Perception towards national health insurance scheme among enrollees of central Terai: a qualitative study

Abstract

Background: Out of Pocket Expenditure has always been a primary means of financing health care service in Nepal. National Health Insurance Scheme ensures universal health coverage by addressing the unregulated out-of-pocket spending and providing quality of health service.

Methods: A descriptive cross-sectional study was conducted among the enrollees of the National Health Insurance Scheme (NHIS) in Bharatpur Metropolitan City of Chitwan district. Focused Group Discussions were conducted among enrollees to assess the perception towards National Health Insurance Scheme. The qualitative data were analyzed as thematic analysis technique.  

Results: Perception towards National Health Insurance Scheme was categorized as perceived quality of care, perceived benefit and provider’s behavior. Respondents were fully satisfied with the premium charge. Availability of drugs was improved but the waiting time and the process of registration was lengthy and full of jargons. Most of the participants perceived that due to less number of service providers or due to inability of allocating separate provider for ensured persons, the consultation time was very less which further affects the quality of care. Enrollment Assistants were considered as primary source of information regarding the NHIS.

Conclusions: Long waiting time, difficulty during registration and less number of service providers remain challenge to receive quality of care under NHIS. Participants perceived that the benefit package under affordable premium charge is in favor of them. Addressing these factors in expansion of this program in other district might leads for success of this scheme.