B.P. Koirala Institute of Health
Sciences was established by an act of
parliament in the year 1993 as an
autonomous institute. As per its stated
mission, it is recognized as socially
accountable medical school and also as
centre for research & innovation in
service as well as education.
There is a gap in the cost of service &
affordability by people. This Program is
based on
- Social Solidarity.
- Contribution on ability to pay.
- Non profit concept.
- Compulsory for house holds
It also takes care of international
labour standard i.e. Social security
(minimum standard) convention 1952 (No.
102) and medical care and sickness
benefits convention 1969 (No. 130
Conceptual Background:-People
should not remain devoid of health care
because of lack of money. BPKIHS is
committed to provide research and trial
based advised to HMGN for the
improvement of Health Sectors.
Approximately 35% of patients attending
the hospital can not afford the tertiary
level treatment needed. It was
discovered through focused group
discussion in village, that on an
average they are spending NRs 1000
/head/year for their health needs. It
was also found out through community
research that people are spending higher
percentage of their income on tobacco
and alcohol. Receipt of recommendation
letters for free treatment from
political parties, NGO, INGO, etc.
Keeping all the above mentioned factors
in mind, We offered various
alternatives/options to the villagers.
VDC can deposit certain amount from
their health budget to the institute and
then recommend patients for free
treatment who cannot-afford for their
health care. To raise money from
NGO/INGO/ local donors and use it on
their recommendation. Social Health
insurance Scheme.
Philosophy: To have the right
to get treatment from the Institute
during illness by investing when in good
health.Taking into consideration the
above policy BPKIHS has developed a
group health insurance plan tailor made
for community.
Objective: To make the
community people aware of health
insurance philosophy, take it to the
masses and to implement it. To insure
health risk by providing costly health
care.
Procedure/Publicity:
- To build up Public awareness
through brochure.
- Conducting Awareness programme
by meeting people of various levels
in the community.
- Awareness programme through
meeting with Vice-Chancellor,
Hospital Director etc. to convince
people and make them believe.
- Programme is organized through
VDC or NGO, INGO president.
- After convincing VDC/NGO/INGO
approaches us.
- Guidelines are given through a
nucleus Insurance Section. All the
procedure there after is having two
parts.
RESPONSIBILITY OF VDC/NGO/INGO
- Identify the interested group
and give the family number.
- Identify the marginalized
community give the family number.
- Get the photographs of the
people (we have given camera also)
Make a list of above with required
parameters.
- Get the premium from user and
approach Institute.
Premium- Villagers:
- Adult : NRs.25.00/ head / month
- Children : NRs.12.50/ head
/month
- Marginalized community as well
as handicapped unemployed, older
people who have been abandoned by
their family.
- 33.33% Institute
- 33.33% VDC
- 33.33% person himself
City People
- Adult : NRs.100/ head / month
- Children : NRs.50/ head /month
Note: Premium should be deposited
in advance for the whole year through
VDC or NGO/INGO etc. who are involved
(Waiting time One month). One individual
Independent person can't have access to
this scheme. He has to come through VDC
or NGO/INGO etc. Total members of the
identified household have to be insured
compulsory.
Benefits of above scheme Per
Head/year (Revised from 2061)
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BPKIHS OPD service
- Consultation - Unlimited
- Investigation- Unlimited
In-patient service at BPKIHS
----------------------------------------
- consultation - Unlimited
- Investigation- Unlimited
- General bed- Unlimited
- Medicine up to Rs. 3000/-
- Surgery up to Rs. 7,000/-
Exception: Only 25% discount provided
for CT scan, MRI, TMT, Echo,
Haemodialysis etc.
Types of disease covered
- All acute cases.
- TB and Leprosy through National
Control Program.
- Normal delivery/ cesarean and
assisted (Maternity case).
- All types of surgery available
in the Institute.
- Exception: Prosthesis, Implants,
etc. that are not available in
Hospital are not covered.
- Eye/ ENT
- Cataract without IOLAll other
operation available
- Dental: - OPD Card/ X-Ray, zinc
oxide filling only.
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