing approaches, including health insurance coverage and co-payments for medication, have been evaluated globally ( 17 ). Nepal recently enacted the National Health Insurance Act 2017 and is moving towards universal health coverage for equitable access to high quality and affordable health care ( 63 ). However, its overall impact on treatment and control of hypertension and its related complications has yet to be studied.…”

Section: Discussionmentioning

confidence: 99%

Barriers, Enablers and Strategies for the Treatment and Control of Hypertension in Nepal: A Systematic Review

Dhungana

Pedišić

Pandey

et al. 2021

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

Background: Understanding country-specific factors influencing hypertension care is critical to address the gaps in the management of hypertension. However, no systematic investigation of factors influencing hypertension treatment and control in Nepal is available. This study aimed to systematically review the published literature and synthesise the findings on barriers, enablers, and strategies for hypertension treatment and control in Nepal.Methods: Embase, PubMed, Web of Science, CINAHL, ProQuest and WorldCat, and Nepali journals and government websites were searched for qualitative, quantitative, and mixed-methods studies on factors or strategies related to hypertension treatment and control in Nepal. Information from qualitative studies was analysed using template analysis, while results from quantitative studies were narratively synthesised. Summary findings were framed under “health system”, “provider”, and “patient” domains. The protocol was registered in PROSPERO (registration number: CRD42020145823).Results: We identified 15 studies; ten related to barriers and enablers and five to strategies. The identified barriers associated with the health system were: lack of affordable services and lack of resources. The barriers at the provider's level were: communication gaps, inadequate counselling, long waiting hours for appointments, lack of national guidelines for hypertension treatment, and provider's unsupportive behaviours. Non-adherence to medication, irregular follow-up visits, lack of awareness on blood pressure target, poor help-seeking behaviours, reluctance to change behaviours, perceived side-effects of anti-hypertensive medication, self-medication, lack of family support, financial hardship, lack of awareness on blood pressure complications, and comorbidity were barriers identified at patient level. The following enablers were identified: free essential health care services, family support, positive illness perception, and drug reminders. Strategies implemented at the health system, provider and patient levels were: establishing digital health records at health centres, health worker's capacity development, and health education.Conclusion: There is a range of barriers for hypertension treatment and control in Nepal pertaining to the health system, health providers, and patients. Comprehensive interventions are needed at all three levels to further improve management and control of hypertension in Nepal.

show abstract

Section: Discussionmentioning

confidence: 99%

Barriers, Enablers and Strategies for the Treatment and Control of Hypertension in Nepal: A Systematic Review

Dhungana

Pedišić

Pandey

et al. 2021

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

“…To increase access to care and minimise excessive health expenditures, different HS nancing approaches, including health insurance coverage and co-payments for medication, have been evaluated globally [14]. Nepal recently enacted the National Health Insurance Act 2017 and is moving towards universal health coverage for equitable access to high quality and affordable health care [59]. However, its overall impact on treatment and control of hypertension and its related complications has yet to be studied.…”

Section: Discussionmentioning

confidence: 99%

Barriers, enablers and strategies for the treatment and control of hypertension in Nepal: a mixed-methods systematic review

Dhungana

Pedišić

Pandey

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: The challenge of achieving effective treatment and control of blood pressure is linked to various barriers to hypertension care at different layers of health system (HS). Evidence is emerging globally on the effectiveness of multi-pronged hypertension control strategies. However, no systematic review of strategies of and factors associated with hypertension treatment and control in Nepal is available. Understanding country-specific factors influencing hypertension care is critical to address the gaps in the management of hypertension. This study aimed to systematically review published literature and synthesise the findings on barriers, enablers and strategies for hypertension treatment and control in Nepal. Methods: Six databases namely Embase, PubMed, Web of Science, CINAHL, ProQuest and WorldCat, Nepali journals and Nepal government websites were systematically searched for qualitative, quantitative and mixed-methods studies investigating the factors or strategies in relation to hypertension treatment and control in Nepal. The methodological quality of selected articles was assessed using Mixed Methods Appraisal Tool. Themes on barriers and enablers were generated and framed under “health system” , “provider” and “patient” domains, according to the framework synthesis approach. Findings on hypertension strategies were narratively synthesised. Results: We identified 14 published studies; one with mixed, three with qualitative and 10 with quantitative methods. Eight were related to barriers and enablers and six of hypertension strategies. The identified barriers associated with the HS were: lack of affordable services and lack of resources. The barriers at the provider’s level were: communication gaps and long waiting hours for appointments. Poor help-seeking behaviour, non-adherence to medication, perceived side-effects of drugs, financial hardship and lack of family support were barriers identified at patient level. The following enablers were identified: positive illness perception, free essential healthcare services and family support. Strategies implemented across the HS, provider and patient were: establishing digital health records at health centres, health worker’s capacity development, health education and yoga practice. Conclusion: There is a range of barriers for hypertension treatment and control in Nepal pertaining to the HS, providers, and patients. Comprehensive interventions are needed at all three levels to further improve management and control of hypertension in Nepal.Registration: The protocol is registered in PROSPERO (registration number: CRD42020145823)

show abstract

Section: Discussionmentioning

confidence: 99%

Barriers, enablers and strategies for the treatment and control of hypertension in Nepal: a mixed-methods systematic review

Dhungana¹,

Pedišić²,

Pandey³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Untreated and uncontrolled hypertension are major challenges in the cascade of care of hypertension in Nepal. The challenge of achieving effective treatment and control of blood pressure is linked to various barriers to hypertension care at different layers of health system. Evidence is emerging globally on the effectiveness of multi-pronged hypertension control strategies. However, no systematic review of strategies of and factors associated with hypertension treatment and control in Nepal is available. Understanding country-specific factors influencing hypertension care is critical to address the gaps in the management of hypertension. This study aimed to systematically review published literature and synthesise the findings on barriers, enablers and strategies for hypertension treatment and control in Nepal. Methods Six databases namely Embase, PubMed, Web of Science, CINAHL, ProQuest and WorldCat were systematically searched for studies investigating the factors or strategies in relation to hypertension treatment and control in Nepal. The methodological quality of selected articles was assessed using Mixed Methods Appraisal Tool. Themes on barriers and enablers were generated and framed under “health system” (HS), “provider” and “patient” domains, according to the framework synthesis approach. Findings on hypertension strategies were narratively synthesised. Results We identified 14 published studies; one with mixed, three with qualitative and 10 with quantitative methods. Eight were related to barriers and enablers and six of hypertension strategies. The identified barriers associated with the HS were: lack of affordable services and lack of resources. The barriers at the provider’s level were: communication gaps and long waiting hours for appointments. Poor help-seeking behaviour, non-adherence to medication, perceived side-effects of drugs, financial hardship and lack of family support were barriers identified at patient level. The following enablers were identified: positive illness perception, free essential healthcare services and family support. Strategies implemented across the HS, provider and patient were: establishing digital health records at health centres, health worker’s capacity development, health education and yoga practice. Conclusion There is a range of barriers for hypertension treatment and control in Nepal pertaining to the health system, providers, and patients. Comprehensive interventions are needed at all three levels to further improve management and control of hypertension in Nepal.Registration: The protocol is registered in PROSPERO (registration number: CRD42020145823)

show abstract

Nepal Health Insurance Bill: Possible Challenges and Way Forwards

Cited by 5 publications

References 26 publications

Barriers, Enablers and Strategies for the Treatment and Control of Hypertension in Nepal: A Systematic Review

Barriers, Enablers and Strategies for the Treatment and Control of Hypertension in Nepal: A Systematic Review

Barriers, enablers and strategies for the treatment and control of hypertension in Nepal: a mixed-methods systematic review

Barriers, enablers and strategies for the treatment and control of hypertension in Nepal: a mixed-methods systematic review

Contact Info

Product

Resources

About