Fifty-five percent of citizens in Gulmi are still without health insurance coverage. According to the 2021 census, the district has a population of 246,836. Out of which 45% of citizens in Gulmi, which is 111,599 individuals, have health insurance as per the Health Insurance Board. Among them, 53,893 are men and 57,706 are women.
According to Subash Ghimire, Registration Officer of the Insurance Board Office, Gulmi, 78,594 citizens have taken health insurance by paying the fee. Ghimire reported that 15,841 senior citizens, 462 HIV-infected individuals, 3,682 people with disabilities of the ‘A’ category, and 25 people with leprosy or complicated tuberculosis have availed the facility of free health insurance in the district. Similarly, Ghimire informed that 4,360 women health volunteers have taken health insurance at a 50% discount. Among the 12 local levels in the district, Madane Rural Municipality has the lowest number of health insurance holders, while Resunga Municipality has the highest. Additionally, Chandrakot Rural Municipality has implemented a policy to cover 50% of the health insurance premium for citizens in poor economic conditions, as part of its policy and program. So far, 250 families have benefited from the health insurance facilities provided by Chandrakot Rural Municipality. Additionally, Madane Rural Municipality has granted insurance concessions to all 67 female health volunteers at the local level.
Resunga Municipality-3 and 4 have provided free health insurance to 83 families. Citizens can access health insurance services at Gulmi Hospital Tamghas, Shringa, Johang, Ruru Primary Health Center, and the Nepal Netra Jyoti Sangh District Eye Treatment Center within the district. Starting this financial year, the Nepal Netra Jyoti Sangh District Eye Treatment Center in Gulmi has integrated eye treatment with health insurance, bringing satisfaction to citizens. The center is the first community organization in the district to offer eye treatment through health insurance, following approval from the Health Insurance Board of the Government of Nepal.
Insured individuals will be required to pay a 20% co-payment for eye treatment. Padam Pandey, Secretary of the Nepal Netra Jyoti Sangh, reported that 11 people underwent cataract surgery during a camp held on July 27, following the start of the insurance coverage. The district has two registered officers and 94 registered assistants. Many citizens with poor economic backgrounds in the district are still unable to access health insurance due to a lack of awareness and financial constraints. Families who spend thousands on treatment each year are also facing losses because they are not informed about available health insurance options.
Sher Bahadur KC, 56, from Malika Rural Municipality-4, says that even medicines worth Rs 20,000 are insufficient for his needs. His family, including his mother and daughter, also requires regular medication. Despite this, KC has not yet taken out health insurance. KC expressed that no one has advised him to get health insurance. He added that the poor will continue to suffer and become even poorer when they fall ill without proper coverage.
Likewise, Anil GC, Registration Officer of the Insurance Board Office, Gulmi, reported that the two registration officers in the district are insufficient to handle the workload. Due to a lack of manpower, campaigning in Rural Municipalities and monitoring health institutions where insurance is implemented remains incomplete. GC emphasized that the government should assist families in Gulmi who cannot afford to pay Rs 3500 required for health insurance.