24/12/2020
“Medical poverty Trap due to out of pocket medical expenses”,
This Research addresses the rising concerns about “Medical poverty Trap due to out of pocket medical expenses”, Meaning how high treatment cost has the possibility of creating catastrophic poverty amongst not only in rural areas but in urban areas of the country. Uncertain nature of the job, low wages, deplorable lack of basic necessities and a dearth of fallback options add to the burden and make them certain candidates for the “medical poverty trap”.
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Article 25.1 of the Universal Declaration of Human Rights and Article 12.1 of International Covenant on Economic Social and Cultural Rights affirms: “Everyone has the right to a standard of living adequate for the health of him/herself and of his/her family, including food, clothing, housing and medical care and necessary social services”. The question that the research is trying to address is; What if the Unaffordable Health care itself was inducing indignified life. Deprivation right to health as analyzed through General comment no. 14 can be seen as derivation of basic freedom and entitlement. Freedom meaning: to Control one’s health and body, including sexual and reproductive freedom, and the right to be free from interference, such as the right to be free from torture, non-consensual medical treatment and experimentation. Entitlements include the right to a system of health protection that provides equality of opportunity for people to enjoy the highest attainable level of health.
The Government has the obligation to respect, Protect and fulfil, those obligations are hurdled when health care becomes Inaccessible, Unavailable, Unacceptable and is of an under quality. However such rights become inaccessible when the Economic burden of healthcare leads to a greater endemic of poverty.
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Health care can be expensive, especially in cases of chronic illness where continuous intervention for a prolonged duration in required. In the absence of Primary Medical Care cover, households with severe and immediate medical needs can be forced to expend a large fraction of the household budget on health care. Such spending must be accommodated by cutting back on the consumption of other goods and services, by accumulating debt, by running down savings or by selling assets. Whichever the financing strategy adopted, the household suffers a cost that may be labeled “catastrophic.”
It aims to assess the areas causing the trap that needs to be addressed, it will also identify patients' household expenditure or if there was saving on future Medical expenses and also identify total dependence on those expenses. It also aims to identify the variants in the catastrophic impact on the individual (patients) household. Furthermore, the research also intends on identifying further impoverishment due to “Out of Pocket” medical expenses, identifying the degrees ranging from people who fall below the poverty line after paying the Medical bills. The research intends to identify household-level impacts of direct costs (medical treatment and related financial costs), indirect costs (productive time losses resulting from illness) and subsequent household responses. Its help identifies the health care financing strategies that place considerable emphasis on out-of-pocket payments that can potentially impoverished households.
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The project’s overall goal is to contribute towards the reaching objective and purpose ideated by the constitution, through reviewing the ex*****on of Article 35 and National Health Policy 2076 BS. which intends to cover inclusion of access in the health sectors, by trying to reduce “Out of Pocket Expensive” by increasing government budget to 6.26 % to which the efficacy and adequacy of the budget is yet to be tested. Agenda 2030/SDGs, Goal no. 3 (Universal Health coverage) is our commitment to the international community and hence such review of the budget, review and finding the friction in achieving such goals remain at the core of the fulfilment and prerequisite to pacta sunt servanda of Nepal’s international commitments.
This growing evidence of households being pushed into poverty or forced into deeper poverty when faced with substantial medical expenses, particularly when combined with a loss of household income due to ill-health. In order to address the stated problem, the project has a series of interconnected objective activities/outputs – participatory mapping of the existing laws to identify the areas of ex*****on of article 35 and other cross-cutting constitutional bodies functions and duties. Likewise, carrying out an in-depth study of international laws and obligation and further reviewing the domestic laws and making a recommendation accordingly. Similarly, for publishing the reviewed research along with a conference with the concerned ministry and civil society stakeholder.
Hence, Primary Health Care, as articulated in the Alma Ata Declaration of 1978, envisions development of prospects for growth of primary health care in many countries and understanding the issue remains at the core of implementation.
Study Significance
By identifying and exploring factors related to healthcare-related disparities experienced, future development planning can better target needs and work towards reducing the chances of citizens being pushed in cycles of poverty brought on by Catastrophic Health Expenditure following acute medical need. As out-of pocket expenditure is a major economic burden facing Nepalese citizens, the proposed research aimed to support the UN’s Sustainable Development Goal 3 ‘Ensure healthy lives and promote wellbeing for all at all ages’ and specifically target 3.8 ‘Achieving universal health coverage’ by bringing awareness and visibility. Financial risk protection from CHE is included within the target which highlights the inter-linkage between poverty and ill health and calls for larger investment in healthcare sectors. Identifying factors leading to CHE and its potential implications could work to make progress towards achieving these goals by connecting abstract scenarios found in the goals with empirical situations witnessed in Nepal.
Core objectives of the project:
To find out types of direct and indirect out of pocket medical expenditures and other financial risks involved in access to quality health care services, quality and affordable essential medicines and vaccines for all.
To find how Direct and Indirect out-of-pocket medical expenditure financially effects on households.
To find out the awareness and adequacy of the current medical package.
Suggesting how out-of-pocket expenditure for healthcare can be kept at a minimum or zero for the most essential services.
Taking special focus on all vulnerable groups and minorities affected by the out-of-pocket expenditure for health care.
Taking a review on the efficacy and adequacy of current health coverage policy set by the ministry of health and population, Nepal.
The research tends to suggest design and implementation of universal health care and ensure their health needs are covered.
The research also intends to find segments of affect whether such out of pocket expenses affect household consumption or its has affected education of the children leading it to Intergenerational poverty trap.
The research will identify the gap between governments medical expenses coverage policy and what is required.
Mean of institutionalization and diffusion or reduction by promoting universal health care and other suggestive intervention.
Identify adequacy of different financial and essential packages for chronic diseases in Nepal.
