Report Identification of scaling up strategies for free health services leading to universal health care”Kathmandu, 2009
Introduction: Health policy of social inclusion: The Nepal Health Sector Programme (2004-2010)- is basically aimed at providing priority access to poor and vulnerable groups on a continued and sustainable fashion. The three year interim plan specifies the strategies for social inclusion....
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| Định dạng: | Technical Report | 
| Ngôn ngữ: | en_US | 
| Được phát hành: | 
        
      Nepal Health Research Council    
    
      2012
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| Những chủ đề: | |
| Truy cập trực tuyến: | http://103.69.126.140:8080/handle/123456789/285 | 
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                  oai:103.69.126.140:123456789-285 | 
    
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                  My University | 
    
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| language | 
                  en_US | 
    
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                  Free Health Services Nepal  | 
    
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                  Free Health Services Nepal Nepal Health Research Council (NHRC), Ramshah Path, Kathmandu, Nepal Report Identification of scaling up strategies for free health services leading to universal health care”Kathmandu, 2009  | 
    
| description | 
                  Introduction: Health policy of social inclusion:  The Nepal Health Sector Programme (2004-2010)-    is basically  aimed at providing    priority access  to  poor and vulnerable groups  on a continued and sustainable fashion.  The three year interim plan specifies the strategies for social inclusion. It also stresses  the need      for  developing  necessary  policies and status to operationalize the concept of providing free  basic  health  services  so  as  to ensure the health right s  of people  as necessary steps towards  extending  universal  access  of  basic health services  to all people. The  ,  40-  item   medicines  for  PHCC and DH and    the  32- item  ones  for    HP/SHP  are the chief initiatives taken toward that end as these medications    are  distributed  free of cost    upon presentation of  prescription  by patients. Similarly, the  Aama program  and  the  support  to  the  uterine  prolapsed  patients    are basically to reinforce  the  policy  of  ensuring  the reproductive health right   of women. Available health services at district hospitals  for target groups  (Poor, ultra poor, destitute, elderly, disabled, FCHV ),    include  provisions  for    safety  nets  for referral and poor patients, in  catastrophic Illnesses-  Cash Support (Rs.50000),  and treatment  support under  social security program at referral hospitals. Additionally, some package policy exists for remote and isolated zones, districts, and for the terai  regions.
Rationale:  Access to  easy health  services  at  district level  hospitals  for all ci tizens  and secondary and tertiary levels of treatment is still related to the paying capacity of the service users.  As the health service costs  in these hospitals  are still  considerably higher than primary health care, service users  are  therefore  forced to make    a larger  out of pocket payments(OOPE).. Because of this higher level of OOPE , the poor and vulnerable people are not able to access the health services at this level. Thus,      capacity to pay has remained a major barrier  to those  seeking to  utilise  the existing  health care  facilities  at an affordable cost.  At  the  district hospitals,  only  some  targeted groups can access the free health care services.    In the light of these prevailing scenario, it is  now    absolutely necessary to scale up the    current  free health care    services so as  to ensure  and expand the accessibility   and affordability  of    these  services for  the    poor and    the  vulnerable groups .  This study  is,  therefore,  aimed  at  identifying  the strategies  and on the basis of which to make suitable recommendations  with the hope  that these would  help  the planners at the central level  to  scale up the free health care  services  at district level hospitals  and  also at the same time  help them    undertake the  time-suited  situation analysis  of  the possible  referral hospitals.  .Objectives:  The overall objective of the proposed activity is to develop options and strategies for effective scaling up of the FHC program at various levels of health service institutions.
Specific Objectives: 1)  To identify the scaling up strategies  for  free  health services in District Hospitals., 2) To explore  the key issues  for  the  management process of free health care service  facilities  in three selected referral hospitals (central and zonal hospital) and 3)  to conduct situati on analysis on the cooperative-  based health facilities/ hospitals and policy and mechanisms  for free  health service delivery.
Methodology:  The study was conducted in three designs 1) Study  and cost analysis  of district-level   hospitals  2) study of referral hospitals  on free health care and 3) Study of cooperative-  based hospitals on health finance policy and   its actual  implementation. The study period is  between July to October 2009.
The study was conducted in the following District Hospitals: Rupandehi, Gorkha, Nuwakot, Bardiya, Sunsari, Baitadi, Referral hospitals: Central Hospital: NAMS Bir Hospital, Lumbini and Koshi Zonal Hospital. Cooperative Hospitals which were under study included: Manamohan Memorial Community Hospital and STUPA Community Hospital in Katmandu.
The findings of  the  study   are  limited to exploring  the  current  situation  of  the  service provisions  at district  level  hospitals,  (primary data)  with  the  cost analysis based on secondary data. Similarly, information    collected and presented here  on the    referral and cooperative hospitals are limited to providing brief  description of  the existing provisionsfor health financing and for free health care. | 
    
| format | 
                  Technical Report | 
    
| author | 
                  Nepal Health Research Council (NHRC), Ramshah Path, Kathmandu, Nepal | 
    
| author_facet | 
                  Nepal Health Research Council (NHRC), Ramshah Path, Kathmandu, Nepal | 
    
| author_sort | 
                  Nepal Health Research Council (NHRC), Ramshah Path, Kathmandu, Nepal | 
    
| title | 
                  Report Identification of scaling up strategies for free health services leading to universal health care”Kathmandu, 2009 | 
    
| title_short | 
                  Report Identification of scaling up strategies for free health services leading to universal health care”Kathmandu, 2009 | 
    
| title_full | 
                  Report Identification of scaling up strategies for free health services leading to universal health care”Kathmandu, 2009 | 
    
| title_fullStr | 
                  Report Identification of scaling up strategies for free health services leading to universal health care”Kathmandu, 2009 | 
    
| title_full_unstemmed | 
                  Report Identification of scaling up strategies for free health services leading to universal health care”Kathmandu, 2009 | 
    
| title_sort | 
                  report identification of scaling up strategies for free health services leading to universal health care”kathmandu, 2009 | 
    
| publisher | 
                  Nepal Health Research Council | 
    
| publishDate | 
                  2012 | 
    
| url | 
                  http://103.69.126.140:8080/handle/123456789/285 | 
    
| work_keys_str_mv | 
                  AT nepalhealthresearchcouncilnhrcramshahpathkathmandunepal reportidentificationofscalingupstrategiesforfreehealthservicesleadingtouniversalhealthcarekathmandu2009 | 
    
| _version_ | 
                  1761501110625894400 | 
    
| spelling | 
                  oai:103.69.126.140:123456789-2852023-01-05T06:44:36Z Report Identification of scaling up strategies for free health services leading to universal health care”Kathmandu, 2009 Nepal Health Research Council (NHRC), Ramshah Path, Kathmandu, Nepal Free Health Services Nepal Introduction: Health policy of social inclusion: The Nepal Health Sector Programme (2004-2010)- is basically aimed at providing priority access to poor and vulnerable groups on a continued and sustainable fashion. The three year interim plan specifies the strategies for social inclusion. It also stresses the need for developing necessary policies and status to operationalize the concept of providing free basic health services so as to ensure the health right s of people as necessary steps towards extending universal access of basic health services to all people. The , 40- item medicines for PHCC and DH and the 32- item ones for HP/SHP are the chief initiatives taken toward that end as these medications are distributed free of cost upon presentation of prescription by patients. Similarly, the Aama program and the support to the uterine prolapsed patients are basically to reinforce the policy of ensuring the reproductive health right of women. Available health services at district hospitals for target groups (Poor, ultra poor, destitute, elderly, disabled, FCHV ), include provisions for safety nets for referral and poor patients, in catastrophic Illnesses- Cash Support (Rs.50000), and treatment support under social security program at referral hospitals. Additionally, some package policy exists for remote and isolated zones, districts, and for the terai regions. Rationale: Access to easy health services at district level hospitals for all ci tizens and secondary and tertiary levels of treatment is still related to the paying capacity of the service users. As the health service costs in these hospitals are still considerably higher than primary health care, service users are therefore forced to make a larger out of pocket payments(OOPE).. Because of this higher level of OOPE , the poor and vulnerable people are not able to access the health services at this level. Thus, capacity to pay has remained a major barrier to those seeking to utilise the existing health care facilities at an affordable cost. At the district hospitals, only some targeted groups can access the free health care services. In the light of these prevailing scenario, it is now absolutely necessary to scale up the current free health care services so as to ensure and expand the accessibility and affordability of these services for the poor and the vulnerable groups . This study is, therefore, aimed at identifying the strategies and on the basis of which to make suitable recommendations with the hope that these would help the planners at the central level to scale up the free health care services at district level hospitals and also at the same time help them undertake the time-suited situation analysis of the possible referral hospitals. .Objectives: The overall objective of the proposed activity is to develop options and strategies for effective scaling up of the FHC program at various levels of health service institutions. Specific Objectives: 1) To identify the scaling up strategies for free health services in District Hospitals., 2) To explore the key issues for the management process of free health care service facilities in three selected referral hospitals (central and zonal hospital) and 3) to conduct situati on analysis on the cooperative- based health facilities/ hospitals and policy and mechanisms for free health service delivery. Methodology: The study was conducted in three designs 1) Study and cost analysis of district-level hospitals 2) study of referral hospitals on free health care and 3) Study of cooperative- based hospitals on health finance policy and its actual implementation. The study period is between July to October 2009. The study was conducted in the following District Hospitals: Rupandehi, Gorkha, Nuwakot, Bardiya, Sunsari, Baitadi, Referral hospitals: Central Hospital: NAMS Bir Hospital, Lumbini and Koshi Zonal Hospital. Cooperative Hospitals which were under study included: Manamohan Memorial Community Hospital and STUPA Community Hospital in Katmandu. The findings of the study are limited to exploring the current situation of the service provisions at district level hospitals, (primary data) with the cost analysis based on secondary data. Similarly, information collected and presented here on the referral and cooperative hospitals are limited to providing brief description of the existing provisionsfor health financing and for free health care. 2012-12-28T22:46:09Z 2022-11-08T10:14:14Z 2012-12-28T22:46:09Z 2022-11-08T10:14:14Z 2009 Technical Report http://103.69.126.140:8080/handle/123456789/285 en_US application/pdf Nepal Health Research Council |