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Pro-poor health policy in Nepal: Enlarging people's choices
*Jhabindra Bhandari, CARE Nepal  

Keywords: pro-poor, health policy, health equity

Background:

Nepal is one of the least developed countries in the world. Poverty, illiteracy, poor public health system are tremendously impacting on majority of people's lives who are living in rural areas and limited access to primary health care services. The government of Nepal declared the free health care policy from early 2008 with a view to improve access to and utilization of health services for people who are poor, socially disadvantaged and marginalized communities. The new health policy has highlighted the needs to expand health services in rural areas where there is acute lack of human resources, irregular supplies of drugs and equipment and poor health infrastructure. The pro-poor health policy aims to narrow the wider gaps of disparities in health care by ensuring health equity and the rights of people to their health and life.

Objective: The objective of this study is to explore the effects of pro-poor health care policy at the community levels.

Methods:

It was a cross-sectional study with primary focus on qualitative research methodology. The methods for data collection were focus group discussion and in-depth interviews with service providers in local health facilities, community groups, key informants and the beneficiaries. Besides, the data from health management information system at local health facilities were reviewed to analyze the trend of health service utilization over the period of two years.

Results and Conclusions:

The pro-poor health policy has been positively impacting on people's access to and utilization of health services. There is 15 to 20 % increment in health facility utilization by poor, socially disadvantaged and marginalized communities. There is significant level of community awareness of free health care policy and provision. The supplies of drugs and other logistics at health facilities are gradually improved in the rural areas where as human resources for health are still lacking and not adequate compared to the health care needs of the people. The pro-poor health policy has been instrumental in accessing and utilizing the services by the poorest of the poor as it is free of charge and available in local health facilities.