Kathmandu Metropolitan City Advances Health Insurance Program
Kathmandu Metropolitan City (KMC) has made significant strides in enhancing healthcare accessibility through the implementation of its health insurance program. This initiative marks a crucial step in ensuring quality healthcare for all residents. Here are the key aspects of this development:
Urban Health Promotion Centers as Primary Service Points:
- Designation: 24 Urban Health Promotion Centers in KMC wards have been established as primary service points for health insurance.
- Preparations: These centers in 24 out of 32 wards are fully equipped and staffed, with the remaining to be ready within three months.
- Purpose: They serve as the first contact point for insured individuals seeking medical treatment.
Transition to Urban Health Centers:
- Following the refusal of major hospitals like Bir Hospital, TU Teaching Hospital Maharajgunj, and Sukraraj Tropical & Infectious Disease Hospital Teku to act as first service points, KMC has adapted by designating these urban centers.
- Referral System: Patients can receive initial treatment at these centers and be referred to central hospitals if necessary.
Health Insurance Facilitators:
- Deployment: Facilitators have been appointed in all 32 wards to assist with the health insurance process.
- Training: The Health Insurance Board is set to provide orientation training to these facilitators.
- Outreach: Post-training, facilitators will visit households to promote and facilitate health insurance enrollment.
Program Benefits and Registration:
- Coverage Start: Treatment services through the insurance program will be available three months after enrollment.
- Family Plans: A family of up to five members can join the program for Rs.3,500 yearly, with an additional Rs.700 for each extra member beyond five.
Background and Impact:
- Introduction: The government launched the insurance program in 2015 to elevate healthcare quality and accessibility.
- Current Scope: Although 7.4 lakh people are insured, only about 4.7 lakh are active in the program.
- Health Insurance Board: Established on April 7, 2016, it now operates in 77 districts, offering free treatment services to up to one lakh insured families.
KMC’s initiative in designating Urban Health Promotion Centers as first service points is a pivotal move towards enhancing healthcare services in the city. This program not only makes healthcare more accessible but also ensures that quality services reach every citizen efficiently. With ongoing efforts and community participation, Kathmandu is set to witness a significant improvement in its public health landscape.
Kathmandu
