Informal Workers, Global Lessons and Nepal’s Path to Universal Health Coverage

Nepal's national health insurance program (NHIP) has achieved universal geographic coverage, but the numbers tell a troubling story. Nepal Health Insurance Board (HIB)’s latest annual report reveals that while all 77 districts now participate in the program, actual enrollment and retention rates remain very low. Despite nationwide implementation, only 8.29 million Nepalis, barely 28% of our population, currently have health insurance and even less (5.01 million people representing 17% of the population)are active members. The problem is particularly acute in Madhesh and Sudurpaschhim provinces, where active participation stands at mere 6% and 9% respectively. With an overall renewal rate of only 54%, more than four in ten insured Nepalis are choosing not to continue their coverage.