Assessing Fiscal Space for Health in Nepal
Nepal has seen impressive improvements in health outcomes and has done well both in its rate of progress and relative to its income level. Infant mortality has been declining over the past five decades to 38.6 per 1,000 live births in 2009. Similar...
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| Format: | Working Paper |
| Language: | English en_US |
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World Bank Group, Washington, DC
2015
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| Online Access: | http://documents.worldbank.org/curated/en/2015/07/24802364/assessing-fiscal-space-health-nepal http://hdl.handle.net/10986/22389 |
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okr-10986-22389 |
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| recordtype |
oai_dc |
| repository_type |
Digital Repository |
| institution_category |
Foreign Institution |
| institution |
Digital Repositories |
| building |
World Bank Open Knowledge Repository |
| collection |
World Bank |
| language |
English en_US |
| topic |
LIVING STANDARDS HEALTH CARE PROVIDERS INFANT MORTALITY RATES WASTE FORECASTS EMPLOYMENT FEMALE EDUCATION RISKS HEALTH INSURANCE SYSTEM FINANCING INFORMAL SECTOR INCOME UNDER-FIVE MORTALITY FEE FOR SERVICE HEALTH EXPENDITURES PUBLIC SECTOR DOCTORS HEALTH ECONOMICS NEEDS ASSESSMENT SHARE OF HEALTH SPENDING PRIMARY CARE COST-EFFECTIVENESS HEALTH SYSTEM EFFICIENCY MONITORING HEALTH INSURANCE HEALTH CARE FINANCIAL PROTECTION PROVISION OF HEALTH SERVICES FISCAL POLICY INCENTIVES NATIONAL HEALTH INSURANCE HEALTH ECONOMIC POLICY BUDGETARY RESOURCES HEALTH WORKERS POCKET PAYMENTS ENVIRONMENTAL HEALTH BASIC HEALTH CARE HEALTH FACILITIES PUBLIC HEALTH LIFE EXPECTANCY HEALTH RESOURCES HOSPITALIZATION ADULT MORTALITY HEALTH SECTOR CAPITATION CHOICE PUBLIC EXPENDITURE ON HEALTH PROTECTION MECHANISMS PRIVATE HOSPITALS HEALTH STATUS COSTS IMMUNIZATION DEMAND FOR HEALTH SERVICES HEALTH INDICATORS HEALTH SYSTEMS FIXED COSTS PUBLIC HOSPITALS HEALTH CENTERS HEALTH SYSTEM PERFORMANCE EXTERNALITIES SOCIAL INSURANCE NURSES HEALTH CARE SERVICES DEBT ALLOCATIVE EFFICIENCY HEALTH SHARE MEDICAL CARE ESSENTIAL HEALTH CARE TUBERCULOSIS HEALTH ORGANIZATION HEALTH-SECTOR MORTALITY HEALTH PROMOTION HEALTH SPENDING SHARE HEALTH SPENDING SOCIAL HEALTH INSURANCE SCHEMES MEDICAL EDUCATION EQUITY INFANT MORTALITY WORKERS SOCIAL HEALTH INSURANCE HEALTH INSURANCE SCHEMES PUBLIC HEALTH CONCERNS PUBLIC EXPENDITURE CROWDING CARE HEALTH CARE POLICY HEALTH POLICY BUDGETS DEMAND HEALTH OUTCOMES INSURANCE CONTRIBUTIONS HOSPITAL REVENUES ADULT MORTALITY RATE FAMILY PLANNING MEDICAL SUPPLIES MEDICAL EQUIPMENT EXPENDITURES INCOME COUNTRIES HEALTH CARE FINANCING FINANCIAL BARRIERS TEACHING HOSPITALS PRIVATE SECTOR MEASUREMENT NUTRITION BEDS HEALTH POSTS HEALTH CARE PROVIDER INSURANCE SYSTEM PRICE OF HEALTH CARE INTERNET NATIONAL HEALTH INSURANCE HEALTH RESULTS HEALTH SYSTEM INSURANCE PREMIUMS COMMUNICABLE DISEASES LOW INCOME ESSENTIAL DRUGS CHILDREN DISEASE CONTROL RISK HUMAN RESOURCES DEMAND FOR HEALTH POVERTY HEALTH INSURANCE CONTRIBUTIONS HEALTH EXPENDITURE ILLNESS INCIDENCE PRIVATE SPENDING POPULATION HOSPITAL BEDS HEALTH- SECTOR FINANCIAL RISK STRATEGY PRIVATE FINANCING FEES HEALTH FINANCING PUBLIC SPENDING HOSPITALS HEALTH SERVICE INFANT MORTALITY RATE HEALTH SERVICES IMPLEMENTATION HEALTH STRATEGY PROVIDER PAYMENT HUMAN DEVELOPMENT |
| spellingShingle |
LIVING STANDARDS HEALTH CARE PROVIDERS INFANT MORTALITY RATES WASTE FORECASTS EMPLOYMENT FEMALE EDUCATION RISKS HEALTH INSURANCE SYSTEM FINANCING INFORMAL SECTOR INCOME UNDER-FIVE MORTALITY FEE FOR SERVICE HEALTH EXPENDITURES PUBLIC SECTOR DOCTORS HEALTH ECONOMICS NEEDS ASSESSMENT SHARE OF HEALTH SPENDING PRIMARY CARE COST-EFFECTIVENESS HEALTH SYSTEM EFFICIENCY MONITORING HEALTH INSURANCE HEALTH CARE FINANCIAL PROTECTION PROVISION OF HEALTH SERVICES FISCAL POLICY INCENTIVES NATIONAL HEALTH INSURANCE HEALTH ECONOMIC POLICY BUDGETARY RESOURCES HEALTH WORKERS POCKET PAYMENTS ENVIRONMENTAL HEALTH BASIC HEALTH CARE HEALTH FACILITIES PUBLIC HEALTH LIFE EXPECTANCY HEALTH RESOURCES HOSPITALIZATION ADULT MORTALITY HEALTH SECTOR CAPITATION CHOICE PUBLIC EXPENDITURE ON HEALTH PROTECTION MECHANISMS PRIVATE HOSPITALS HEALTH STATUS COSTS IMMUNIZATION DEMAND FOR HEALTH SERVICES HEALTH INDICATORS HEALTH SYSTEMS FIXED COSTS PUBLIC HOSPITALS HEALTH CENTERS HEALTH SYSTEM PERFORMANCE EXTERNALITIES SOCIAL INSURANCE NURSES HEALTH CARE SERVICES DEBT ALLOCATIVE EFFICIENCY HEALTH SHARE MEDICAL CARE ESSENTIAL HEALTH CARE TUBERCULOSIS HEALTH ORGANIZATION HEALTH-SECTOR MORTALITY HEALTH PROMOTION HEALTH SPENDING SHARE HEALTH SPENDING SOCIAL HEALTH INSURANCE SCHEMES MEDICAL EDUCATION EQUITY INFANT MORTALITY WORKERS SOCIAL HEALTH INSURANCE HEALTH INSURANCE SCHEMES PUBLIC HEALTH CONCERNS PUBLIC EXPENDITURE CROWDING CARE HEALTH CARE POLICY HEALTH POLICY BUDGETS DEMAND HEALTH OUTCOMES INSURANCE CONTRIBUTIONS HOSPITAL REVENUES ADULT MORTALITY RATE FAMILY PLANNING MEDICAL SUPPLIES MEDICAL EQUIPMENT EXPENDITURES INCOME COUNTRIES HEALTH CARE FINANCING FINANCIAL BARRIERS TEACHING HOSPITALS PRIVATE SECTOR MEASUREMENT NUTRITION BEDS HEALTH POSTS HEALTH CARE PROVIDER INSURANCE SYSTEM PRICE OF HEALTH CARE INTERNET NATIONAL HEALTH INSURANCE HEALTH RESULTS HEALTH SYSTEM INSURANCE PREMIUMS COMMUNICABLE DISEASES LOW INCOME ESSENTIAL DRUGS CHILDREN DISEASE CONTROL RISK HUMAN RESOURCES DEMAND FOR HEALTH POVERTY HEALTH INSURANCE CONTRIBUTIONS HEALTH EXPENDITURE ILLNESS INCIDENCE PRIVATE SPENDING POPULATION HOSPITAL BEDS HEALTH- SECTOR FINANCIAL RISK STRATEGY PRIVATE FINANCING FEES HEALTH FINANCING PUBLIC SPENDING HOSPITALS HEALTH SERVICE INFANT MORTALITY RATE HEALTH SERVICES IMPLEMENTATION HEALTH STRATEGY PROVIDER PAYMENT HUMAN DEVELOPMENT Belay, Tekabe Tandon, Ajay Assessing Fiscal Space for Health in Nepal |
| geographic_facet |
South Asia Nepal |
| relation |
Heath, nutrition and population discussion paper; |
| description |
Nepal has seen impressive improvements
in health outcomes and has done well both in its rate of
progress and relative to its income level. Infant mortality
has been declining over the past five decades to 38.6 per
1,000 live births in 2009. Similarly, maternal mortality has
decreased to 380 per 100,000 live births in 2008. Life
expectancy has been steadily increasing to 67 years in 2009.
The rate of progress is better than those witnessed by
neighboring countries. But challenges remain in addressing
inequality, high and increasing out of pocket payments.
Geographic and income-related inequalities in population
health outcomes remain large and are increasing. For
example, not only is the decline in infant mortality not
uniform, some regions have seen an increase. The policy
response to these challenges has been to expand free care
services and pilot protection mechanism against the
financial risk of ill health. There is growing demand to
expand the package as well as the coverage of existing free
essential health care to all Nepalese; to introduce new
programs such as health insurance, and other similar
initiatives This note identifies efficiency gains as the
main potential source of additional fiscal space. The
analysis presented herein indicates that improvement in
health system efficiency i.e., getting more value for money
is by far the most plausible option for realizing additional
fiscal space for health in Nepal. As the note demonstrates,
the prospects for additional resources for health from all
other possible sources from conducive macroeconomic
conditions, re-prioritization of health, external resources,
and other health-sector specific sources is limited in
Nepal. On the other hand, there are many indications of
systemic inefficiencies in the health system of the country
and the challenge would be to focus on identifying and
implementing appropriate interventions to improve the
situation and reduce waste. The note highlights some
specific areas, such as those related to provider payments,
drug procurement mechanisms, and hospital and district grant
allocations whereby significant improvements in obtaining
better value for money can be realized. |
| format |
Working Paper |
| author |
Belay, Tekabe Tandon, Ajay |
| author_facet |
Belay, Tekabe Tandon, Ajay |
| author_sort |
Belay, Tekabe |
| title |
Assessing Fiscal Space for Health in Nepal |
| title_short |
Assessing Fiscal Space for Health in Nepal |
| title_full |
Assessing Fiscal Space for Health in Nepal |
| title_fullStr |
Assessing Fiscal Space for Health in Nepal |
| title_full_unstemmed |
Assessing Fiscal Space for Health in Nepal |
| title_sort |
assessing fiscal space for health in nepal |
| publisher |
World Bank Group, Washington, DC |
| publishDate |
2015 |
| url |
http://documents.worldbank.org/curated/en/2015/07/24802364/assessing-fiscal-space-health-nepal http://hdl.handle.net/10986/22389 |
| _version_ |
1764450994040602624 |
| spelling |
okr-10986-223892021-04-23T14:04:08Z Assessing Fiscal Space for Health in Nepal Belay, Tekabe Tandon, Ajay LIVING STANDARDS HEALTH CARE PROVIDERS INFANT MORTALITY RATES WASTE FORECASTS EMPLOYMENT FEMALE EDUCATION RISKS HEALTH INSURANCE SYSTEM FINANCING INFORMAL SECTOR INCOME UNDER-FIVE MORTALITY FEE FOR SERVICE HEALTH EXPENDITURES PUBLIC SECTOR DOCTORS HEALTH ECONOMICS NEEDS ASSESSMENT SHARE OF HEALTH SPENDING PRIMARY CARE COST-EFFECTIVENESS HEALTH SYSTEM EFFICIENCY MONITORING HEALTH INSURANCE HEALTH CARE FINANCIAL PROTECTION PROVISION OF HEALTH SERVICES FISCAL POLICY INCENTIVES NATIONAL HEALTH INSURANCE HEALTH ECONOMIC POLICY BUDGETARY RESOURCES HEALTH WORKERS POCKET PAYMENTS ENVIRONMENTAL HEALTH BASIC HEALTH CARE HEALTH FACILITIES PUBLIC HEALTH LIFE EXPECTANCY HEALTH RESOURCES HOSPITALIZATION ADULT MORTALITY HEALTH SECTOR CAPITATION CHOICE PUBLIC EXPENDITURE ON HEALTH PROTECTION MECHANISMS PRIVATE HOSPITALS HEALTH STATUS COSTS IMMUNIZATION DEMAND FOR HEALTH SERVICES HEALTH INDICATORS HEALTH SYSTEMS FIXED COSTS PUBLIC HOSPITALS HEALTH CENTERS HEALTH SYSTEM PERFORMANCE EXTERNALITIES SOCIAL INSURANCE NURSES HEALTH CARE SERVICES DEBT ALLOCATIVE EFFICIENCY HEALTH SHARE MEDICAL CARE ESSENTIAL HEALTH CARE TUBERCULOSIS HEALTH ORGANIZATION HEALTH-SECTOR MORTALITY HEALTH PROMOTION HEALTH SPENDING SHARE HEALTH SPENDING SOCIAL HEALTH INSURANCE SCHEMES MEDICAL EDUCATION EQUITY INFANT MORTALITY WORKERS SOCIAL HEALTH INSURANCE HEALTH INSURANCE SCHEMES PUBLIC HEALTH CONCERNS PUBLIC EXPENDITURE CROWDING CARE HEALTH CARE POLICY HEALTH POLICY BUDGETS DEMAND HEALTH OUTCOMES INSURANCE CONTRIBUTIONS HOSPITAL REVENUES ADULT MORTALITY RATE FAMILY PLANNING MEDICAL SUPPLIES MEDICAL EQUIPMENT EXPENDITURES INCOME COUNTRIES HEALTH CARE FINANCING FINANCIAL BARRIERS TEACHING HOSPITALS PRIVATE SECTOR MEASUREMENT NUTRITION BEDS HEALTH POSTS HEALTH CARE PROVIDER INSURANCE SYSTEM PRICE OF HEALTH CARE INTERNET NATIONAL HEALTH INSURANCE HEALTH RESULTS HEALTH SYSTEM INSURANCE PREMIUMS COMMUNICABLE DISEASES LOW INCOME ESSENTIAL DRUGS CHILDREN DISEASE CONTROL RISK HUMAN RESOURCES DEMAND FOR HEALTH POVERTY HEALTH INSURANCE CONTRIBUTIONS HEALTH EXPENDITURE ILLNESS INCIDENCE PRIVATE SPENDING POPULATION HOSPITAL BEDS HEALTH- SECTOR FINANCIAL RISK STRATEGY PRIVATE FINANCING FEES HEALTH FINANCING PUBLIC SPENDING HOSPITALS HEALTH SERVICE INFANT MORTALITY RATE HEALTH SERVICES IMPLEMENTATION HEALTH STRATEGY PROVIDER PAYMENT HUMAN DEVELOPMENT Nepal has seen impressive improvements in health outcomes and has done well both in its rate of progress and relative to its income level. Infant mortality has been declining over the past five decades to 38.6 per 1,000 live births in 2009. Similarly, maternal mortality has decreased to 380 per 100,000 live births in 2008. Life expectancy has been steadily increasing to 67 years in 2009. The rate of progress is better than those witnessed by neighboring countries. But challenges remain in addressing inequality, high and increasing out of pocket payments. Geographic and income-related inequalities in population health outcomes remain large and are increasing. For example, not only is the decline in infant mortality not uniform, some regions have seen an increase. The policy response to these challenges has been to expand free care services and pilot protection mechanism against the financial risk of ill health. There is growing demand to expand the package as well as the coverage of existing free essential health care to all Nepalese; to introduce new programs such as health insurance, and other similar initiatives This note identifies efficiency gains as the main potential source of additional fiscal space. The analysis presented herein indicates that improvement in health system efficiency i.e., getting more value for money is by far the most plausible option for realizing additional fiscal space for health in Nepal. As the note demonstrates, the prospects for additional resources for health from all other possible sources from conducive macroeconomic conditions, re-prioritization of health, external resources, and other health-sector specific sources is limited in Nepal. On the other hand, there are many indications of systemic inefficiencies in the health system of the country and the challenge would be to focus on identifying and implementing appropriate interventions to improve the situation and reduce waste. The note highlights some specific areas, such as those related to provider payments, drug procurement mechanisms, and hospital and district grant allocations whereby significant improvements in obtaining better value for money can be realized. 2015-08-13T18:02:34Z 2015-08-13T18:02:34Z 2015-04 Working Paper http://documents.worldbank.org/curated/en/2015/07/24802364/assessing-fiscal-space-health-nepal http://hdl.handle.net/10986/22389 English en_US Heath, nutrition and population discussion paper; CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank World Bank Group, Washington, DC Publications & Research Publications & Research :: Working Paper South Asia Nepal |