Nepal

 

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.

 

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Previous Updates

Mar 2013 – Nepal moves forward on HI policy

Nepal moves forward on HI policy

Mar 2013Ministry 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.


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Feb 2012 – Course on health financing and social health protection

Course on health financing and social health protection

Feb 2012A 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.


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Jan 2012 – Drafting vision statement for health financing strategy

Drafting vision statement for health financing strategy

Jan 2012A 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.


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Jan 2012 – MoHP prepares Health Insurance Policy

MoHP prepares Health Insurance Policy

Jan 2012The 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.

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Jan 2012 – Government officials attend Bangkok P4H event

Government officials attend Bangkok P4H event

Jan 2012A 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.

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Dec 2011 – High level meeting on health financing strategy

High level meeting on health financing strategy

Dec 2011Top 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.

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Nov 2011 – Health financing background paper completed

Health financing background paper completed

Nov 2011WHO 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).


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Sep 2011 – WHO/WB mission to develop health financing strategy

WHO/WB mission to develop health financing strategy

Sep 2011A 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).

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Aug 2011 – WB releases fiscal space study

WB releases fiscal space study

Aug 2011The 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.


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Jun 2011 – Assessment of demand-side financing schemes

Assessment of demand-side financing schemes

Jun 2011A 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.


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Jun 2011 – High level meeting results in agreement on purchasing and targeting

High level meeting results in agreement on purchasing and targeting

Jun 2011Minister 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.

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May 2011 – Assessment of Government Health Financing System in Nepal

Assessment of Government Health Financing System in Nepal

May 2011GIZ 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.


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Mar 2011 – Technical Working Group forms

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.

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Mar 2011 – Workshop results in agreement on consolidating SHP programmes

Workshop results in agreement on consolidating SHP programmes

Mar 2011A 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.


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Sep 2010 – New report on SHP in Nepal

New report on SHP in Nepal

Sep 2010GIZ 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.


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Jun 2010 – Nepal draws up timeline for health financing strategy

Nepal draws up timeline for health financing strategy

Jun 2010Nepal 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.

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Feb 2010 – Steering Committee on SHP formed

Steering Committee on SHP formed

Feb 2010An 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.

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Nov 2009 – Nepal workshop on SHP

Nepal workshop on SHP

Nov 2009A 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.

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