Seventy-two Percent of Citizens Lack Access to Health Insurance

  January 10, 2024 By: Shreya Parajuli

The Article 35 of Constitution of Nepal 2015 states that every citizen shall have the right to seek basic health care services from the state and no citizen shall be deprived of emergency health care. The government implemented a health insurance program from the financial year 2015-2016 for providing convenient health services to the citizens.

Health Insurance Board, Dhankuta stated that the health insurance program in the district has been in run since 2020. However, even after 3 years of the program , only 28% of the citizens have access to health insurance. As per the National Census of 2022 , the total population of the district is 149984. Among 12661 families in the district, only 42189 individuals including  20313 male and 21876 female have health insurance.

Insured individuals in the district have received proper health services whereas those without access are still deprived of health insurance. Citizens are still not able to get access to health insurance due to lack of public awareness and poverty. A family with 5 members should pay Rs 3500 per year to be a part of the health insurance. And with more than 5 members it costs an additional amount of Rs 700 per person.

According to the Health Insurance Regulations 2018, the government of Nepal provides free health insurance to senior citizens who have completed 70 years of age by paying a premium amount. Namita Khatiwada, the Coordinator of  Health Insurance Board, Dhankuta, said that the government has provided health services worth Rs 100000 annually to five members affiliated to the insurance.

Amitabh Thakur, Acting Chief  of Dhankuta Hospital, says that those who are covered by health insurance are provided facilities in various primary health centers and district hospitals. In addition, people are referred to Terai Hospital if they are unable to provide services within the district. 1 to 150 insured people come to the district hospital for treatment daily as per the records off the hospital.

Dr. Thakur expressed that the health facilities have also been provided to the insured as per the government. However, there is a  problem in purchasing adequate medicine when the government does not provide the required amount of medicines according to the insurance policy. He added that this hampers in providing effective health services to the citizens who are covered by the insurance.

Chhatra Bahadur Subba, Chairperson of the Chhathar, Jorpati Rural Municipality said that the Municipality has started to cover 50% of the health insurance amount of all citizens. Similarly, Jitendra Rai, chairman of Sangurigardi Rural Municipality, said that the municipality pays for the health insurance of Dalit community and women health volunteers. Due to not being able to pay for health insurance, they have to spend lakhs on treatment and in the worst case people have to lose their life. Although the Local level of the district provides health insurance and ensures their right to health, 72 % of the citizens in the district are beyond the reach of health insurance.


Ishwor Thapa