A system in crisis

The future of Nepal’s health insurance rests on political commitment to health equity for all.

With the aim to achieve universal health coverage, the government of Nepal launched the National Health Insurance Programme (NHIP) in 2017. The programme, under the Health Insurance Act of 2017, also sought to ensure access to quality healthcare for all, regardless of their economic status. This was in line with the Constitution of Nepal, which guarantees free basic health services as a fundamental right of citizens. Article 51 (H) of the constitution has a provision for health insurance. Following the programme’s introduction, many citizens enrolled in it; still, the 2022 National Demographic Health Survey revealed that of the total population aged 15–49, only 10 percent have participated in the service. This figure is not surprising given the NHIP’s failure to attract new beneficiaries due to bureaucratic hurdles and to retain those already enrolled through effective service delivery, transparency and, most important, adequate funding.