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Analysis of the cost of health interventions is crucial in national health policy planning and decision making. In the recent years, the focus in Nepal has been towards development of universal health coverage where quality of care provided to the population is a central concern and efficient use of financial resources allocated by the government to achieve this goal becomes the target. However, the existing health insurance schemes, although widely used, are cost-effective in the limited circumstances and if they are to be made more effective and accessible to the entire population, the number of enrolled beneficiaries needs to be expanded.
However, the effectiveness of the health insurance in the current scenario is not high enough to motivate the households to enroll in the schemes. The coverage of the women enrolled in the schemes was around only 25.9%, while it is very much needed in order to contribute to the Universal Health Coverage agenda. This low enrollment of the women is a reflection of the weak public support system as well as the service delivery systems in the country. The outreach activities need to be improved in order to address the needs of the women at the local level to increase enrollment of women in health insurance schemes. Further, mechanisms to increase efficiency of service delivery need to be developed in order to improve the quality of care and increase the effectiveness of health insurance schemes.
Over all, the results of the study showed that health insurance is a cost-effective strategy to finance health services. Though the service utilization is low, the utilization of cost effective services is increasing because of the insurance coverage. The findings of the study should be interpreted with caution as the study could not reflect the entire picture of health insurance in the country. This study was conducted in a single setting where the design of the study was a cross-sectional design with a purposive sample.
Although health insurance has received positive coverage in the general population, various findings regarding the impact of health insurance on household finances need to be considered. Though the households are satisfied with the health insurance, only 18% of the interviewed households were willing 0b46394aab