Mapping DP support for NHI
Dec 2013 – 18th September 2013: A joint meeting between the MoHP National Health Unit (NHI) and External Development Partners (DP) defines thematic areas which require further support for the implementation of the national health insurance and allocates responsibilities to different partners. ToRs for each thematic works are being drafted and key responsibility for the work agreed as depicted in the table below. The NHI Unit of the MoHP is coordinating ongoing works on different work packages.
The 10 work areas cover: implementation guidelines, clinical protocol, district assessment/baseline survey, criteria for provider enlisting/selection, provider payment mechanism, legal framework, IT and database management, benefit/service package, costing of services, Institutional setup.
Final reports will be posted as soon as they become available.
Nepal moves forward on HI policy
Mar 2013 – Ministry of Health and Population (MoHP) approves health insurance (HI) policy, advancing a health financing agenda, which, since early 2012 has been driven by the Prime Minister’s commitment to developing a national HI scheme. Access to quality health care is a constitutional right in Nepal, but direct payments deter many from using health services. The government sees the development of HI policy as a vital stepping stone in the transition to universal health coverage, and has been supported by P4H members WHO, the World Bank, GIZ and other development partners (DFID/OPM, KOICA, etc.) offering tailored health financing options and solutions.
Review of community based health insurance initiatives in Nepal: In 2012, the Ministry of Health and Population commissions a review of existing community based health insurance (CBHI) schemes in Nepal. The study evaluates the performance of existing CBHI schemes and their contribution to the overall health-care financing system.
Analysis of benefit incidence: the Nepal Health Sector Support Programme (NHSSP) is currently analysing the data from the National Living Standard Survey and other sources to estimate the monetary value of services (benefits) received, broken down by different wealth quintile, ethnic group, ecological and geographical region. Results are expected by end of April 2012.
- National Health Insurance Policy 2013 (pdf, 644kb)
- Review of Community-based Health Insurance Initiatives in Nepal (pdf, 1.64Mb)
Course on health financing and social health protection
Feb 2012 – A 10-day course on Health Systems Strengthening and Sustainable Financing, organized by the Ministry of Health and Population (MoHP), GIZ, USAID and the World Bank, and partially funded by P4H, takes place in Kathmandu. The course, attended by sixty participants from the MoHP, other ministries, international Non Governmental Organisations (NGOs), external development partners (EDPs), and the private sector, focuses on decentralization and health financing in Nepal.
- Report Flagship Course Nepal Feb12 (pdf, 940kb)
Drafting vision statement for health financing strategy
Jan 2012 – A WHO mission participates in the Joint Annual Review of the health sector, providing technical support to the Ministry of Health and Population (MoHP), and, along with experts from external development partners (EDPs), World Bank and GIZ, discusses the drafting of the Nepal health financing strategy vision statement. The EDPs also offer to support the development of a health insurance pilot.
- HF Vision (pdf, 15kb)
MoHP prepares Health Insurance Policy
Jan 2012 – The Office of the Prime Minister directs Ministry of Health and Population (MoHP) to prepare and implement a health insurance policy with a view to providing financial risk protection against ill health.
Government officials attend Bangkok P4H event
Jan 2012 – A group of eight government officials, 4 from the Ministry of Health and Population (MoHP), 3 from the National Planning Commission Ministry of Finance and the Ministry of Labour, and an academic expert from the Patan Academy of Health Sciences, attend the Prince Mahidol Conference and the P4H event in Bangkok running from 23-29 January, six of them funded by the P4H network and the rest by the WHO country office in Nepal.
High level meeting on health financing strategy
Dec 2011 – Top MoHP officials and P4H members of the health financing technical working group (TWG) meet with the Health Minister on December 6 to discuss broad health financing issues and the health financing strategy development process.
Health financing background paper completed
Nov 2011 – WHO contributes a background paper providing a situation analysis of the health financing system in Nepal to the Technical Working Group (TWG), incorporating inputs from P4H network partners and other relevant stakeholders (see report for details).
- HF Background paper (pdf, 641kb)
WHO/WB mission to develop health financing strategy
Sep 2011 – A joint WHO-WB mission, partially funded by P4H, is organized to assist the Ministry of Health and Population (MoHP) in their efforts to develop a national health financing strategy. As part of this mission, a note on the health financing vision is prepared based on discussions between top MoHP officials and the external development partners (EDPs).
WB releases fiscal space study
Aug 2011 – The World Bank publishes fiscal space study looking at ways to expand the fiscal space to accommodate increased expenditures. The study looks at conducive macroeconomic conditions, the re-prioritization of health in the budget, health-sector specific sources, grants and foreign aid, and potential efficiency gains, and concludes that a great deal can be achieved through efficiency gains. The note highlights some specific areas – such as those related to provider payments, drug procurement mechanisms, and hospital and district grant allocations – whereby significant improvements in obtaining better value for money might be achieved.
- Assessing Fiscal Space for Health in Nepal (pdf, 689kb)
Assessment of demand-side financing schemes
Jun 2011 – A study commissioned by the Nepal Health Sector Support Programme (NHSSP) and DFID on demand-side financing schemes reviews the coverage, effects and bottlenecks of the various health financing schemes currently operating in Nepal. The study recommends integrating the contracting and payment mechanisms of the schemes in a single unit within the Ministry of Health and Population (MoHP) to minimize transaction costs and strengthen purchasing capacity.
- Demand Side Financing Report (pdf, 1.14Mb)
High level meeting results in agreement on purchasing and targeting
Jun 2011 – Minister for health (Mr. Shakti Basnet) is briefed on the findings of different studies in a meeting of high level Ministry of Health and Population (MoHP) officials and external development partners (EDPs). The meeting focuses on ways to improve the health financing system so as to expand social health protection, and results in an agreement to create a purchasing agency, expand output-based budgeting and strategic purchasing, and develop a targeting method/tool and pilot it in some districts.
Assessment of Government Health Financing System in Nepal
May 2011 – GIZ and the Nepal Health Sector Support Programme (NHSSP) produce a report – “Assessment of Government Health Financing System in Nepal: Suggestions for Reform” – which explores ways to make the system more efficient and equitable. Adopting the WHO framework on health financing functions, the report analyzes issues, such as fragmentation in resource allocation, passive purchasing, and challenges in reaching the poor. The report suggests ways to make purchasing arrangements more strategic while building up the existing output-based financing programmes.
- Government Health Financing System (pdf, 2.02Mb)
Technical Working Group forms
Mar 2011 – External development partners (EDPs) put together a Technical Working Group (TWG) on Health Care Financing to support the government, and in particular the Ministry of Health and Population (MoHP). The TWG comprises members from various EDPs supporting the government on health financing, and is to meet regularly to discuss health financing issues, options and processes related to the health financing strategy. The group will also provide technical support at the request of the government. P4H partners active in the TWG are WHO, the World Bank and GIZ.
Workshop results in agreement on consolidating SHP programmes
Mar 2011 – A joint Ministry of Health and Population (MoHP) and external development partners (EDP) workshop takes place, focused on identifying ways to improve the health financing system and social health protection (SHP). Agreement is reached on consolidating existing SHP programmes under one umbrella fund, and introducing strategic purchasing.
New report on SHP in Nepal
Sep 2010 – GIZ and the Minister for Health and Population (MoHP), produce a report, “Nepal at the Crossroads: Setting the Stage for Improved Social Health Protection”, that assesses the current policy environment and outlines some preconditions for new financing arrangements. The report also offers six different options for enhancing social health protection and is widely discussed within the MoHP.
- Nepal SHP report (final print) (pdf, 2.69Mb)
Nepal draws up timeline for health financing strategy
Jun 2010 – Nepal Minister for Health and Population (MoHP) officials participate in the South Asian Regional Forum organized by the World Bank in the Maldives at which the P4H CD makes a presentation on social health protection (SHP). The Nepali group discusses the importance of providing financial protection to the people to ensure access to quality health, and draws up a timeline for the development of a health financing strategy.
Steering Committee on SHP formed
Feb 2010 – An inter-ministerial Steering Committee on social health protection (SHP) is formed under the chairpersonship of the Minister for Health and Population (MoHP). A Working Committee was also formed later in March with the responsibility to foster technical discussions on health financing and contribute in policy formulation process. These committees also included representatives from some of the EDPs.
Nepal workshop on SHP
Nov 2009 – A workshop, focusing on ways to improve social health protection (SHP) in Nepal, includes a presentation by P4H CD. The workshop discusses existing SHP initiatives and highlights the importance of developing health financing policy to enhance equitable access to health care services.