Strengthening Universal Health Coverage through Health Insurance (ADB-57204-001)

Countries
  • Nepal
Geographic location where the impacts of the investment may be experienced.
Financial Institutions
  • Asian Development Bank (ADB)
International, regional and national development finance institutions. Many of these banks have a public interest mission, such as poverty reduction.
Project Status
Approved
Stage of the project cycle. Stages vary by development bank and can include: pending, approval, implementation, and closed or completed.
Bank Risk Rating
C
Environmental and social categorization assessed by the development bank as a measure of the planned project’s environmental and social impacts. A higher risk rating may require more due diligence to limit or avoid harm to people and the environment. For example, "A" or "B" are risk categories where "A" represents the highest amount of risk. Results will include projects that specifically recorded a rating, all other projects are marked ‘U’ for "Undisclosed."
Voting Date
Feb 26, 2024
Date when project documentation and funding is reviewed by the Board for consideration and approval. Some development banks will state a "board date" or "decision date." When funding approval is obtained, the legal documents are accepted and signed, the implementation phase begins.
Borrower
Government of Nepal
A public entity (government or state-owned) provided with funds or financial support to manage and/or implement a project.
Sectors
  • Education and Health
  • Technical Cooperation
The service or industry focus of the investment. A project can have several sectors.
Investment Type(s)
Grant
The categories of the bank investment: loan, grant, guarantee, technical assistance, advisory services, equity and fund.
Investment Amount (USD)
$ 1.50 million
Value listed on project documents at time of disclosure. If necessary, this amount is converted to USD ($) on the date of disclosure. Please review updated project documents for more information.
Project Cost (USD)
$ 1.50 million
Value listed on project documents at time of disclosure. If necessary, this amount is converted to USD ($) on the date of disclosure. Please review updated project documents for more information.
Bank Documents
Primary Source

Original disclosure @ ADB website

Updated in EWS May 11, 2024

Disclosed by Bank Mar 6, 2024

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Project Description
If provided by the financial institution, the Early Warning System Team writes a short summary describing the purported development objective of the project and project components. Review the complete project documentation for a detailed description.

According to the Bank’s website, the proposed TA aims to assess issues hampering implementation of National Health Insurance Program (NHIP), identify systemic, policy, procedural, and technical causes, and provide, institutional capacity building, and information management solutions to overcome those challenges. The focus is on both NHIP implementation as well as on the information architecture underpinning the NHIP and other social protection schemes.

Nepal's Current Health Expenditure (CHE) per person of $58 is significantly lower than the South Asia average of $174. The 54% share of out-of-pocket (OOPS) health expenditures of this CHE is slightly higher than the South Asia average of 48%. The share of the government's health expenditure of CHE is 30%, 12% lower than the South Asia average. Nepal spends less on health, and of this low amount is a large part, making households more vulnerable to catastrophic health expenditures and subsequent impoverishment.

To address this, the Government of Nepal has committed to achieve universal health coverage by (i) improving financial risk protection, (ii) providing free quality basic health-care services, and (iii) providing quality and affordable essential medicines for all. The constitution guarantees the fundamental right to access basic health services free of charge, including essential health services due to unforeseen health emergencies, and provides the basis for the Health Insurance Act 2018 ensuring financial risk protection and reducing OOPs. The NHIP is the main instrument to improve financial risk protection for families. All Nepali families can enroll in the NHIP. Those below the poverty line are exempted from paying premium. The Health Insurance HIB) implements the NHIP. In addition, the Social Security Fund provides health insurance to employees, not their families, in the formal sector.

Early Warning System Project Analysis
For a project with severe or irreversible impacts to local community and natural resources, the Early Warning System Team may conduct a thorough analysis regarding its potential impacts to human and environmental rights.

Risk Categorization: Low

Investment Description
Here you can find a list of individual development financial institutions that finance the project.

The TA financing amount is $1,500,000, which will be financed on a grant basis by the Japan Fund for Prosperous and Resilient Asia and the Pacific (JFPR) and administered by ADB. 


Contact Information
This section aims to support the local communities and local CSO to get to know which stakeholders are involved in a project with their roles and responsibilities. If available, there may be a complaint office for the respective bank which operates independently to receive and determine violations in policy and practice. Independent Accountability Mechanisms receive and respond to complaints. Most Independent Accountability Mechanisms offer two functions for addressing complaints: dispute resolution and compliance review.

Contact Information

Project Officer: Rudi Louis Hendrikus Van Dael

Designation: Principal Social Sector Specialist - Asian Development Bank

Email: rvandael@adb.org

ACCESS TO INFORMATION

You can submit an information request for project information at: https://www.adb.org/forms/request-information-form

ADB has a two-stage appeals process for requesters who believe that ADB has denied their request for information in violation of its Access to Information Policy. You can learn more about filing an appeal at: https://www.adb.org/site/disclosure/appeals

ACCOUNTABILITY MECHANISM OF ADB

The Accountability Mechanism is an independent complaint mechanism and fact-finding body for people who believe they are likely to be, or have been, adversely affected by an Asian Development Bank-financed project. If you submit a complaint to the Accountability Mechanism, they may investigate to assess whether the Asian Development Bank is following its own policies and procedures for preventing harm to people or the environment. You can learn more about the Accountability Mechanism and how to file a complaint at: http://www.adb.org/site/accountability-mechanism/main.

How it works

How it works