Awareness on Social Health Insurance Scheme among Locals in Bhaktapur Municipality.

BACKGROUND: Illnesses impose a huge economic burden on individuals and families. Costly health care also discourages people from using health services thereby generating prolonged or worsened health problems. The recently endorsed National Health Insurance Policy forecasts the integration of all social health protection schemes thereby ultimately achieving universal coverage. The aim of this study was to find out the awareness of health insurance and evaluate source of information about health insurance. METHODS: A cross sectional study was conducted on 385 participants from 5 randomly selected wards of Bhaktapur Municipality on July 2019. Households with health insurance were selected. The interview was taken either from the head of the family or the family member who takes financial decisions in the house. Face to face interview was taken in local language (Newari). Good and poor categories on awareness were developed. Descriptive statistics was applied. RESULTS: Good awareness of social health Insurance scheme was found among 335(87.2%) participants. 99% of the participants showed the importance of social health insurance. The main source of information was insurance agents (47.3%) and female community health volunteers (28.6%). Regarding benefits of opting health insurance, 66.5 % of the participants stated that it would reduce out-of-pocket expenditure. 65.5% opined that it would help in case of emergency medical situations. About 91.9% of respondents wanted to renew their health insurance in future also. CONCLUSIONS: Awareness regarding health insurance was found good, which shows the positive acceptance of social health Insurance scheme by community. Insurance agent and hemale community health volunteers (FCHV) seemed to have played an important role in dissemination of information.

Health Co-morbidities and Early Marriage in Women of a Rural Area of Nepal: A Descriptive Cross-Sectional Study.

INTRODUCTION: Early marriage is defined as the marriage of a young person less than 18 years. Early marriage is more prevalent in South Asia as more than half of all child marriage occurs here. Thirtyseven percent of girls in Nepal marry before age 18 years. This study was done to find out the health consequences of early marriage in women of a rural area of Nepal. METHODS: A descriptive cross-sectional study was conducted from 10th to 15th Feb 2020 February in 358 women from Panauti, Kavrepalchowk. The convenient sampling method was used. Ethical approval was taken from the Institutional Review Committee. Economic status was assessed by using Kuppuswamy’s socioeconomic scale. The collected data were analyzed using the Statistical Package for Social Science version 20. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. RESULTS: The prevalence of early marriage was 187 (52.2%) (47.03 to 57.37 at 95% confidence interval). One hundred sixteen (62%) early marriage women had gynecological problems followed by depression problem 85 (45.5%) and miscarriage 32 (17.1%). The mean age of marriage was 17.2 years. The majority, i.e. 167 (89.3%) of respondents who married earlier were Hindu by religion. Early marriage was observed in 104 (55.6 %) of illiterate women. CONCLUSIONS: The prevalence of early marriage was high. Early married women had a lower level of socio-economic status, lower level of education, which harmed the participants' health status.

Household Expenditure on Diarrhea Treatment among Under Five Children in Godawari Municipality of Nepal.

BACKGROUND: Diarrheal disease is a global public health problem. In Nepal, diarrhea is still the leading cause of waterborne disease, which constitutes 48% among all hospitalized disease cases who come to health center for treatment. Despite low treatment cost of diarrhea, out-of-pocket expenditure required at the time of treatment is a major barrier to seek health care. This study, therefore, aims to explore household expenditure for the diarrheal treatment in under five children and its financial burden in households. METHODS: A community based cross sectional study was carried out in 14 wards of Godawari Municipality among under five children with diarrhea from June 2018 to September 2018. We conducted financial burden survey among 371 household with diarrhea cases. RESULTS: Prevalence rate of diarrhea was found 50% among under five children. The average out-of-pocket expenditure was NRs 568.62 (US $5.06) per episode for diarrhea treatment. The total average direct cost for diarrheal treatment was NRs 183.58 (US $1.63). The two major cost driver during each episode were loss of wage by parents NRs 360.97 (US $3.21) and medicine costs NRs 114.15 (US $1.01). CONCLUSIONS: The Diarrheal prevalence rate in the study area was found higher than the National. The indirect cost of each diarrheal episode is more than three times of the direct cost.