Paving Way Towards Universal Health Coverage: Health Insurance, Priority Setting and Packaging Safety Nets in Nepal

Universal Health Coverage (UHC) is instrumental for achieving sustainable development goals (SDGs) and its agenda of leaving no one behind (LNOB). For resource poor setting, the frictions between free health services, priority programs and health insurance schemes are not unlikely. Asynchronous saf...

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Main Authors: Ambika Thapa Pachya, Uttam Pachya, Kapil Amgain, Madan Kumar Upadhyaya, Krishna Kumar Aryal
Format: Article
Language:English
Published: Karnali Academy of Health Sciences 2023-08-01
Series:Journal of Karnali Academy of Health Sciences
Subjects:
Online Access:http://jkahs.org.np/jkahs/index.php/jkahs/article/view/852
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author Ambika Thapa Pachya
Uttam Pachya
Kapil Amgain
Madan Kumar Upadhyaya
Krishna Kumar Aryal
author_facet Ambika Thapa Pachya
Uttam Pachya
Kapil Amgain
Madan Kumar Upadhyaya
Krishna Kumar Aryal
author_sort Ambika Thapa Pachya
collection DOAJ
description Universal Health Coverage (UHC) is instrumental for achieving sustainable development goals (SDGs) and its agenda of leaving no one behind (LNOB). For resource poor setting, the frictions between free health services, priority programs and health insurance schemes are not unlikely. Asynchronous safety nets - free health services, subsidized or targeted free programs, with existing health insurance schemes fail to protect the population from catastrophic out of pocket expenditure in health. Multiple scientific publications and media narratives have declared health insurance to be failing in Nepal, they either recommend or report government of Nepal (GoN) to restructure health insurance program. The answers on how to restructure are catered in the scope of coverage of health insurance schemes, application of contextual evidence for ethical priority setting and appropriate packaging of safety nets. Evidences clearly show that uptake of insurance schemes have multiple supply and demand side factors and they are contextual, thus one size fit for all approach will not be effective. It is high time government reconsiders rigorous and ethical priority setting for packaging of safety nets synchronous with health insurance program, committed and transparent governance, vigilant civil societies and commitment of political leadership for paving path towards universal health coverage.  
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spelling doaj.art-3e5c123febaa42c5b3b491bec8f17b0f2023-10-31T15:25:22ZengKarnali Academy of Health SciencesJournal of Karnali Academy of Health Sciences2616-00642676-13272023-08-01621001Paving Way Towards Universal Health Coverage: Health Insurance, Priority Setting and Packaging Safety Nets in NepalAmbika Thapa Pachya0Uttam Pachya1Kapil Amgain2Madan Kumar Upadhyaya3Krishna Kumar Aryal4Daayitwa Nepal Public Policy Fellow, Daayitwa, Lalitpur, Nepal; Editor, Journal of Karnali Academy of Health Sciences (JKAHS)Senior Medical Generalist, Dept. of General Practice & Emergency Medicine, Bir Hospital, NAMS, KathmanduEditor-in-Chief, Journal of Karnali Academy of Health Sciences (JKAHS)Chief, Quality Standards and Regulation Division, Ministry of Health and Population, Kathmandu, NepalResearcher, Department of Global Public Health and Primary Care, Bergen Center for Ethics and Priority Settings (BCEPS), University of Bergen, Norway Universal Health Coverage (UHC) is instrumental for achieving sustainable development goals (SDGs) and its agenda of leaving no one behind (LNOB). For resource poor setting, the frictions between free health services, priority programs and health insurance schemes are not unlikely. Asynchronous safety nets - free health services, subsidized or targeted free programs, with existing health insurance schemes fail to protect the population from catastrophic out of pocket expenditure in health. Multiple scientific publications and media narratives have declared health insurance to be failing in Nepal, they either recommend or report government of Nepal (GoN) to restructure health insurance program. The answers on how to restructure are catered in the scope of coverage of health insurance schemes, application of contextual evidence for ethical priority setting and appropriate packaging of safety nets. Evidences clearly show that uptake of insurance schemes have multiple supply and demand side factors and they are contextual, thus one size fit for all approach will not be effective. It is high time government reconsiders rigorous and ethical priority setting for packaging of safety nets synchronous with health insurance program, committed and transparent governance, vigilant civil societies and commitment of political leadership for paving path towards universal health coverage.   http://jkahs.org.np/jkahs/index.php/jkahs/article/view/852Universal Health CoverageSustainable Development GoalsPriority Setting Safety Nets, Health InsurancePriority Setting, Safety Nets, Health Insurance
spellingShingle Ambika Thapa Pachya
Uttam Pachya
Kapil Amgain
Madan Kumar Upadhyaya
Krishna Kumar Aryal
Paving Way Towards Universal Health Coverage: Health Insurance, Priority Setting and Packaging Safety Nets in Nepal
Journal of Karnali Academy of Health Sciences
Universal Health Coverage
Sustainable Development Goals
Priority Setting Safety Nets, Health Insurance
Priority Setting, Safety Nets, Health Insurance
title Paving Way Towards Universal Health Coverage: Health Insurance, Priority Setting and Packaging Safety Nets in Nepal
title_full Paving Way Towards Universal Health Coverage: Health Insurance, Priority Setting and Packaging Safety Nets in Nepal
title_fullStr Paving Way Towards Universal Health Coverage: Health Insurance, Priority Setting and Packaging Safety Nets in Nepal
title_full_unstemmed Paving Way Towards Universal Health Coverage: Health Insurance, Priority Setting and Packaging Safety Nets in Nepal
title_short Paving Way Towards Universal Health Coverage: Health Insurance, Priority Setting and Packaging Safety Nets in Nepal
title_sort paving way towards universal health coverage health insurance priority setting and packaging safety nets in nepal
topic Universal Health Coverage
Sustainable Development Goals
Priority Setting Safety Nets, Health Insurance
Priority Setting, Safety Nets, Health Insurance
url http://jkahs.org.np/jkahs/index.php/jkahs/article/view/852
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