In the district, even after seven years since the implementation of the health insurance program, a large number of citizens are still outside its coverage. According to the Health Insurance Board contact office, out of a total population of 246,836, only 132,434 people ie 53.72 percent, have enrolled in health insurance so far, while 46.28 percent of citizens are still not covered.
The health insurance program was launched in the district on February 2, 2020. However, the program has not been able to expand effectively. It has been observed that participation has not increased significantly due to a lack of adequate awareness among many citizens about the importance of health insurance.
According to registration assistant Manisha Khatri, poor and economically disadvantaged families are unable to pay the annual premium, and dissatisfaction with service quality and shortages of medicines have reduced trust in the insurance system. “When we go door to door, people often complain that they do not receive good services from the insurance scheme, that essential medicines are not available, and that quality healthcare is lacking,” she said. She also expressed concern that the government has not been able to run effective public awareness programs.
The number of citizens enrolled in health insurance also varies across local levels. In Musikot Municipality, 8,201 people are enrolled; in Kaligandaki Rural Municipality, 6,844; in Satyawati Rural Municipality, 16,202; in Chandrakot Rural Municipality, 6,571; and in Rurukshetra Rural Municipality, 14,357. Similarly, in Chhatra Khot Rural Municipality, 12,661 people are enrolled; in Gulmidarbar Rural Municipality, 10,559; in Isma Rural Municipality, 7,967; in Dhurkot Rural Municipality, 10,913; in Madane Rural Municipality, 4,030; and in Malika Rural Municipality, 8,537 citizens have enrolled in health insurance.
In the district, there are two staff members and 94 registration assistants working for the implementation of the health insurance program. Currently, health insurance services are being provided through Gulmi Hospital, District Eye Treatment Center Tamghas, Dhurkot Basic Hospital, Gulmidarbar Basic Hospital, Shringha Primary Health Center, Ruru Primary Health Center, and Johang Primary Health Center.
According to Dr. Bibhav Basyal, Acting Medical Superintendent of Gulmi Hospital, frequently changing policies have affected both hospitals and service users. He informed that more than 40 million rupees in payments are still pending, and urged the governement to ensure that all citizens are compulsory enrolled in the insurance scheme and to focus on raising public awareness.
Resunga Municipality Mayor Khiladhwaj Panthi stated that government attention is needed to make the health insurance program more effective. “Citizens’ lives and health are the country’s greatest assets, so all three tiers of government must be responsible for health insurance,” he said.