This study explains why Nepal needs to strengthen its National Health Insurance Program (NHIP) to better shield households from the financial impact of health care costs and achieve its ambitious goal of universal health coverage by 2030.
Nepal has made significant progress in its healthcare system, with improvements in life expectancy and reductions in mortality rates. To further enhance access to healthcare and protect people from financial hardship, the government has been developing health insurance in the country since 1976. The National Health Insurance Program (NHIP) provides financial risk protection through health insurance to the Nepalese population. The scheme involves financial contributions from the government and insured members in the form of annual insurance premiums. Certain groups receive subsidies on premiums, and members are entitled to free care at designated health facilities up to a maximum amount annually.
However, challenges such as low population coverage, stagnant financing, and inadequate local-level empanelment of health facilities persist.
Key recommendations to strengthen NHIP include updating the benefit package, expanding population coverage, and enhancing risk pooling. Empanelling more health facilities and incorporating updated information technology tools are also suggested to improve efficiency and effectiveness.
Strengthening NHIP is crucial for Nepal’s goal of achieving universal healthcare. Addressing the identified challenges and implementing proposed recommendations can enhance the program’s effectiveness, ensuring equitable access to quality healthcare for all citizens.