Health Financing of Nepal: Towards Universal Health Coverage?

Getting your Trinity Audio player ready...

I. Introduction: The Foundation of a Healthy Nation

Health financing—the way funds are raised, pooled, and spent—is the cornerstone of any robust health system. It directly influences the quality, equity, and sustainability of services, and is indispensable for achieving Universal Health Coverage (UHC). In Nepal’s evolving federal context, understanding money flow through various channels is critical. It includes federal, provincial, local, and private channels. This understanding is essential for policymakers, health professionals, academics, and development partners alike.

This post offers:

A concise definition of health financing
Current health financing landscape, with key data
A literature review (2010–present)
Policy and legal frameworks
Time‑series and regional comparisons
Stakeholder perspectives
Challenges, opportunities and recommendations

II. Defining Health Financing: A Global and National Perspective

According to WHO, health financing comprises three core functions:

Revenue Raising: Sources of funds (taxes, insurance premiums, out‑of‑pocket payments, donor aid).
Pooling: Accumulation and management of prepaid funds to spread financial risk.
Purchasing: Strategic allocation of resources to providers, using payment methods that incentivize quality and efficiency WHO Health Financing.

The ultimate goal is UHC: all people receive needed services—promotive, preventive, curative, rehabilitative, and palliative—without financial hardship WHO UHC. Sustainable financing also demands stability, equity, and efficiency over the long term UNDP Sustainable Financing.

III. The Current State of Health Financing in Nepal

Nepal’s National Health Accounts (2019/20) reveal the following:

Indicator	FY 2018/19	FY 2019/20
Total Health Expenditure (THE)	NPR 183.8 billion (5.3% GDP)	NPR 223.4 billion (5.8% GDP)
THE per capita	USD 54.7	USD 63.6
Government Health Expenditure (% of GGE)	5.6%	8.0%
Government Health Expenditure (% of THE)	26.5%	31.9%
Out‑of‑Pocket Expenditure (% of CHE)	57.9%	54.2%
External Funding (% of CHE)	11.9%	10.5%
Health Insurance (% of CHE)	0.8% (FY 2016/17)	—

Key insight: Over half of Nepal’s health costs are still paid directly by households. This payment method risks catastrophic spending and impoverishment NHA 2019/20.

IV. Literature Review (2010–Present)

Federalism & Financing

Studies note mixed effects of federal restructuring on fund allocation and execution. It allows for improved local tailoring. However, coordination delays and underspending remain challenges JOGH 2021.

Social Health Insurance (NHIP)

Launched 2016, but coverage plateaued at ~25% by 2023; dropouts and adverse selection hinder risk pooling BMJ Open 2022.

Out‑of‑Pocket Burden

Persistent OOP >50% of THE for two decades; associated with catastrophic expenditures and inequitable access [Lancet Global Health 2018].

Donor Funding Transition

External contributions fell from ~17% of THE (2000–2017) to ~10–15% by 2020, amid Nepal’s graduation from LDC status WHO GHO.

COVID‑19 Impact

Pandemic spurred a temporary surge in public spending (2020: THE rose to 5.4% of GDP) but strained fiscal space World Bank 2021.

V. Policy & Legal Framework

Document	Year	Highlights
Constitution of Nepal	2015	Health as a fundamental right; mandates free basic and emergency care [Art. 35].
Public Health Service Act	2018	Legally guarantees free essential health services and emergency care.
Health Insurance Act	2017	Establishes NHIP; aims for universal enrollment and financial protection.
National Health Policy	2019	Sets UHC vision; prioritizes equitable access and financing reforms.
NHSS / NHSSP	2016–21, 2023–30	Roadmaps for system strengthening, including financing and social protection.
National Health Financing Strategy	2023–33	Targets 10% of government budget for health; expands fiscal space; improves pooling.

These frameworks signal strong policy intent. Implementation gaps—in budget execution, local capacity, and financial management—must be closed for real impact.

VI. Time‑Series Analysis (2016–2020)

Indicator	FY 2016/17	FY 2017/18	FY 2018/19	FY 2019/20	FY 2020/21
Govt Health Exp. (% of GDP)	1.7%	—	—	2.2%	2.4%
OOP (% of CHE)	—	—	57.9%	54.2%	—
NHIP Coverage (% of pop.)	—	—	—	—	25%

Trend: Modest rise in public spending, but OOP remains stubbornly high. Insurance shows nascent growth but needs scale to affect OOP.

VII. Nepal in the South Asian Context

Country	CHE (% GDP)	Govt Exp. (% GDP)	OOP (% CHE)	Insurance Coverage
Nepal	5.4%	1.1%	51.3%	~25% (NHIP)
India	3.3%	1.0%	49.8%	~40% (PM-JAY & states)
Bangladesh	2.4%	0.4%	73.0%	<10% (pilot SHI schemes)
Sri Lanka	4.1%	2.0%	43.6%	~100% (tax‑funded system)
Bhutan	4.0%	3.4%	18.8%	~100% (free public care)

Lesson: Countries with stronger public financing (Sri Lanka, Bhutan) achieve lower OOP and better financial protection. Nepal’s mix resembles India but at a smaller scale.

VIII. Voices from the Ground

MoHP officials warn budget caps risk undoing gains: only 1.11% of GDP is public health spending, while OOP is ~3.5% of GDP, ~60% of THE [Kathmandu Post 2024].
Health Insurance Board reports: claim‑reimbursement delays, rising administrative costs, and beneficiary dissatisfaction due to medicine stock‑outs [HIB Annual Report 2023].
Local governments cite delays in fund disbursement and low absorptive capacity as barriers to program rollout [NLTA Workshop 2023].

IX. Challenges & Opportunities

Challenges	Opportunities
High OOP (>50% of THE)	NHFS 2023–33: roadmap to 10% health budget
Low govt spending (≈2% of GDP)	Earmarked “sin taxes” (tobacco/alcohol)
NHIP low enrollment & retention	Digital enrollment platforms; incentives for renewals
Fragmented schemes & federal coordination	Performance‑based budgeting; pooled procurements
Reduced donor aid	Domestic resource mobilization; blended finance

X. Conclusion & Recommendations

To realize UHC, Nepal must bolster public investment, strengthen insurance, and reduce out‑of‑pocket burden. Key steps:

Increase health budget toward 5–6% of GDP (WHO) by protecting/enhancing the sector’s share.
Revitalize NHIP: expand benefits, streamline claims, subsidize premiums for the poor.
Improve financial management: timely fund flows, build local fiscal capacity, integrate schemes.
Innovative financing: earmark health taxes, explore health bonds, enhance DRM.
Invest in primary care: expand free essential services, ensure medicine supply.
Monitor & evaluate: robust M&E systems to track expenditures, outcomes, equity.
Multi‑stakeholder engagement: align ministries, partners, civil society, and communities.

Nepal’s policy frameworks are progressive but implementation must accelerate. Nepal can seize policy momentum, which is anchored in the National Health Financing Strategy 2023–2033. By learning from regional peers, Nepal can build an equitable, efficient, and sustainable health financing system. This system should deliver quality care without financial hardship for every citizen.

Source	Authentic URL	Why to Read
1	https://www.who.int/health-topics/health-financing	Provides the WHO’s definition of health financing and its core functions.
2	https://www.worldbank.org/en/topic/health/overview	Offers an overview of the World Bank’s perspective on health financing and universal health coverage.
3	https://www.who.int/health-topics/health-financing	Elaborates on the core functions of health financing as defined by the WHO.
4	https://www.who.int/health-topics/health-financing	Further explains the concept of health financing and its importance in achieving universal health coverage.
5	https://www.who.int/health-topics/health-financing	Reinforces the WHO’s definition and objectives of health financing.
6	https://www.who.int/health-topics/health-financing	Highlights the importance of sustainable health financing for long-term health system development.
7	https://nhrc.gov.np/wp-content/uploads/2023/04/Policy-brief-Towards-Universal-Health-Coverage.pdf	A policy brief discussing Nepal’s progress towards universal health coverage, including health financing challenges.
8	https://publichealthupdate.com/nepal-national-health-accounts-2018-19-and-2019-20/	Presents key findings from Nepal’s National Health Accounts for fiscal years 2018/19 and 2019/20, providing data on health expenditure.
9	https://nhrc.gov.np/wp-content/uploads/2023/04/Policy-brief-Towards-Universal-Health-Coverage.pdf	Provides data and analysis on the state of health financing in Nepal, including government expenditure and out-of-pocket payments.
10	https://bmjopen.bmj.com/content/11/11/e050922	Examines the coverage and equity of health insurance enrollment in Nepal.
11	https://nhrc.gov.np/wp-content/uploads/2023/04/Policy-brief-Towards-Universal-Health-Coverage.pdf	Outlines the constitutional mandate for health and discusses health financing policies in Nepal.
12	https://nhrc.gov.np/wp-content/uploads/2023/04/Policy-brief-Towards-Universal-Health-Coverage.pdf	Presents data on out-of-pocket expenditure and its impact on financial hardship in Nepal.
13	https://nhrc.gov.np/wp-content/uploads/2023/04/Policy-brief-Towards-Universal-Health-Coverage.pdf	Discusses the challenges faced by the government in adequately financing healthcare in Nepal.
14	https://nhrc.gov.np/wp-content/uploads/2023/04/Policy-brief-Towards-Universal-Health-Coverage.pdf	Provides data on government health expenditure as a percentage of GDP in Nepal.
15	https://www.worldbank.org/en/topic/health/overview	Highlights the World Bank’s efforts to support universal health coverage.
16	https://nhrc.gov.np/wp-content/uploads/2023/04/Policy-brief-Towards-Universal-Health-Coverage.pdf	Mentions external aid as a source of health financing in Nepal.
17	https://pmc.ncbi.nlm.nih.gov/articles/PMC10311367/	Discusses the impact of federalism and the COVID-19 pandemic on health financing in Nepal.
18	https://pmc.ncbi.nlm.nih.gov/articles/PMC10311367/	Examines the challenges of limited fiscal space for local governments in health financing.
19	https://www.researchgate.net/publication/371950537_Nepal_health_financing_in_light_of_federalism_and_pandemic	Offers a viewpoint on Nepal’s health financing in the context of federalism and the pandemic.
20	https://pmc.ncbi.nlm.nih.gov/articles/PMC10311367/	Highlights the increase in the Ministry of Health and Population’s budget during the federalism period.
21	https://pmc.ncbi.nlm.nih.gov/articles/PMC10311367/	Points out the issue of delayed release of funds as a challenge in health financing under federalism.
22	https://www.researchgate.net/publication/375237329_Overcoming_the_challenges_facing_Nepal’s_health_system_during_federalisation_an_analysis_of_health_system_building_blocks 1	Identifies poor coordination between government tiers as a challenge in Nepal’s health system under federalism.
23	https://pmc.ncbi.nlm.nih.gov/articles/PMC12021158/	Provides information on the objectives and challenges of the National Health Insurance Program in Nepal.
24	https://pmc.ncbi.nlm.nih.gov/articles/PMC12021158/	Details the features and challenges of the National Health Insurance Program in Nepal.
25	https://pmc.ncbi.nlm.nih.gov/articles/PMC12021158/	Discusses the low enrollment and high dropout rates in Nepal’s National Health Insurance Program.
26	https://pmc.ncbi.nlm.nih.gov/articles/PMC12021158/	Reports on the concerns about the quality of healthcare services within the National Health Insurance Program.
27	https://pmc.ncbi.nlm.nih.gov/articles/PMC12021158/	Highlights the issues related to medicine and diagnostic facilities affecting the National Health Insurance Program.
28	https://pmc.ncbi.nlm.nih.gov/articles/PMC12021158/	Mentions the increased patient load in public facilities due to the National Health Insurance Program.
29	https://bmjopen.bmj.com/content/11/11/e050922	Shows that households from richer wealth quintiles are more likely to have health insurance membership.
30	https://pmc.ncbi.nlm.nih.gov/articles/PMC12021158/	Indicates the increased administrative burden on service providers due to the National Health Insurance Program.
31	https://pmc.ncbi.nlm.nih.gov/articles/PMC12021158/	Points out the lack of awareness and health insurance literacy as a challenge for the National Health Insurance Program.
32	https://nhrc.gov.np/wp-content/uploads/2023/04/Policy-brief-Towards-Universal-Health-Coverage.pdf	Reveals disparities in healthcare utilization based on wealth quintiles in Nepal.
33	https://www.researchgate.net/publication/371950537_Nepal_health_financing_in_light_of_federalism_and_pandemic	Notes the increase in per capita government spending on health in Nepal between 2000 and 2017.
34	https://www.researchgate.net/publication/371950537_Nepal_health_financing_in_light_of_federalism_and_pandemic	Mentions the tripling of the Ministry of Health and Population’s budget during the federalism period.
35	https://www.researchgate.net/publication/371950537_Nepal_health_financing_in_light_of_federalism_and_pandemic	Discusses the limited fiscal space for local governments in health.
36	https://academic.oup.com/heapol/article/31/7/817/1749611	Indicates a pro-rich distribution of healthcare use in private service providers in Nepal.
37	https://academic.oup.com/heapol/article/31/7/817/1749611	Shows an increase in per capita government spending on health in Nepal between 2000 and 2011.
38	https://pmc.ncbi.nlm.nih.gov/articles/PMC10311367/	Highlights the impact of COVID-19 lockdowns on reducing coverage of essential health services.
39	https://pmc.ncbi.nlm.nih.gov/articles/PMC10311367/	Notes the limited increase in budget allocation at the subnational level for COVID-19 activities.
40	https://www.researchgate.net/publication/371950537_Nepal_health_financing_in_light_of_federalism_and_pandemic	Mentions the COVID-19-imposed lockdowns in 2020 leading to a decrease in institutional births.
41	https://nhrc.gov.np/wp-content/uploads/2023/04/Policy-brief-Towards-Universal-Health-Coverage.pdf	States the constitutional mandate for free basic health services in Nepal.
42	https://nhrc.gov.np/wp-content/uploads/2023/04/Policy-brief-Towards-Universal-Health-Coverage.pdf	Mentions the government’s commitment to achieving Universal Health Coverage as per the SDGs.
43	https://publichealthupdate.com/nepal-health-sector-strategic-plan-2023-2030/	Provides an overview of the Nepal Health Sector Strategic Plan 2023-2030.
44	https://publichealthupdate.com/nepal-health-sector-strategic-plan-2023-2030/	Outlines the strategic objectives of the Nepal Health Sector Strategic Plan 2023-2030, including promoting sustainable financing.
45	https://publichealthupdate.com/national-health-financing-strategy-2080-2090/	Provides information about the National Health Financing Strategy 2080-2090 (2023-2033).
46	https://publichealthupdate.com/national-health-financing-strategy-2080-2090/	States the aim of the National Health Financing Strategy to ensure equitable financial management for UHC.
47	https://publichealthupdate.com/national-health-financing-strategy-2080-2090/	Mentions the strategic interventions of the National Health Financing Strategy.
48	https://p4h.world/en/news/nepal-national-health-financing-strategy-2023-2033/	Describes the key objective of the National Health Financing Strategy 2023-2033.
49	https://p4h.world/en/news/nepal-national-health-financing-strategy-2023-2033/	Lists the strategic interventions of the National Health Financing Strategy 2023-2033.
50	https://nhrc.gov.np/wp-content/uploads/2023/04/Policy-brief-Towards-Universal-Health-Coverage.pdf	Refers to the Public Health Service Act (2018) reinforcing the right to free basic health services.
51	https://data.who.int/countries/524	Provides data on current health expenditure as a percentage of GDP for Nepal in 2021.
52	https://www.google.com/search?q=https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS%3Flocations%3DNP-IN-BD-LK	Shows current health expenditure as a percentage of GDP for South Asian countries in 2021.
53	https://www.scielo.org.mx/scielo.php?pid=S0185-16672022000100117&script=sci_arttext	Presents data on current health expenditure as a percentage of GDP for South Asian countries.
54	https://www.google.com/search?q=https://data.worldbank.org/indicator/SH.XPD.GHED.GD.ZS%3Flocations%3DNP-IN-BD-LK	Shows government health expenditure as a percentage of GDP for South Asian countries (latest available data).
55	https://data.who.int/countries/524	Provides data on out-of-pocket expenditure as a percentage of current health expenditure for Nepal in 2021.
56	https://www.worldbank.org/en/topic/universalhealthcoverag 2 e/publication/high-performance-health-financing-for-universal-health-coverage-driving-sustainable-inclusive-growth-in-the-21st-century	Mentions that people in developing countries pay over half a trillion dollars out-of-pocket for health services annually.
57	https://www.google.com/search?q=https://www.nhp.gov.in/health-schemes_pg	Lists various government-funded health insurance schemes in India.
58	https://www.worldbank.org/en/topic/health/publication/from-double-shock-to-double-recovery-health-financing-in-the-time-of-covid-19	Indicates that Sri Lanka initially responded well to the COVID-19 pandemic due to better UHC indicators.
59	https://www.social-protection.org/gimi/RessourcePDF.action?id=57665	Describes Sri Lanka’s health system with a dominant government role in healthcare provision.
60	https://www.ijhpm.com/article_4179.html	Mentions that health financing is underfunded in Bangladesh.
61	https://www.social-protection.org/gimi/RessourcePDF.action?id=57665	Notes that government spending constitutes a significant portion of health financing in Sri Lanka.
62	https://www.social-protection.org/gimi/RessourcePDF.action?id=57665	Indicates that out-of-pocket spending is also a major source of health financing in Sri Lanka.
63	https://www.social-protection.org/gimi/RessourcePDF.action?id=57665	States that health insurance contributes only fractionally to health financing in Sri Lanka.
64	https://www.social-protection.org/gimi/RessourcePDF.action?id=57665	Mentions that external funding is a minor source of health financing in Sri Lanka.
65	https://www.social-protection.org/gimi/RessourcePDF.action?id=57665	Highlights that most private healthcare in Sri Lanka is financed by out-of-pocket expenditures.
66	https://www.google.com/search?q=https://www.nhp.gov.in/health-schemes_pg	Provides information on the Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY) in India.
67	https://www.google.com/search?q=https://www.nhp.gov.in/health-schemes_pg	Describes the Rashtriya Swasthya Bima Yojana (RSBY) in India.
68	https://pubmed.ncbi.nlm.nih.gov/28759681/	Shows low financial risk protection in Nepal compared to other South Asian countries.
69	https://www.google.com/search?q=https://www.nhp.gov.in/health-schemes_pg	Mentions the funding division between central and state governments for public insurance schemes in India.
70	https://www.ijhpm.com/article_4179.html	States that out-of-pocket contributions to health expenditure in Bangladesh are among the highest in the world.
71	https://www.ijhpm.com/article_4179.html	Notes the questionable quality of care in the public sector in Bangladesh.
72	https://www.ijhpm.com/article_4179.html	Indicates that health expenditure in private facilities in Bangladesh is almost exclusively from out-of-pocket payments.
73	https://www.ijhpm.com/article_4179.html	Mentions the Bangladeshi Constitution’s commitment to address inequalities in access to health.
74	https://www.ijhpm.com/article_4179.html	States that health insurance, both national and private, is practically nonexistent in Bangladesh.
75	https://shs.gov.np/	Official website of the Health Insurance Board in Nepal.
76	https://kathmandupost.com/health/2025/05/02/budget-cap-threatens-years-of-nepal-s-healthcare-gains-officials-warn	Reports on health officials warning about budget caps threatening healthcare gains in Nepal.
77	https://www.researchgate.net/publication/371950537_Nepal_health_financing_in_light_of_federalism_and_pandemic	Discusses the need for Nepal to increase domestic resource mobilization for health.
78	https://www.worldbank.org/en/topic/health/overview	Highlights the World Bank’s focus on improving the efficiency of spending in health.
79	https://www.worldbank.org/en/topic/health/overview	Mentions the World Bank’s support for strengthening primary care systems.
80	https://www.worldbank.org/en/topic/health/publication/from-double-shock-to-double-recovery-health-financing-in-the-time-of-covid-19	Indicates a decline in per capita government health spending in low- and lower-middle-income countries after an initial COVID-19 peak.
81	https://www.google.com/search?q=https://data.worldbank.org/indicator/SH.XPD.GHED.GD.ZS%3Flocations%3DNP-IN-BD-LK	Provides data on domestic general government health expenditure as a percentage of GDP for South Asian countries.
82	https://www.worldbank.org/en/topic/universalhealthcoverage	States that governments in low-income countries spend less than 2% of GDP on health.
83	https://www.who.int/docs/default-source/nepal-documents/procurement/health-financing-for-srh-services.pdf?sfvrsn=d7315d31_2	Mentions the Government of Nepal’s commitment to provide a Basic Healthcare Services package free of cost.
84	https://nhrc.gov.np/wp-content/uploads/2023/04/Policy-brief-Towards-Universal-Health-Coverage.pdf	Notes that the percentage of the national budget allocated to health in Nepal has mostly remained below 7%.
85	https://www.unicef.org/rosa/media/10016/file/Social%20spending%20in%20South%20Asia.pdf	Shows that South Asia spends less on health compared to other regions.
86	https://pmc.ncbi.nlm.nih.gov/articles/PMC12040125/	Describes community-based health systems in Nepal.
87	https://ieg.worldbankgroup.org/reports/f4d-health-finance-summary	Highlights that the way countries finance health care influences health system performance.
88	https://kathmandupost.com/columns/2025/02/05/sustainable-financing-for-health	Discusses the high out-of-pocket payments in Nepal’s health financing.
89	https://www.google.com/search?q=https://data.worldbank.org/indicator/SH.XPD.GHED.GD.ZS%3Flocations%3DNP-IN-BD-LK	Provides data on government health expenditure as a percentage of GDP for Nepal in 2020.
90	https://www.jointlearningnetwork.org/wp-content/uploads/2021/12/Nepal-JLN-General-Gov-Expenditures-23092021.pdf	Shows Nepal’s government expenditures as a percentage of GDP in 2017.
91	https://www.researchgate.net/publication/371950537_Nepal_health_financing_in_light_of_federalism_and_pandemic	Indicates that the Ministry of Health and Population’s budget tripled in five years of federalism.
92	https://www.exemplars.health/-/media/files/vaccine-delivery/nepal/36-nhsp_ip.pdf	Mentions the WHO Commission on Macroeconomics and Health’s recommendation for health spending in developing countries.
93	https://publichealthupdate.com/health-sector-budget-for-fiscal-year-2023-24-red-book/ 3	Provides the health sector budget for Nepal’s fiscal year 2023-24.
94	https://pmc.ncbi.nlm.nih.gov/articles/PMC9862822/ 4	Lists challenges in the implementation and sustainability of Nepal’s National Health Insurance Program.
95	https://www.ncbi.nlm.nih.gov/books/NBK590186/	Defines health financing and its core functions.
96	https://www.researchgate.net/publication/316640925_On_the_examination_Of_out-of-pocket_health_expenditures_in_India_Pakistan_Sri_Lanka_Maldives_Bhutan_Bangladesh_and_Nepal	States that out-of-pocket health expenditure as a percentage of total expenditure on health is highest for India among the studied South Asian countries.
97	https://wjarr.com/sites/default/files/WJARR-2024-0587.pdf	Emphasizes the need for good governance and increased government spending on health in Nepal.
98	https://nhrc.gov.np/wp-content/uploads/2023/04/Policy-brief-Towards-Universal-Health-Coverage.pdf	Provides data on government health expenditure as a percentage of GDP for FY 2020/21.
99	https://pmc.ncbi.nlm.nih.gov/articles/PMC6154066/	Shows the percentage of out-of-pocket expenditure in current health expenditure for Nepal in 2015.
100	https://www.google.com/search?q=https://www.joghr.org/article/94931	Highlights the progress in health indicators in Nepal over the last few years.
101	https://ieg.worldbankgroup.org/blog/health-financing-drives-equitable-health-care	Points to health financing as a key policy instrument for equitable healthcare.
102	https://pmc.ncbi.nlm.nih.gov/articles/PMC10143109/	Provides an estimate of the additional amount required to meet UHC service utilization standards in Nepal.
103	https://www.worldbank.org/en/topic/health/overview	States the World Bank’s commitment to helping developing countries achieve Universal Health Coverage.
104	https://www.kfw-entwicklungsbank.de/PDF/Download-Center/Dokumente-Evaluierung/Sector-wide-Approach-Healthcare.pdf	Mentions the percentage of external help in Nepal’s total current health expenditure.
105	https://pmc.ncbi.nlm.nih.gov/articles/PMC10311367/	Notes the high out-of-pocket payment as a percentage of all health expenditures in Nepal.
106	https://gh.bmj.com/content/8/Suppl_8/e012040	Indicates that health taxes in Nepal are below WHO-recommended rates.
107	https://www.medrxiv.org/content/10.1101/2021.05.27.21257843v1.full-text	States that health financing in Nepal is highly dependent on out-of-pocket expenditure.
108	https://pmc.ncbi.nlm.nih.gov/articles/PMC10311367/	Highlights the fragmented management of social health protection programs in Nepal.
109	https://www.scirp.org/journal/paperinformation?paperid=35544	Discusses health care financing mechanisms to improve equity in health care in developing countries.
110	https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.978732/full	Reports high out-of-pocket expenditure for healthcare in Nepal.
111	https://documents1.worldbank.org/curated/en/187641594202895951/pdf/Situational-Analysis-of-Health-Financing-in-Nepal.pdf	Provides a situational analysis of health financing in Nepal.
112	https://pmc.ncbi.nlm.nih.gov/articles/PMC10257514/	Mentions the World Health Organization’s estimate of Nepal’s UHC service coverage index in 2019.
113	https://www.joghr.org/api/v1/articles/94931-understanding-key-factors-for-strengthening-nepal-s-healthcare-needs-health-systems-perspectives.pdf	Describes the historical development of Nepal’s healthcare delivery system.
114	https://www.who.int/teams/health-financing-and-economics/health-financing	Provides information on the WHO’s work on health financing.
115	https://pubmed.ncbi.nlm.nih.gov/37291678/	Reviews the impact of federalization on Nepal’s health system.
116	https://pmc.ncbi.nlm.nih.gov/articles/PMC9862822/	Outlines the mixed healthcare financing system in Nepal.
117	https://apps.who.int/iris/bitstream/handle/10665/205257/B0677.pdf?sequence=1	Presents an overview of major challenges in Nepal’s health sector.
118	https://rune.une.edu.au/web/retrieve/d7b1f5be-d5d4-4067-9c13-7484c18981eb	Describes a study involving interviews with public health officials in Nepal.
119	https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.978732/full	Reports on a study examining healthcare expenditure in Nepal.
120	https://pmc.ncbi.nlm.nih.gov/articles/PMC12040125/	Highlights challenges to healthcare system sustainability in Nepal.
121	https://pmc.ncbi.nlm.nih.gov/articles/PMC11971764/	Examines the catastrophic and impoverishing impact of household-level healthcare expenditures in Nepal.
122	https://jogh.org/the-nepalese-health-care-system-and-challenges-during-covid-19/	Discusses the challenges faced by the healthcare system in Nepal during the COVID-19 pandemic.
123	https://pmc.ncbi.nlm.nih.gov/articles/PMC6154066/	Documents the financial protection status in South-East Asian countries, including Nepal.
124	https://pmc.ncbi.nlm.nih.gov/articles/PMC11308952/	Explores the perspectives of healthcare professionals working in rural areas of Nepal.
125	https://www.who.int/nepal/news/detail/18-06-2024-stakeholder-s-consultative-workshop-on-health-financing-strategy-implementation-plan-2023-2033-held	Reports on a stakeholder’s consultative workshop on Health Financing Strategy Implementation Plan 2023-2033 in Nepal.
126	https://www.social-protection.org/gimi/RessourcePDF.action?id=57665	Describes the absence of major health financing reforms in Sri Lanka compared to other low-income countries.
127	https://humancapital.worldbank.org/en/indicator/WB_HCP_HEALTH_EXP	Provides data on current health expenditure as a percentage of GDP.
128	https://heu.portal.gov.bd/sites/default/files/files/heu.portal.gov.bd/page/c1d65061_f61c_4df2_bd96_cd2e06a4d7f9/2024-04-22-09-54-6a997da367a434169e7da35af5dc7d4b.pdf	Mentions the participatory process in reviewing Bangladesh’s Health Care Financing Strategy.
129	https 5 ://kathmandupost.com/columns/2025/02/05/sustainable-financing-for-health	Discusses the need 6 for sustainable health financing in Nepal.
130	https://pmc.ncbi.nlm.nih.gov/articles/PMC11521915/	Proposes a conceptual framework for responsive financing of district hospitals in India.
131	https://ibn.gov.np/uploads/documents/summaryhealthpdf-1746-819-1730783448.pdf 7	Provides an overview of Nepal’s health sector, including expenditure.
132	https://www.researchgate.net/publication/375237329_Overcoming_the_challenges_facing_Nepal’s_health_system_during_federalisation_an_analysis_of_health_system_building_blocks 8	Identifies opportunities and challenges in Nepal’s health system during federalisation.
133	https://www.researchgate.net/publication/316640925_On_the_examination_Of_out-of-pocket_health_expenditures_in_India_Pakistan_Sri_Lanka_Maldives_Bhutan_Bangladesh_and_Nepal	Analyzes healthcare expenditures in seven South Asian countries.
134	https://www.intelligencefusion.co.uk/insights/resources/article/healthcare-risk-and-health-system-sustainability-in-south-asia/	Discusses healthcare risk and health system sustainability in South Asia, including Nepal.
135	https://www.who.int/teams/health-financing-and-economics/health-financing	Defines health financing and its role in universal health coverage.
136	https://undp-capacitydevelopmentforhealth.org/undp-support-to-sustainable-health-financing/	Explains the concept of sustainable health financing.
137	https://internationalbudget.org/publications/examining-budget-credibility-in-nepals-health-sector/	Examines budget credibility in Nepal’s health sector.
138	https://www.cia.gov/the-world-factbook/field/current-health-expenditure/	Provides a list of countries and their current health expenditure.
139	https://dhs.maryland.gov/child-support-services/	This URL is not relevant to health financing in Nepal.
140	https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?locations=8S	Shows current health expenditure as a percentage of GDP for South Asia.
141	https://www.who.int/nepal/news/detail/18-06-2024-stakeholder-s-consultative-workshop-on-health-financing-strategy-implementation-plan-2023-2033-held	Reports on a workshop about Nepal’s Health Financing Strategy Implementation Plan.
142	https://chartingtheglobe.com/region/micronesia/health/heathcare-expenditure?indicator=government-health-expenditure-of-gdp	This URL is not directly relevant as it focuses on Micronesia.
143	https://ibn.gov.np/uploads/documents/health-sector-full-versionpdf-1746-552-1730779800.pdf	Provides information on Nepal’s health sector and investment opportunities.
144	https://www.cia.gov/the-world-factbook/field/current-health-expenditure/	Lists countries and their current health expenditure.
145	https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?locations=NP	Shows Nepal’s current health expenditure as a percentage of GDP.
146	https://www.commonwealthfund.org/international-health-policy-center/countries/india	Describes India’s health insurance schemes and financing.
147	https://data.worldbank.org/indicator/SH.XPD.GHED.PP.CD	Provides data on domestic general government health expenditure per capita (PPP).
148	https://humancapital.worldbank.org/en/indicator/WB_HCP_HEALTH_EXP	Shows current health expenditure as a percentage of GDP for various countries.
149	https://data360.worldbank.org/en/indicator/WB_WDI_SH_XPD_GHED_GD_ZS	Provides data on domestic general government health expenditure as a percentage of GDP.
150	https://www.grantthornton.in/en/insights/thought-leadership/vitals-for-growth-decoding-healthcare-financing-and-funding-in-india/	Discusses healthcare financing and funding in India.
151	https://www.slideshare.net/slideshow/financing-in-health-care-sector-in-sri-lanka-suleimanpptx/267162682	Provides an overview of healthcare financing in Sri Lanka.
152	https://l4uhc.world/nepals-strategic-breakthrough/	Reports on Nepal’s progress in developing a National Health Financing Strategy.
153	https://www.tandfonline.com/doi/full/10.1080/16549716.2024.2432069	Mentions Nepal’s National Health Policy recognizing climate change as a threat to the health system.
154	https://documents1.worldbank.org/curated/en/187641594202895951/pdf/Situational-Analysis-of-Health-Financing-in-Nepal.pdf	Provides a situational analysis of health financing in Nepal.
155	https://shs.gov.np/	Official website of Nepal’s Health Insurance Board.
156	https://www.tbsnews.net/thoughts/towards-transformative-framework-health-financing-bangladesh-1093436	Discusses health financing models in Bangladesh.
157	https://kathmandupost.com/columns/2025/02/05/sustainable-financing-for-health	Highlights the high out-of-pocket payments in Nepal’s health financing.
158	https://www.exemplars.health/topics/vaccine-delivery/nepal/what-did-nepal-do	Mentions Nepal’s recognition of vaccination as a human right.
159	https://pmc.ncbi.nlm.nih.gov/articles/PMC11125507/	Assesses user satisfaction with Nepal’s National Health Insurance Program.
160	https://www.youtube.com/watch?v=0gHXTWOVV4E	A news report on maternal mortality rate reduction in Nepal and budget issues.
161	https://p4h.world/en/news/nepal-national-health-financing-strategy-2023-2033/	Announces the endorsement of Nepal’s National Health Financing Strategy 2023-2033.
162	https://www.ips.lk/wp-content/uploads/2018/07/Health-Care-Financing-in-Sri-Lanka.pdf	Describes health care financing in Sri Lanka.
163	https://publichealth.tulane.edu/blog/healthcare-finance/	Explains the concept of healthcare finance.
164	https://www.jointlearningnetwork.org/wp-content/uploads/2021/12/Nepal-JLN-General-Gov-Expenditures-23092021.pdf	Shows Nepal’s total government expenditures as a percentage of GDP in 2017.
165	https://l4uhc.world/nepals-national-health-financing-strategy/	Reports on the development of Nepal’s National Health Financing Strategy.
166	https://www.gavinpublishers.com/article/view/health-system-in-nepal-in-context-of-who-building-blocks	Provides an overview of Nepal’s health system in the context of WHO building blocks.
167	https://www.cbgaindia.org/blog/health-care-financing-india-time-revisit-policy-framework/	Discusses the healthcare financing policy framework in India.
168	https://risingnepaldaily.com/news/40853	Highlights inefficiencies in Nepal’s healthcare delivery and resource management.
169	https://apps.who.int/nha/database/country_profile/index/en	Provides WHO data on health expenditure for various countries.
170	https://documents.worldbank.org/curated/en/423511468307190661/pdf/899540WP0Box380th0Care0in0Sri0Lanka.pdf	Reviews the private health sector in Sri Lanka.
171	https://www.iomcworld.org/open-access/efficiency-of-health-sector-in-south-asia-some-evidences-from-stochastic-frontier-analysis-47306.html	Examines the efficiency of the health sector in South Asia.
172	https://medicopublication.com/index.php/ijphrd/article/download/18797/16306/36599	Analyzes health status, financing, and facilities in South Asian countries.
173	https://data.worldbank.org/indicator/SH.XPD.GHED.CH.ZS	Provides data on domestic general government health expenditure as a percentage of current health expenditure.
174	https://www.health.gov.au/sites/default/files/documents/2021/12/national-preventive-health-strategy-2021-2030_1.pdf	This URL is not directly relevant as it focuses on Australia’s preventive health strategy.
175	https://pubmed.ncbi.nlm.nih.gov/36537796/	Reviews health and socioeconomic resources for older people in South Asian countries.
176	https://binaytara.org/news/news/binaytara-hosts-landmark-policy-debate-on-health-insurance-reform-in-nepal	Reports on a policy debate on health insurance reform in Nepal.
177	https://datos.bancomundial.org/indicador/SH.XPD.OOPC.CH.ZS?locations=NP	Shows out-of-pocket expenditure as a percentage of current health expenditure for Nepal.
178	https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS	Provides data on current health expenditure as a percentage of GDP.
179	https://www.macrotrends.net/global-metrics/countries/npl/nepal/healthcare-spending	Presents Nepal’s healthcare spending data.
180	https://data.worldbank.org/indicator/SH.XPD.OOPC.CH.ZS	Provides data on out-of-pocket expenditure as a percentage of current health expenditure.
181	https://www.google.com/search?q=https://datos.bancomundial.org/indicador/SH.XPD.GHED.GD.ZS%3Flocations%3DIN	Shows domestic general government health expenditure as a percentage of GDP for India.
182	https://www.who.int/nepal/news/detail/18-06-2024-stakeholder-s-consultative-workshop-on-health-financing-strategy-implementation-plan-2023-2033-held	Reports on a stakeholder workshop on Nepal’s Health Financing Strategy Implementation Plan.
183	https://nhsrcindia.org/hc-financing	Explains health care financing and its relevance to universal health coverage.
184	https://documents1.worldbank.org/curated/en/187641594202895951/pdf/Situational-Analysis-of-Health-Financing-in-Nepal.pdf	Indicates that the document focuses on opportunities and financial challenges in achieving UHC in Nepal.
185	https://p4h.world/en/countries/sri-lanka/	Provides key health financing indicators for Sri Lanka.
186	https://blume.vc/reports/healthcare-financing-india-bluprint	Discusses healthcare financing in India.
187	https://data.worldbank.org/indicator/SH.XPD.OOPC.CH.ZS	Provides data on out-of-pocket expenditure as a percentage of current health expenditure.
188	https://p4h.world/en/news/nepal-national-health-financing-strategy-2023-2033/	Announces the endorsement of Nepal’s National Health Financing Strategy 2023-2033.
189	https://data.worldbank.org/indicator/SH.XPD.EHEX.PP.CD?locations=8S	Provides data on external health expenditure per capita (PPP) for South Asia.
190	https://ijphap.com/index.php/home/article/view/71	Reports on a study about healthcare providers’ perspectives on Nepal’s National Health Insurance Program.
191	https://www.google.com/search?q=https://kathmandupost.com/columns/2025/02/05/sustainable-financing-for-health%23:~:text%3DThe%2520Nepal%2520Health%2520Financing%2520Strategy,enhance%2520financial%2520protection%2520in%2520health.	Highlights the Nepal Health Financing Strategy 2023-2033’s aim to enhance financial protection in health.
192	https://www.oecd.org/en/topics/policy-issues/official-development-assistance-oda.html	Explains what Official Development Assistance (ODA) is.
193	https://www.jointlearningnetwork.org/wp-content/uploads/2021/02/Bangladesh-JLN-Health-Expenditure-18Feb2021.pdf	Provides data on public expenditure for health in Bangladesh.
194	https://faolex.fao.org/docs/pdf/nep187742.pdf	This URL appears to be related to FAO and not directly relevant to health financing in Nepal.
195	https://digitalcommons.library.umaine.edu/etd/3009/	Assesses the public and private health sectors in Nepal.
196	https://www.jointlearningnetwork.org/wp-content/uploads/2021/12/Nepal-JLN-General-Gov-Expenditures-23092021.pdf	Compares health outcomes across different countries.
197	https://wdi.worldbank.org/table/2.12	Provides World Bank data on health expenditure.
198	http://oldweb.heu.gov.bd/health-care-financing-strategy/	Provides information on Bangladesh’s Health Care Financing Strategy 2012-2032.