People’s health, nepal’s wealth: Community health insurance programme faces hiccups
The Ministry of Health and Population is “not looking before leaping”. As it plans to launch an ambitious cooperative health insurance scheme, the community health insurance (CHI) programme declared in six Primary Health Care (PHC) Centres as a pilot survey has started facing hiccups.
The CHI programme is witnessing a high dropout rate— more than 50 percent. It was launched in Mangalbare (Morang), Katari (Udaypur), Chandranigahapur (Rautahat), Dumkauli (Nawalparasi), Lamahi (Dang) and Tikapur (Kailali). However, among the six, two of the PHCs have been converted into 15-bed hospitals.
For a family to be insured, the health insurance committee of the respective health institute decides as to how much sum one has to pay yearly. The rates, basically, vary from one health institutes to another. Out of the collected sum (not more than Rs 1,000 per year for a six-member family), people get the health benefit equivalent to at least Rs 20,000. Around 80 percent of the total cost of insurance is borne by the government.
Among the piloted districts, Katari had 256 families insured in 2006-07. However, the number plunged to 223 in 2009-10 covering only 8 percent of the total population. It also saw a dropout of around 401 members in 2009-10.
Likewise, Damkauli saw an enrollment of 503 members in 2008-9, which decreased to 296 in 2009-10 with merely two percent of the total population being covered. Alike others, the dropout rate is around 53 percent. The situation of Lamahi is no different, which saw a dropout of around 54 percent in 2009/10.
Khagendra Adhikari, focal person of CHI Katari, said people started boasting of the money they paid. They expect sophisticated facilities which the scheme cannot cover and they don’t renew the scheme, he said.
Experts say the government’s unscientific plan is to blame for the failure of the CHI programme. “Initially launched as a pilot programme, CHI has been continuing even in the sixth year. However, the community people are dismissive of the insurance scheme,” said Ramji Ghimire, chief of CHI at PHC Revitalisation Division.
He also said that the free health service campaign launched in 2007-08 high on the heels of CHI. People showed hesitancy to give an additional sum in the name of insurance thinking that they don’t have to pay for the free health service, Ghimire said. “Therefore, it’s high time for the government to review its programme so that the upcoming programmes won’t be affected,” he said.
Posted on: 2011-09-02 07:21
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