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Health Financing

Health financing is one of Nepal's most pressing policy challenges. With out-of-pocket expenditure accounting for over 50% of total health spending, millions of Nepalis face catastrophic health costs each year. The government launched a Social Health Insurance scheme in 2016, but enrollment and implementation remain uneven. This collection brings together global evidence on what financing mechanisms work — from community-based health insurance to conditional cash transfers — with particular attention to what has succeeded in similar low-income, federal contexts.

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4 papers

Achieving Universal Health Coverage in Thailand: Fiscal Space and Policy Sustainability

Viroj Tangcharoensathien, Walaiporn Patcharanarumol, Woranan Witthayapipopsakul · 2019 · BMJ Global Health

Health FinancingHigh

Thailand achieved UHC in 2002 with a GDP per capita similar to Nepal's current level. Their experience with the Universal Coverage Scheme — funded through general taxation rather than contributory insurance — offers a directly relevant model for Nepal's Social Health Insurance programme.

Impact of the Aama Programme on Institutional Delivery in Nepal

Suresh Mehata, Yuba Raj Paudel, Maureen Dariang · 2017 · Journal of Nepal Health Research Council

Maternal HealthHealth FinancingModerate

The Aama (Mother) programme is Nepal's flagship demand-side financing initiative for maternal health. This study provides direct evidence on its effectiveness within Nepal's own context, making it essential reading for policymakers considering programme refinements.

Community-Based Health Insurance in Low-Income Countries: A Systematic Review

Priyanka Saksena, Ankit Sharma, Holly Smith · 2021 · Health Policy and Planning

Health FinancingHigh

Nepal has experimented with community-based health insurance in several districts. This review's finding that CBHI schemes struggle with adverse selection and low enrollment unless heavily subsidised is directly relevant to Nepal's rollout challenges.

Performance-Based Financing and Health Outcomes in Rwanda: A Rigorous Evaluation

Paul Gertler, Christel Vermeersch · 2012 · Health Economics

Health FinancingPrimary CareHigh

Rwanda's performance-based financing model has been widely cited as a success story for LICs. Nepal has piloted results-based financing in some districts. Rwanda's experience offers lessons on designing payment systems that incentivise quality and coverage.