Social Protection in Health: Characteristics and Coverage of Health Insurance Programme in Nepal

Abstract

The agenda of social protection has become very popular in recent years. Several social protection programs in healthcare are designed to increase the healthcare coverage, ensure financial protection and enhance the scope and quality of services and access to medicines which ultimately paves the way for universal health coverage. The national health insurance programme (NHIP) is one of the approaches implemented in Nepal to cover healthcare expenditure. This paper discusses the gradual development of the health insurance programme in Nepal and the key features of NHIP that have been implemented since 2016. It further highlights the implementation status of NHIP, the milestones it covered, and the role of political parties in implementing NHIP in Nepal. Furthermore, the paper discusses the challenges associated with enrollment of formal and non-formal sectors, the mismatch between geographical coverage and the number of service contact points, and commitment from the political parties for effective implementation of NHIP. It seeks major implementation reforms to ensure effective implementation of NHIP.

Social Protection Policy and its Response in Nepal

“…Nepal faces the challenge of extending social security benefits to all workers operating in the informal economy, which accounts for more than 90 per cent of the total labour force (Khanal, 2013). Social assistance programs are marred by various problems (Kohler, 2014).…”

“…All tiers of government must offer social protection services, including social allowances, to citizens identified as poor, as per the constitutional mandate. The federal government's current social insurance scheme excludes over 90 percent of workers, i.e., those in the informal sector, who often work in the most precarious conditions (Khanal, D. R. (2013). These workers are disproportionately women and from marginalized ethnic groups.…”

“…Social protection is increasingly recognized as an effective measure to address poverty and vulnerability in developing countries (Conway et al, 2000). The social protection floor is effective in reducing poverty, containing inequality, and sustaining economic growth, however, there is a need to combine these measures with more comprehensive social security (Khanal, 2013). The social protection programs placing its priorities on reducing poverty and promoting social justice can be sustainable and effective.…”

The perception of employees about the regulatory environment in the tourism industry: Insights from Nepal

“…The result of Lindner's (1998) study of 25 employees at the Piketon Research and Extension Centre and Enterprise Centre found that good working conditions ranked fifth among top ten factors that motivated employees at work. Apart from improving working conditions, the provision of overall social security benefits such as family benefits, unemployment benefits, medical insurance, and maternity benefits, among others, to workers are also important and their presence contribute to raising labour productivity and curbing social tensions, violent conflicts, and uncontrolled migration (Khanal, 2012). Government, as a key industrial relations actor, can provide a regulatory environment through its laws and policies that can improve working conditions and increase employees' welfare.…”

“…The workers' situation in various industries including tourism is particularly challenging as a large number of workers, as much as 90 per cent of the total workforce, operate in informal sectors such as farms, trading, crafts business, and transportation among others (Khanal, 2012). Although the government of Nepal has expressed its commitment to expand safety nets and social protection coverage for these workers through the new Labour Act 2017, they have typically been deprived of social protection benefits such as universal family benefits, social assistance, and social insurance.…”