Choices of health care financing schemes for resource poor country: An analysis of Nepal’s experiences

Shiva Raj Adhikari

doi:10.4236/health.2013.58176

Abstract

An appropriate health care financing scheme can improve the efficient, equitable, and effective use of health care resources; however, each popular health care financing scheme has some advantages and disadvantages. The designing of health care financing strategy to fit with the country specific features is not straightforward. In resource poor country, allocation of resources for health care services are always critical and frequently unstable due to nuances annual budget process, small fiscal space, uncertainties in contributions of external development partners. Considerable quantities of country specific researches require for the choice of an appropriate health care financing scheme. The paper illustrates possible better options for the government to pursue the goal of ensuring that the poor receive more benefits. The paper compares the benefit incidences and cost of services with different options purposed for primary health care services by utilizing recently collected data from different hospitals in Nepal. The paper offers an alternative policy such as a universal free care below the district level services; but in the district level which is top level of primary care, “extended targeted free health care” may be an efficient, fair, and relatively simple approach.

Highlights

Considerable quantities of researches have explored extensive policy debates on health care financing mechanism to improve efficiency in resource use, mobilizing new resources and to ensure equity in health care in developing countries [1,2,3,4,5]
Health care services are frequently less offered to poor people and even the services are frequently underutilized by the poor people due to financial and non-financial barriers [6,7]
Debates are heightening on universal free health care services-providing all segments of the population with a wide range of government-operated health services with free of charge, in Nepal, similar to other developing countries; because it is still not clear about who gets the benefits from the provision of universal free care

Summary

Introduction

Considerable quantities of researches have explored extensive policy debates on health care financing mechanism to improve efficiency in resource use, mobilizing new resources and to ensure equity in health care in developing countries [1,2,3,4,5]. Allocations of resources for health care services are always critical and frequently unstable due to nuances annual budget process, small fiscal space, uncertainties in contributions of external development partners in the developing countries [6,7], the government has made some efforts to improve access of the services to the poor people to promoting equity. Evidences suggest conflicting results: benefits of health care services are disproportionately concentrated among the better-off [8]

Objectives

Methods

Findings

Conclusion