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Review
. 2019 Feb 4:77:5.
doi: 10.1186/s13690-019-0331-7. eCollection 2019.

Challenges and opportunities towards the road of universal health coverage (UHC) in Nepal: a systematic review

Chhabi Lal Ranabhat  1   2 , Chun-Bae Kim  2   3 , Ajanta Singh  4 , Devaraj Acharya  5 , Krishna Pathak  6 , Basundhara Sharma  7 , Shiva Raj Mishra  6
Affiliations
Review

Challenges and opportunities towards the road of universal health coverage (UHC) in Nepal: a systematic review

Chhabi Lal Ranabhat et al. Arch Public Health. .

Abstract

Background: Universal health coverage (UHC) assures all types of health service and protects all citizens financially in any conditions due to illness. Globally, the UN sustainable development goal (SDG) provides high priority for UHC as a health related goal. The National health system of Nepal has prioritized in similar way. The aim of this study is to explore the challenges and opportunities on the road to UHC in Nepal.

Method: We used varieties of search terminologies with popular search engines like PubMed, Google, Google Scholar, etc. to identify studies regarding Nepal's progress towards UHC. Reports of original studies, policies, guidelines and government manuals were taken from the web pages of Ministry of Health and its department/division. Searches were designed to identify the status of service coverage on UHC, financial protection on health particularly, health insurance coverage with its legal status. Other associated factors related to UHC were also explored and presented in Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow chart.

Results: We found 14 studies that were related to legal assurance, risk pulling and financing of health service, 11 studies associated to UHC service coverage status and, 7 articles linked to government stewardship, health system and governance on health care. Constitutional provision, global support, progress on the health insurance act, decentralization of health service to the grass root level, positive trends of increasing service coverage are seen as opportunities. However, existing volunteer types of health insurance, misleading role of trade unions and high proportion of population outside the country are main challenges. The political commitment under the changing political context, a sense of national priority and international support were identified as the facilitating factors towards UHC.

Conclusion: To achieve UHC, service and population coverage of health services has to be expanded along with financial protection for marginalized communities. Government stewardship, support of stakeholders and fair contribution and distribution of resources by appropriate health financing modality can speed up the path of UHC in Nepal.

Keywords: Health insurance; Nepal; Opportunity and challenges; Out-of-pocket expenditure; Sustainable development goal; Universal health coverage.

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Conflict of interest statement

CR is researcher in Institute for Poverty Alleviation and International Development (IPAID) and faculty in Manmohan Memorial Institute of Health Science Kathmandu Nepal. CBK is Professor and researcher of Yonsei University and IPAID. BS is senior public health officer in National Tuberculosis Center, Nepal. AS is Assistant Professor in Tribhuwan University, Institute of Medicine, Faculty of Nursing Kathmandu. DA is Ph.D. candidate in Tribhuwan University, Nepal. SRM is the Ph.D. candidate and KP is researcher in Nepal Development society.Not applicable.Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram indicating the study selection procedure on challenges and opportunities towards the road of UHC to include into systematic review, Nepal, 2018
See this image and copyright information in PMC

Comment in

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