Assessing Fiscal Space for Health in Nepal

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dc.creatorBelay, Tekabe
dc.creatorTandon, Ajay
dc.date2015-08-13T18:02:34Z
dc.date2015-08-13T18:02:34Z
dc.date2015-04
dc.date.accessioned2026-07-01T00:49:57Z
dc.descriptionNepal 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.
dc.formatapplication/pdf
dc.formattext/plain
dc.identifierhttp://documents.worldbank.org/curated/en/2015/07/24802364/assessing-fiscal-space-health-nepal
dc.identifierhttps://hdl.handle.net/10986/22389
dc.identifierhttps://doi.org/10.1596/22389
dc.identifier.urihttp://hdl.handle.net/123456789/411678
dc.languageEnglish
dc.languageen_US
dc.publisherWorld Bank Group, Washington, DC
dc.relationHeath, nutrition and population discussion paper;
dc.rightsCC BY 3.0 IGO
dc.rightshttp://creativecommons.org/licenses/by/3.0/igo/
dc.rightsWorld Bank
dc.subjectLIVING STANDARDS
dc.subjectHEALTH CARE PROVIDERS
dc.subjectINFANT MORTALITY RATES
dc.subjectWASTE
dc.subjectFORECASTS
dc.subjectEMPLOYMENT
dc.subjectFEMALE EDUCATION
dc.subjectRISKS
dc.subjectHEALTH INSURANCE SYSTEM
dc.subjectFINANCING
dc.subjectINFORMAL SECTOR
dc.subjectINCOME
dc.subjectUNDER-FIVE MORTALITY
dc.subjectFEE FOR SERVICE
dc.subjectHEALTH EXPENDITURES
dc.subjectPUBLIC SECTOR
dc.subjectDOCTORS
dc.subjectHEALTH ECONOMICS
dc.subjectNEEDS ASSESSMENT
dc.subjectSHARE OF HEALTH SPENDING
dc.subjectPRIMARY CARE
dc.subjectCOST-EFFECTIVENESS
dc.subjectHEALTH SYSTEM EFFICIENCY
dc.subjectMONITORING
dc.subjectHEALTH INSURANCE
dc.subjectHEALTH CARE
dc.subjectFINANCIAL PROTECTION
dc.subjectPROVISION OF HEALTH SERVICES
dc.subjectFISCAL POLICY
dc.subjectINCENTIVES
dc.subjectNATIONAL HEALTH INSURANCE
dc.subjectHEALTH
dc.subjectECONOMIC POLICY
dc.subjectBUDGETARY RESOURCES
dc.subjectHEALTH WORKERS
dc.subjectPOCKET PAYMENTS
dc.subjectENVIRONMENTAL HEALTH
dc.subjectBASIC HEALTH CARE
dc.subjectHEALTH FACILITIES
dc.subjectPUBLIC HEALTH
dc.subjectLIFE EXPECTANCY
dc.subjectHEALTH RESOURCES
dc.subjectHOSPITALIZATION
dc.subjectADULT MORTALITY
dc.subjectHEALTH SECTOR
dc.subjectCAPITATION
dc.subjectCHOICE
dc.subjectPUBLIC EXPENDITURE ON HEALTH
dc.subjectPROTECTION MECHANISMS
dc.subjectPRIVATE HOSPITALS
dc.subjectHEALTH STATUS
dc.subjectCOSTS
dc.subjectIMMUNIZATION
dc.subjectDEMAND FOR HEALTH SERVICES
dc.subjectHEALTH INDICATORS
dc.subjectHEALTH SYSTEMS
dc.subjectFIXED COSTS
dc.subjectPUBLIC HOSPITALS
dc.subjectHEALTH CENTERS
dc.subjectHEALTH SYSTEM PERFORMANCE
dc.subjectEXTERNALITIES
dc.subjectSOCIAL INSURANCE
dc.subjectNURSES
dc.subjectHEALTH CARE SERVICES
dc.subjectDEBT
dc.subjectALLOCATIVE EFFICIENCY
dc.subjectHEALTH SHARE
dc.subjectMEDICAL CARE
dc.subjectESSENTIAL HEALTH CARE
dc.subjectTUBERCULOSIS
dc.subjectHEALTH ORGANIZATION
dc.subjectHEALTH-SECTOR
dc.subjectMORTALITY
dc.subjectHEALTH PROMOTION
dc.subjectHEALTH SPENDING SHARE
dc.subjectHEALTH SPENDING
dc.subjectSOCIAL HEALTH INSURANCE SCHEMES
dc.subjectMEDICAL EDUCATION
dc.subjectEQUITY
dc.subjectINFANT MORTALITY
dc.subjectWORKERS
dc.subjectSOCIAL HEALTH INSURANCE
dc.subjectHEALTH INSURANCE SCHEMES
dc.subjectPUBLIC HEALTH CONCERNS
dc.subjectPUBLIC EXPENDITURE
dc.subjectCROWDING
dc.subjectCARE
dc.subjectHEALTH CARE POLICY
dc.subjectHEALTH POLICY
dc.subjectBUDGETS
dc.subjectDEMAND
dc.subjectHEALTH OUTCOMES
dc.subjectINSURANCE CONTRIBUTIONS
dc.subjectHOSPITAL REVENUES
dc.subjectADULT MORTALITY RATE
dc.subjectFAMILY PLANNING
dc.subjectMEDICAL SUPPLIES
dc.subjectMEDICAL EQUIPMENT
dc.subjectEXPENDITURES
dc.subjectINCOME COUNTRIES
dc.subjectHEALTH CARE FINANCING
dc.subjectFINANCIAL BARRIERS
dc.subjectTEACHING HOSPITALS
dc.subjectPRIVATE SECTOR
dc.subjectMEASUREMENT
dc.subjectNUTRITION
dc.subjectBEDS
dc.subjectHEALTH POSTS
dc.subjectHEALTH CARE PROVIDER
dc.subjectINSURANCE SYSTEM
dc.subjectPRICE OF HEALTH CARE
dc.subjectINTERNET
dc.subjectNATIONAL HEALTH
dc.subjectINSURANCE
dc.subjectHEALTH RESULTS
dc.subjectHEALTH SYSTEM
dc.subjectINSURANCE PREMIUMS
dc.subjectCOMMUNICABLE DISEASES
dc.subjectLOW INCOME
dc.subjectESSENTIAL DRUGS
dc.subjectCHILDREN
dc.subjectDISEASE CONTROL
dc.subjectRISK
dc.subjectHUMAN RESOURCES
dc.subjectDEMAND FOR HEALTH
dc.subjectPOVERTY
dc.subjectHEALTH INSURANCE CONTRIBUTIONS
dc.subjectHEALTH EXPENDITURE
dc.subjectILLNESS
dc.subjectINCIDENCE
dc.subjectPRIVATE SPENDING
dc.subjectPOPULATION
dc.subjectHOSPITAL BEDS
dc.subjectHEALTH- SECTOR
dc.subjectFINANCIAL RISK
dc.subjectSTRATEGY
dc.subjectPRIVATE FINANCING
dc.subjectFEES
dc.subjectHEALTH FINANCING
dc.subjectPUBLIC SPENDING
dc.subjectHOSPITALS
dc.subjectHEALTH SERVICE
dc.subjectINFANT MORTALITY RATE
dc.subjectHEALTH SERVICES
dc.subjectIMPLEMENTATION
dc.subjectHEALTH STRATEGY
dc.subjectPROVIDER PAYMENT
dc.subjectHUMAN DEVELOPMENT
dc.titleAssessing Fiscal Space for Health in Nepal
dc.typeWorking Paper
dc.typeDocument de travail
dc.typeDocumento de trabajo

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