{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T03:20:03Z","timestamp":1793157603483,"version":"4.5.0"},"reference-count":204,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T00:00:00Z","timestamp":1748476800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec039\">\n<jats:title>Background<\/jats:title>\n<jats:p>Nepal has been undergoing demographic and epidemiological transitions, marked by an increasing burden of non-communicable diseases (NCDs) and injuries. These transitions\u00a0have led to financial implications, including rising out-of-pocket (OOP) expenses. This study reviews and synthesizes evidence on the status, issues and challenges in health financing system, policies, and programs to achieve universal health coverage (UHC) in Nepal.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec040\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We conducted a scoping review of literature on Nepal\u2019s health financing system,\u00a0policies, and programs. A search strategy was developed using keywords related to two core concepts: health financing and universal health coverage. Grey literature was identified from the web pages of relevant ministries and organizations. A total of 148 studies\/policy documents published in Nepali and English up to 31 December 2024 were included. Policies and content related to the health financing system were reviewed to understand the status, issues and challenges of health financing functions, and UHC\u00a0. A framework-guided deductive content analysis approach was employed, and findings were interpreted using the three UHC components: service coverage, population coverage, and financial coverage.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec041\">\n<jats:title>Results<\/jats:title>\n<jats:p>Nepal\u2019s health policy documents prioritize financial protection for low-income people and target groups through social health protection programs\/schemes. However, multiple social health protection schemes coexist with fragmented risk pooling and low efficiency in health financing. OOP expenditure is high at 54.2%, with 10% of the population facing catastrophic health expenditures. Injuries and chronic morbidities contribute significantly to this burden, with 70% of injury-related and 62% of NCD-related expenses borne through OOP payments. Despite efforts to improve financial risk protection, the National Health Insurance Program (NHIP) suffers from low population coverage (28%), low renewal rate (54%), and financial sustainability issues (as provider payments exceed revenue collection). The UHC service coverage index, though improving, was only 54 out of 100 in 2021 reflecting limited health system capacity and insufficient readiness to address\u00a0health challenges, including those posed by shifting demographics and the growing burden of NCDs. Nepal\u2019s total health expenditure remains around 2% of GDP, with persistent inefficiencies in resource allocation, fiscal decentralization, and budget absorption.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec042\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Nepal\u2019s health financing policies align with UHC goals, yet critical gaps remain in multiple dimensions . Issues such as inefficiencies, underfunding, and fragmented social health protection schemes limit equitable access to quality health care. Therefore, comprehensive structural reforms-spanning legal, institutional, and policy frameworks-are urgently needed. Key reforms \u00a0include: (1) merging or harmonizing existing social health protection schemes for efficient pooling and purchasing; (2) enhancing domestic health financing through increased health funding (\u22655% of GDP) via payroll contributions, progressive taxation, and earmarked sin taxes; (3) reforming NHIP\u00a0to mandatory enrollment starting from formal sector, subsidizing premium for informal sector and free coverage for disadvantaged groups, alongside strengthening policy implementation including accrediting of health facilities, ensuring service quality, prioritising and expanding coverage packages\u00a0with strategic purchasing from all public and private health facilities; and (4) equitable public financing to ensure needs-based allocation across government levels that respond to demographic and epidemiological patterns. Further research is needed to assess hybrid tax and premium based insurance models, strategic purchasing optimization, and digital health innovations for financial sustainability.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0324880","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T17:39:57Z","timestamp":1748540397000},"page":"e0324880","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":16,"title":["Navigating Nepal\u2019s health financing system: A road to universal health coverage amid epidemiological and demographic transitions"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5216-606X","authenticated-orcid":true,"given":"Resham B.","family":"Khatri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratik","family":"Khanal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7567-303X","authenticated-orcid":true,"given":"Dipendra Singh","family":"Thakuri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prabesh","family":"Ghimire","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9160-6846","authenticated-orcid":true,"given":"Mihajlo","family":"Jakovljevic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,5,29]]},"reference":[{"key":"pone.0324880.ref001","volume-title":"Basic Health Service Package In","author":"Ministry of Health and Population","year":"2019"},{"issue":"11","key":"pone.0324880.ref002","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgph.0001298","article-title":"Assessment of health system readiness for routine maternal and newborn health services in Nepal: Analysis of a nationally representative health facility survey, 2015","volume":"2","author":"RB Khatri","year":"2022","journal-title":"PLOS Glob Public Health"},{"key":"pone.0324880.ref003","volume-title":"Situation Analysis of Health Financing in Nepal","author":"MOHP WB, WHO, GIZ.","year":"2019"},{"issue":"2","key":"pone.0324880.ref004","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1093\/inthealth\/ihaa055","article-title":"Burden, prevention and control of tobacco consumption in Nepal: a narrative review of existing evidence","volume":"13","author":"GN Khanal","year":"2021","journal-title":"Int Health"},{"issue":"5","key":"pone.0324880.ref005","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1038\/s41591-020-0807-6","article-title":"Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017","volume":"26","author":"Collaborators LBD Double Burden of Malnutrition","year":"2020","journal-title":"Nat Med"},{"key":"pone.0324880.ref006","volume-title":"National Population and Housing Census 2021","author":"National Statistical Office.","year":"2023"},{"key":"pone.0324880.ref007","volume-title":"A Country Report based on the 2019 Global Burden of Disease Study In","author":"Nepal Health Research Council; Ministry of Health and Population, Institute for Health Metrics and Evaluation, Monitoring Evaluation and Operational Research: Nepal Burden of Disease 2019.","year":"2021"},{"key":"pone.0324880.ref008","volume-title":"Nepal Living Standard Survey IV 2022\/23","author":"National Statistics Office.","year":"2024"},{"issue":"1","key":"pone.0324880.ref009","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.1186\/s12889-022-13905-3","article-title":"Social determinants of health and the double burden of disease in Nepal: a secondary analysis","volume":"22","author":"H Gardner","year":"2022","journal-title":"BMC Public Health"},{"issue":"1","key":"pone.0324880.ref010","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s12992-022-00798-5","article-title":"Transforming Nepal\u2019s primary health care delivery system in global health era: addressing historical and current implementation challenges","volume":"18","author":"B Adhikari","year":"2022","journal-title":"Global Health"},{"key":"pone.0324880.ref011","volume-title":"The Global Health Observatory: Explore a world of health data","author":"World Health Organization.","year":"2025"},{"key":"pone.0324880.ref012","first-page":"1","volume-title":"Health systems financing: the path to universal coverage. In","author":"World health Organization","year":"2010"},{"key":"pone.0324880.ref013","volume-title":"Global Health Expenditure Database. In","author":"World Health Organization","year":"2025"},{"issue":"1","key":"pone.0324880.ref014","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/s12961-022-00952-w","article-title":"Evaluation of the National Health Insurance Program of Nepal: are political promises translated into actions?","volume":"21","author":"GN Khanal","year":"2023","journal-title":"Health Res Policy Syst"},{"key":"pone.0324880.ref015","doi-asserted-by":"crossref","first-page":"100142","DOI":"10.1016\/j.dialog.2023.100142","article-title":"A critical analysis of health system in Nepal; Perspective\u2019s based on COVID-19 response","volume":"3","author":"BS Kuikel","year":"2023","journal-title":"Dialogues Health"},{"key":"pone.0324880.ref016","doi-asserted-by":"crossref","first-page":"105337","DOI":"10.1016\/j.actatropica.2020.105337","article-title":"Climate change and infectious disease research in Nepal: Are the available prerequisites supportive enough to researchers?","volume":"204","author":"D Bhandari","year":"2020","journal-title":"Acta Trop"},{"key":"pone.0324880.ref017","first-page":"1","article-title":"Health System Preparedness for COVID-19 and Its Impacts on Frontline Health-Care Workers in Nepal: A Qualitative Study Among Frontline Health-Care Workers and Policy-Makers","author":"N Shrestha","year":"2021","journal-title":"Disaster Med Public Health Prep"},{"key":"pone.0324880.ref018","volume-title":"Monitoring progress on universal health coverage and the health-related Sustainable Development Goals in the WHO South-East Asia Region: 2022 update. In. South-East Asia Region","author":"WHO South-East Asia Region","year":"2022"},{"key":"pone.0324880.ref019","volume-title":"Constitution of the kingdom of Nepal 1990","author":"His majesty\u2019s government","year":"1990"},{"key":"pone.0324880.ref020","volume-title":"National Health Policy\u20101991. In","author":"Ministry of Health and Population.","year":"1991"},{"key":"pone.0324880.ref021","volume-title":"The Interim Constitution of Nepal 2007. In","author":"Government of Nepal.","year":"2007"},{"key":"pone.0324880.ref022","volume-title":"Constitution of Nepal 2015","author":"CA Secretariat of","year":"2015"},{"key":"pone.0324880.ref023","volume-title":"Health Insurance Act. In","author":"Government of Nepal.","year":"2017"},{"key":"pone.0324880.ref024","volume-title":"Annual Health Report 2021\/2022. In","author":"Ministry of Health and Population.","year":"2022"},{"key":"pone.0324880.ref025","volume-title":"Nepal Health Sector Strategic Plan, 2022-2030. In","author":"Ministry of Health and Population.","year":"2022"},{"key":"pone.0324880.ref026","volume-title":"National Health Financing Strategy, 2023-2033. In","author":"Ministry of Health and Population.","year":"2023"},{"issue":"2","key":"pone.0324880.ref027","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1002\/hpm.3377","article-title":"Does perceived susceptibility and severity of health problems serve as drivers for household enrolment in health insurance? A case study from Nepal","volume":"37","author":"D Acharya","year":"2022","journal-title":"Int J Health Plann Manage"},{"issue":"10","key":"pone.0324880.ref028","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0310324","article-title":"Enrollment and associated factors of the national health insurance program of Nepal: Further analysis of the Nepal Demographic and Health Survey 2022","volume":"19","author":"D Acharya","year":"2024","journal-title":"PLoS One"},{"key":"pone.0324880.ref029","doi-asserted-by":"crossref","first-page":"03021","DOI":"10.7189\/jogh.13.03021","article-title":"Health financing reforms in the quest for universal health coverage: Challenges and opportunities in the context of Nepal","volume":"13","author":"AR Pandey","year":"2023","journal-title":"J Glob Health"},{"key":"pone.0324880.ref030","doi-asserted-by":"crossref","DOI":"10.22617\/TCS240257-2","volume-title":"A Study on Nepal\u2019s National Health Insurance Program. In","author":"R Ayer","year":"2024"},{"key":"pone.0324880.ref031","volume-title":"Social health protection in Nepal. State of play and recommendations towards universal extension of coverage. In","author":"International Labour Organization.","year":"2023"},{"key":"pone.0324880.ref032","volume-title":"Extending social protection for all in Nepal, an analysis of protection gaps. In","author":"International Labour Organization.","year":"2023"},{"issue":"7","key":"pone.0324880.ref033","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgph.0003538","article-title":"Factors influencing the utilisation of National health insurance program in urban areas of Nepal: Insights from qualitative study","volume":"4","author":"S Ghimire","year":"2024","journal-title":"PLOS Glob Public Health"},{"issue":"1","key":"pone.0324880.ref034","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1186\/s12913-023-09145-9","article-title":"Factors affecting health insurance utilization among insured population: evidence from health insurance program of Bhaktapur district of Nepal","volume":"23","author":"S Ghimire","year":"2023","journal-title":"BMC Health Serv Res"},{"issue":"5","key":"pone.0324880.ref035","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0303045","article-title":"User satisfaction with the National Health Insurance Program: A community-based survey from the Ilam district of Nepal","volume":"19","author":"R Shrestha","year":"2024","journal-title":"PLoS One"},{"issue":"1","key":"pone.0324880.ref036","doi-asserted-by":"crossref","first-page":"86","DOI":"10.24083\/apjhm.v16i1.479","article-title":"Utilization of Healthcare Services & Healthcare Expenditure Patterns in the Rural Households of Nepal","volume":"16","author":"S Pokharel","year":"2021","journal-title":"APJHM"},{"key":"pone.0324880.ref037","doi-asserted-by":"crossref","first-page":"100150","DOI":"10.1016\/j.dialog.2023.100150","article-title":"Causes of dropout from health insurance program: An experience from Lumbini Province, Nepal","volume":"3","author":"D Acharya","year":"2023","journal-title":"Dialogues Health"},{"issue":"1","key":"pone.0324880.ref038","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1186\/s13643-021-01821-3","article-title":"Scoping reviews: reinforcing and advancing the methodology and application","volume":"10","author":"MDJ Peters","year":"2021","journal-title":"Syst Rev"},{"issue":"1","key":"pone.0324880.ref039","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1080\/1364557032000119616","article-title":"Scoping studies: towards a methodological framework","volume":"8","author":"H Arksey","year":"2005","journal-title":"International Journal of Social Research Methodology"},{"key":"pone.0324880.ref040","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1186\/1748-5908-5-69","article-title":"Scoping studies: advancing the methodology","volume":"5","author":"D Levac","year":"2010","journal-title":"Implement Sci"},{"key":"pone.0324880.ref041","volume-title":"Making fair choices on the path to universal health coverage: Final report of the WHO Consultative Group on Equity and Universal Health Coverage. In","author":"World Health Organization","year":"2014"},{"key":"pone.0324880.ref042","volume-title":"Universal health coverage and health financing. In","author":"World Health Organization","year":"2019"},{"key":"pone.0324880.ref043","volume-title":"Review of national health policy 1991. In","author":"MOHP and NHSSP.","year":"2012"},{"key":"pone.0324880.ref044","volume-title":"Social Health Security Development Board Development Board (formation) Order 2014 In","author":"Nepal Go.","year":"2014"},{"key":"pone.0324880.ref045","volume-title":"Progress of health and population sector 2023\/24. In","author":"Ministry of Health and Population.","year":"2024"},{"key":"pone.0324880.ref046","volume-title":"Acts, rules, directives and procedures. In","author":"Health Insurance Board.","year":"2024"},{"issue":"4","key":"pone.0324880.ref047","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgph.0000201","article-title":"Predictors of annual membership renewal to increase the sustainability of the Nepal National Health Insurance program: A cross-sectional survey","volume":"2","author":"GB Gurung","year":"2022","journal-title":"PLOS Glob Public Health"},{"key":"pone.0324880.ref048","first-page":"2024","volume-title":"Operational guideline for implementation of co-payment system in the health insurance program, 2080 In","author":"Health Insurance Borard."},{"key":"pone.0324880.ref049","author":"Ministry of Health and Population. Annual Health Report 2022\/2023. In","year":"2024"},{"key":"pone.0324880.ref050","author":"Health Insurance Borard. Accreditation guideline for service providing facilities, 2024. In","year":"2024"},{"key":"pone.0324880.ref051","volume-title":"Annual report 2022\/23: factsheet and executive summary. In","author":"Health Insurance Board.","year":"2024"},{"key":"pone.0324880.ref052","volume-title":"Public Health Service Act. In","author":"Government of Nepal.","year":"2018"},{"key":"pone.0324880.ref053","author":"Ministry of Health and Population. Standard Treatment Protocol (STP) For Basic Health Services (BHS) Package 2078. In","year":"2020"},{"key":"pone.0324880.ref054","volume-title":"Standard Treatment Protocol of Emergency Health Service Package. In","author":"Ministry of Health and Population.","year":"2020"},{"key":"pone.0324880.ref055","article-title":"Baseline Status of Basic Health Service Delivery, 2022 Nepal DHS and 2021 Nepal HFS","volume-title":"DHS Further Analysis Reports","author":"P Poudel","year":"2024"},{"key":"pone.0324880.ref056","volume-title":"Health Insurance Regulation. In","author":"Government of Nepal.","year":"2019"},{"key":"pone.0324880.ref057","volume-title":"National Health Policy 1991. In","author":"Ministry of Health and Population.","year":"1991"},{"key":"pone.0324880.ref058","volume-title":"Review of community-based health insurance initiatives in Nepal","author":"M Stoermer","year":"2012"},{"issue":"1","key":"pone.0324880.ref059","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1080\/19439342.2020.1853794","article-title":"Free delivery care and supply-side incentives in Nepal\u2019s poorest districts: the effect on prenatal care and neonatal tetanus vaccinations","volume":"13","author":"S Pandey","year":"2020","journal-title":"Journal of Development Effectiveness"},{"key":"pone.0324880.ref060","article-title":"The national free delivery policy in Nepal: early evidence of its effects on health facilities","author":"S Witter","year":"2011","journal-title":"Health Policy Plan"},{"key":"pone.0324880.ref061","volume-title":"National Health Policy 2014. In","author":"Ministry of Health and Population.","year":"2014"},{"key":"pone.0324880.ref062","volume-title":"Budget Analysis of Ministry of Health FY 2017\/18. In","author":"MoH and NHSSP.","year":"2018"},{"key":"pone.0324880.ref063","article-title":"Health budgeting and financing in nepal: policy perspectives","author":"S Uprety","year":"2016","journal-title":"Health Policy"},{"key":"pone.0324880.ref064","volume-title":"National Health Policy 2019. In","author":"Ministry of Health and Population.","year":"2019"},{"key":"pone.0324880.ref065","volume-title":"Directives, Guidelines and Manuals. In","author":"Ministry of Health and Population.","year":"2021"},{"key":"pone.0324880.ref066","volume-title":"Towards Universal Health Coverage: Addressing Financial Hardship and Improving Access to Healthcare in Nepal (Policy brief)","author":"NHRC.","year":"2022"},{"issue":"1","key":"pone.0324880.ref067","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1186\/s12961-023-01033-2","article-title":"Overcoming the challenges facing Nepal\u2019s health system during federalisation: an analysis of health system building blocks","volume":"21","author":"SP Wasti","year":"2023","journal-title":"Health Res Policy Syst"},{"key":"pone.0324880.ref068","volume-title":"National Health Insurance Policy 2014. In","author":"Ministry of Health and Population.","year":"2014"},{"key":"pone.0324880.ref069","volume-title":"Nepal Health Sector Strategy, 2010-2015. In","author":"Ministry of Health and Population.","year":"2010"},{"key":"pone.0324880.ref070","author":"Ministry of Health and Population. Nepal Health Sector Strategy, 2015-2022. In","year":"2015"},{"key":"pone.0324880.ref071","volume-title":"Budget Details: Red Book (Fiscal year 2010\/11) In","author":"Government of Nepal.","year":"2014"},{"key":"pone.0324880.ref072","volume-title":"Strategic Review of Social Audit in the Health Sector","author":"Ministry of Health and Population.","year":"2019"},{"key":"pone.0324880.ref073","volume-title":"Progress Report on Financial Management In Nepal\u2019s Health Sector","author":"Ministry of Health and Population.","year":"2014"},{"key":"pone.0324880.ref074","volume-title":"Nepal health sector programme II mid-term review","author":"D Daniels","year":"2013"},{"key":"pone.0324880.ref075","volume-title":"Innovative Good Practices in Nepal\u2019s Health Sector","author":"NHSSP.","year":"2016"},{"key":"pone.0324880.ref076","volume-title":"Annual Health Report 2016\/17","author":"Ministry of Health and Population.","year":"2018"},{"key":"pone.0324880.ref077","volume-title":"Nepal National Health Accounts 2015\/16 report In","author":"Ministry of Health and Population.","year":"2018"},{"key":"pone.0324880.ref078","volume-title":"Annual Report of Employee Provident Fund","author":"Employee Provident Fund.","year":"2020"},{"issue":"1","key":"pone.0324880.ref079","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/s12961-022-00952-w","article-title":"Evaluation of the National Health Insurance Program of Nepal: are political promises translated into actions?","volume":"21","author":"GN Khanal","year":"2023","journal-title":"Health Res Policy Syst"},{"key":"pone.0324880.ref080","volume-title":"Partnership, Alignment and Harmonisation in the Health Sector","author":"Ministry of Health and Population.","year":"2015"},{"key":"pone.0324880.ref081","volume-title":"Nepal Health Sector Strategy (NHSS) Mid Term Review Report","author":"Ministry of Health and Population.","year":"2018"},{"issue":"1","key":"pone.0324880.ref082","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3126\/hprospect.v18i1.22856","article-title":"Federal governance and the undying parade for universal health coverage in Nepal","volume":"18","author":"P Khanal","year":"2019","journal-title":"Health Prospect"},{"issue":"1","key":"pone.0324880.ref083","doi-asserted-by":"crossref","DOI":"10.33314\/jnhrc.v21i1.4922","article-title":"Free Basic Healthcare in Nepal: Can the Dream be Turned into Reality in the Pursuit of Universal Health Coverage?","volume":"21","author":"KK Aryal","year":"2023","journal-title":"J Nepal Health Res Counc"},{"key":"pone.0324880.ref084","volume-title":"Towards Universal Health Coverage: Addressing Financial Hardship and Improv ing Access to Healthcare in Nepal (Policy brief)","author":"Nepal Health Research Council.","year":"2022"},{"key":"pone.0324880.ref085","volume-title":"Nepal Health Sector Support Programme 2017-2022 Achievements, Learning and Future Approaches: Results Brief","author":"Ministry of Health and Population.","year":"2022"},{"key":"pone.0324880.ref086","volume-title":"Nepal Health Sector Support Programme (NHSSP 3) \u2013 No Cost Extension","author":"Ministry of Health and Population, NHSSP, Options.","year":"2023"},{"key":"pone.0324880.ref087","volume-title":"Health Insurance Reform Proposal Task Force Report, 2081 (2025), Nepali version In","author":"Health Insurance Reform Proposal Task Force.","year":"2025"},{"key":"pone.0324880.ref088","volume-title":"Medical treatment of deprived citizens","author":"Ministry of Health and Population.","year":"2025"},{"key":"pone.0324880.ref089","volume-title":"Annual Report 2023\/2024","author":"Social Security Fund.","year":"2024"},{"key":"pone.0324880.ref090","volume-title":"Annual Report of Employee Provident Fund 2022\/2023","author":"Employee Provident Fund.","year":"2024"},{"key":"pone.0324880.ref091","volume-title":"Healthcare Plan","author":"Employees Providednt Fund","year":"2024"},{"key":"pone.0324880.ref092","volume-title":"Social Service Unit Establishment and Operational Guidelines","author":"Ministry of Health and Population.","year":"2020"},{"key":"pone.0324880.ref093","volume-title":"Senior Citizen Health Service OperationGuideline 2077 (2021)","author":"Ministry of Health and Population","year":"2021"},{"key":"pone.0324880.ref094","volume-title":"Nepal Health Sector Strategy, 2004-2009. In","author":"Ministry of Health and Population.","year":"2005"},{"key":"pone.0324880.ref095","volume-title":"2022 Nepal Demographic and Health Survey Key Findings","author":"Ministry of Health and Population, New ERA, ICF.","year":"2023"},{"key":"pone.0324880.ref096","volume-title":"National HIV Factsheet","author":"National Centre for AIDS and STD Control.","year":"2023"},{"key":"pone.0324880.ref097","volume-title":"Public Health Service Regulation 2020 (unofficial translation)","author":"Government of Nepal.","year":"2020"},{"key":"pone.0324880.ref098","volume-title":"Nepal Multiple Indicator Cluster Survey 2019,Survey Findings Report","author":"Central Bureau of Statistics (CBS).","year":"2020"},{"key":"pone.0324880.ref099","volume-title":"Daily Summary Report as of 09 Jan 2024","author":"Social Security Fund.","year":"2024"},{"key":"pone.0324880.ref100","volume-title":"Daily summary report as of 7 October 2023","author":"Social Security Fund.","year":"2023"},{"key":"pone.0324880.ref101","volume-title":"Geriatrics (Senior Citizens) Health Service Operational Guideline- 2023\/24","author":"Ministry of Health and Population.","year":"2024"},{"issue":"10","key":"pone.0324880.ref102","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1080\/17441692.2012.733719","article-title":"Ability to pay and impoverishment among women who give birth at a University Hospital in Kathmandu, Nepal","volume":"7","author":"P Gartoulla","year":"2012","journal-title":"Glob Public Health"},{"issue":"8","key":"pone.0324880.ref103","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1093\/heapol\/czx070","article-title":"Incentivizing universal safe delivery in Nepal: 10\u2009years of experience","volume":"32","author":"T Ensor","year":"2017","journal-title":"Health Policy Plan"},{"issue":"18","key":"pone.0324880.ref104","doi-asserted-by":"crossref","first-page":"11737","DOI":"10.3390\/ijerph191811737","article-title":"Prevalence and Correlates of Underweight among Women of Reproductive Age in Nepal: A Cross-Sectional Study","volume":"19","author":"K Rana","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"pone.0324880.ref105","doi-asserted-by":"crossref","DOI":"10.1596\/40348","volume-title":"Tracking universal health coverage: 2023 global monitoring report. In","author":"World Health Organization","year":"2023"},{"key":"pone.0324880.ref106","doi-asserted-by":"crossref","DOI":"10.1596\/978-9-2400-4061-8","volume-title":"Tracking Universal Health Coverage: global monitoring report. In","author":"World Health Organization","year":"2021"},{"issue":"2","key":"pone.0324880.ref107","doi-asserted-by":"crossref","first-page":"343","DOI":"10.33314\/jnhrc.v19i2.3432","article-title":"Epidemiology of Road Traffic Accidents in Nepal from 2009\/10 to 2019\/20: A 10 Year Study","volume":"19","author":"A Atreya","year":"2021","journal-title":"J Nepal Health Res Counc"},{"issue":"9","key":"pone.0324880.ref108","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0272361","article-title":"Health sector readiness for the prevention and control of non-communicable diseases: A multi-method qualitative assessment in Nepal","volume":"17","author":"BP Sapkota","year":"2022","journal-title":"PLoS One"},{"key":"pone.0324880.ref109","article-title":"Non-communicable disease service readiness in Nepal: a further analysis of Nepal health facility survey-2021","volume":"2023","author":"B Adhikari","year":"2023","journal-title":"medRxiv"},{"key":"pone.0324880.ref110","doi-asserted-by":"crossref","first-page":"2319","DOI":"10.2147\/COPD.S268110","article-title":"Prevalence of Chronic Obstructive Pulmonary Disease and its Associated Factors in Nepal: Findings from a Community-based Household Survey","volume":"15","author":"TB Adhikari","year":"2020","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"pone.0324880.ref111","doi-asserted-by":"crossref","first-page":"105","DOI":"10.3389\/fmed.2019.00105","article-title":"Antimicrobial Resistance in Nepal","volume":"6","author":"KP Acharya","year":"2019","journal-title":"Front Med (Lausanne)"},{"key":"pone.0324880.ref112","volume-title":"A review of studies on Nepal\u2019s national free health care programme","author":"Ministry of Health and Population.","year":"2013"},{"issue":"1","key":"pone.0324880.ref113","doi-asserted-by":"crossref","DOI":"10.1002\/hpm.2691","article-title":"Conditional cash transfer policies in maternal health service utilization in Nepal: Analysis of safe delivery incentive program (Aama Surakshya Karyakram) using Kingdon\u2019s multiple streams framework","volume":"34","author":"GN Khanal","year":"2019","journal-title":"Int J Health Plann Manage"},{"key":"pone.0324880.ref114","doi-asserted-by":"crossref","first-page":"24","DOI":"10.3389\/fpubh.2019.00024","article-title":"Health Care Utilization and Health Care Expenditure of Nepali Older Adults","volume":"7","author":"S Acharya","year":"2019","journal-title":"Front Public Health"},{"issue":"4","key":"pone.0324880.ref115","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1080\/08959420.2020.1851429","article-title":"Health Services Utilization among Older Adults in Pokhara Metropolitan City","volume":"34","author":"I Karmacharya","year":"2022","journal-title":"J Aging Soc Policy"},{"key":"pone.0324880.ref116","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/s12962-020-00227-7","article-title":"Status and determinants of enrollment and dropout of health insurance in Nepal: an explorative study","volume":"18","author":"CL Ranabhat","year":"2020","journal-title":"Cost Eff Resour Alloc"},{"key":"pone.0324880.ref117","doi-asserted-by":"crossref","first-page":"250","DOI":"10.3389\/fpubh.2017.00250","article-title":"A Comparative Study on Outcome of Government and Co-Operative Community-Based Health Insurance in Nepal","volume":"5","author":"CL Ranabhat","year":"2017","journal-title":"Front Public Health"},{"key":"pone.0324880.ref118","article-title":"Social health insurance in nepal: A health system departure toward the universal health coverage","author":"R Pokharel","year":"2018","journal-title":"Int J Health Plann Manage"},{"issue":"210","key":"pone.0324880.ref119","doi-asserted-by":"crossref","first-page":"633","DOI":"10.31729\/jnma.3600","article-title":"Nepal Health Insurance Bill: Possible Challenges and Way Forwards","volume":"56","author":"N Kandel","year":"2018","journal-title":"JNMA J Nepal Med Assoc"},{"issue":"11","key":"pone.0324880.ref120","first-page":"2476","article-title":"Dropout Analysis of a National Social Health Insurance Program at Pokhara Metropolitan City, Kaski, Nepal","volume":"11","author":"P Sharma","year":"2022","journal-title":"Int J Health Policy Manag"},{"issue":"1","key":"pone.0324880.ref121","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1186\/s12913-024-11717-2","article-title":"Older people\u2019s challenges accessing health services in central Nepal: a qualitative study using the domain of access framework","volume":"24","author":"R Adhikari","year":"2024","journal-title":"BMC Health Serv Res"},{"key":"pone.0324880.ref122","volume-title":"Annual report 2022\/23: factsheet and executive summary","author":"Ministry of Health and Population.","year":"2024"},{"key":"pone.0324880.ref123","volume-title":"Annual Health Report 2020\/21","author":"Ministry of Health and Population.","year":"2020"},{"key":"pone.0324880.ref124","volume-title":"Work on 400 basic hospitals in local units may not start next fiscal year. In: The Kathmandu Post","author":"A Paudel","year":"2023"},{"key":"pone.0324880.ref125","volume-title":"National joint annual review report","author":"Ministry of Health and Population.","year":"2024"},{"issue":"11","key":"pone.0324880.ref126","doi-asserted-by":"crossref","first-page":"636","DOI":"10.15171\/ijhpm.2019.54","article-title":"Factors Associated with Enrolment of Households in Nepal\u2019s National Health Insurance Program","volume":"8","author":"P Ghimire","year":"2019","journal-title":"Int J Health Policy Manag"},{"issue":"11","key":"pone.0324880.ref127","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2021-050922","article-title":"Predictors of health insurance enrolment and wealth-related inequality in Nepal: evidence from Multiple Indicator Cluster Survey (MICS) 2019","volume":"11","author":"UP Bhusal","year":"2021","journal-title":"BMJ Open"},{"issue":"3","key":"pone.0324880.ref128","doi-asserted-by":"crossref","first-page":"388","DOI":"10.33314\/jnhrc.v17i3.2026","article-title":"Factors Affecting Enrollment in Government Health Insurance Program in Kailali District","volume":"17","author":"DR Paudel","year":"2019","journal-title":"J Nepal Health Res Counc"},{"issue":"41","key":"pone.0324880.ref129","doi-asserted-by":"crossref","first-page":"378","DOI":"10.33314\/jnhrc.v16i41.1581","article-title":"Factors Affecting Enrolment in the Community Based Health Insurance Scheme of Chandranigahapur Hospital of Rautahat District","volume":"16","author":"N Adhikari","year":"2019","journal-title":"J Nepal Health Res Counc"},{"issue":"1","key":"pone.0324880.ref130","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1002\/hpm.3301","article-title":"Implementation bottlenecks of the National Health Insurance program in Nepal: Paving the path towards Universal Health Coverage: A qualitative study","volume":"37","author":"GB Gurung","year":"2022","journal-title":"Int J Health Plann Manage"},{"key":"pone.0324880.ref131","doi-asserted-by":"crossref","first-page":"28763","DOI":"10.3402\/gha.v8.28763","article-title":"National health insurance policy in Nepal: challenges for implementation","volume":"8","author":"SR Mishra","year":"2015","journal-title":"Glob Health Action"},{"key":"pone.0324880.ref132","volume-title":"Country profile:Nepal. In","author":"Our World in Data.","year":"2023"},{"key":"pone.0324880.ref133","volume-title":"Air quality in Nepal Air quality in Nepal In","author":"IQAir.","year":"2022"},{"key":"pone.0324880.ref134","volume-title":"Nepal National Health Accounts 2018\/19 \u2013 2019\/20","author":"Ministry of Health and Population.","year":"2023"},{"issue":"1","key":"pone.0324880.ref135","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0280840","article-title":"Occupational and geographical differentials in financial protection against healthcare out-of-pocket payments in Nepal: Evidence for universal health coverage","volume":"18","author":"VP Sapkota","year":"2023","journal-title":"PLoS One"},{"issue":"4","key":"pone.0324880.ref136","article-title":"Cost and economic burden of illness over 15 years in Nepal: A comparative analysis","volume":"13","author":"KT Swe","year":"2018","journal-title":"PLoS One"},{"issue":"11","key":"pone.0324880.ref137","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2018-022002","article-title":"Catastrophic health expenditure among industrial workers in a large-scale industry in Nepal, 2017: a cross-sectional study","volume":"8","author":"P Pyakurel","year":"2018","journal-title":"BMJ Open"},{"issue":"10","key":"pone.0324880.ref138","doi-asserted-by":"crossref","first-page":"760","DOI":"10.2471\/BLT.13.126615","article-title":"Catastrophic household expenditure on health in Nepal: a cross-sectional survey","volume":"92","author":"E Saito","year":"2014","journal-title":"Bull World Health Organ"},{"issue":"12","key":"pone.0324880.ref139","article-title":"Catastrophic health expenditure on chronic non-communicable diseases among elder population: A cross-sectional study from a sub-metropolitan city of Eastern Nepal","volume":"17","author":"S Rai","year":"2022","journal-title":"PLoS One"},{"issue":"4","key":"pone.0324880.ref140","doi-asserted-by":"crossref","first-page":"741","DOI":"10.33314\/jnhrc.v18i4.2392","article-title":"National and Provincial Estimates of Catastrophic Health Expenditure and its Determinants in Nepal","volume":"18","author":"AK Thapa","year":"2021","journal-title":"J Nepal Health Res Counc"},{"issue":"1","key":"pone.0324880.ref141","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/s12939-018-0736-x","article-title":"Cumulative incidence, distribution, and determinants of catastrophic health expenditure in Nepal: results from the living standards survey","volume":"17","author":"M Ghimire","year":"2018","journal-title":"Int J Equity Health"},{"key":"pone.0324880.ref142","doi-asserted-by":"crossref","first-page":"160","DOI":"10.3389\/fpubh.2019.00160","article-title":"Estimating the Direct Cost of Cancer in Nepal: A Cross-Sectional Study in a Tertiary Cancer Hospital","volume":"7","author":"SR Khatiwoda","year":"2019","journal-title":"Front Public Health"},{"issue":"75","key":"pone.0324880.ref143","first-page":"58","article-title":"National Needs Assessment of Health Information System to Address Cardiovascular Diseases in Nepal: A Mixed Method Study","volume":"19","author":"A Shrestha","year":"2021","journal-title":"Kathmandu Univ Med J (KUMJ)"},{"issue":"194","key":"pone.0324880.ref144","doi-asserted-by":"crossref","first-page":"811","DOI":"10.31729\/jnma.2757","article-title":"Analysis of Health Sector Budget of Nepal","volume":"52","author":"RK Dulal","year":"2014","journal-title":"JNMA J Nepal Med Assoc"},{"issue":"3","key":"pone.0324880.ref145","doi-asserted-by":"crossref","first-page":"238","DOI":"10.4103\/2224-3151.206746","article-title":"Correlates of out-of-pocket spending on health in Nepal: implications for policy","volume":"3","author":"I Gupta","year":"2014","journal-title":"WHO South East Asia J Public Health"},{"key":"pone.0324880.ref146","unstructured":"Evidence on social health protection for strong institutions. In: 9th National Virtual Summit of Health and Population Scientists in Nepal. Kathmandu, Nepal: Nepal Health Research Council. 2023."},{"key":"pone.0324880.ref147","volume-title":"Budget Analysis of Health Sector In","author":"MoHP and UKaid\/NHSSP.","year":"2020"},{"key":"pone.0324880.ref148","volume-title":"Nepal, All-cause, Spending as % of GDP, 1995-2024","author":"Institute for Health Metrics and Evaluation.","year":"2023"},{"key":"pone.0324880.ref149","volume-title":"Budget Brief Updates. Health Budget: FY 2021\/22 In","author":"United Nations International Children\u2019s Emergency Fund.","year":"2021"},{"key":"pone.0324880.ref150","volume-title":"Nepal National Health Accounts 2017\/18 report In","author":"Ministry of Health and Population.","year":"2022"},{"key":"pone.0324880.ref151","volume-title":"Nepal National Health Accounts 2016\/17","author":"Ministry of Health and Population.","year":"2019"},{"key":"pone.0324880.ref152","volume-title":"Nepal National Health Accounts 2017\/18","author":"Ministry of Health and Population.","year":"2022"},{"key":"pone.0324880.ref153","article-title":"Non-communicable diseases and their risk factors: panel discussion on its interventions in Nepal","volume-title":"Webinar and panel discussion organised by Nepal Public Health Association","author":"A Pandey","year":"2023"},{"key":"pone.0324880.ref154","volume-title":"Health Sector Budget Analysis: First Five Years of Federalism","author":"Ministry of Health and Population, NHSSP.","year":"2022"},{"key":"pone.0324880.ref155","volume-title":"Budget Analysis of Ministry of Health FY 2021\/22. In","author":"Ministry of Health and Population, Nepal Health Sector Support Programme.","year":"2022"},{"key":"pone.0324880.ref156","unstructured":"Gyanwali S. Status, challenges and way forward for Health Insurance Programme in Nepal (Inv Talk). In: 9th National Virtual Summit of Health and Population Scientists in Nepal. Kathmandu, Nepal; 2023."},{"issue":"1","key":"pone.0324880.ref157","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1186\/s12913-021-06681-0","article-title":"Health system gaps in cardiovascular disease prevention and management in Nepal","volume":"21","author":"A Shrestha","year":"2021","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"pone.0324880.ref158","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1186\/s13690-020-00518-8","article-title":"Association of information, education, and communication with enrolment in health insurance: a case of Nepal","volume":"78","author":"D Acharya","year":"2020","journal-title":"Arch Public Health"},{"key":"pone.0324880.ref159","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s13690-019-0331-7","article-title":"Challenges and opportunities towards the road of universal health coverage (UHC) in Nepal: a systematic review","volume":"77","author":"CL Ranabhat","year":"2019","journal-title":"Arch Public Health"},{"issue":"1","key":"pone.0324880.ref160","doi-asserted-by":"crossref","first-page":"1788262","DOI":"10.1080\/16549716.2020.1788262","article-title":"Building Strong Primary Health Care to Tackle the Growing Burden of Non-Communicable Diseases in Nepal","volume":"13","author":"B Gyawali","year":"2020","journal-title":"Glob Health Action"},{"issue":"232","key":"pone.0324880.ref161","first-page":"1024","article-title":"Out of pocket Expenditure on Health Service Delivery at a Tertiary Care Women\u2019s Hospital: A Descriptive Cross-sectional Study","volume":"58","author":"P Gartaula","year":"2020","journal-title":"JNMA J Nepal Med Assoc"},{"issue":"5","key":"pone.0324880.ref162","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0265993","article-title":"Utilization of social health security scheme among the households of Illam district, Nepal","volume":"17","author":"S Shah","year":"2022","journal-title":"PLoS One"},{"key":"pone.0324880.ref163","volume-title":"Standards Related toTreatment Expenses, Relief, and Financial Assistance, 2077 In","author":"Ministry of Home Affairs.","year":"2019"},{"key":"pone.0324880.ref164","volume-title":"Access to the poor\u2019s money, who took how much (list) (Nepali)","author":"MB Basnet","year":"2023"},{"key":"pone.0324880.ref165","volume-title":"Government\u2019s decision to bear former Prime Minister Khanal\u2019s medical expenses, violating the provisions of the Act","author":"Reporter Swasthya Khabar Pratika.","year":"2021"},{"key":"pone.0324880.ref166","volume-title":"Working procedure related to citizen relief, compensation and financial support","author":"Ministry of Health and Population.","year":"2016"},{"key":"pone.0324880.ref167","volume-title":"GDP (current US$) - Nepal","author":"World Bank.","year":"2024"},{"key":"pone.0324880.ref168","volume-title":"Size of informal economy in Nepal","author":"SR Adhikari","year":"2024"},{"key":"pone.0324880.ref169","volume-title":"Annual report FY 2022\/23","author":"Nepal Rastra Bank.","year":"2023"},{"issue":"3","key":"pone.0324880.ref170","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1111\/pbaf.12314","article-title":"Implementing federalism: The case of Nepal","volume":"42","author":"RW Bahl","year":"2022","journal-title":"Public Budgeting & Finance"},{"key":"pone.0324880.ref171","volume-title":"Ministry of Finance Budget speech 2024\/25","year":"2024"},{"issue":"1","key":"pone.0324880.ref172","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1093\/inthealth\/ihaa016","article-title":"Vicious cycle of chronic disease and poverty: a qualitative study in present day Nepal","volume":"13","author":"T Sapkota","year":"2021","journal-title":"Int Health"},{"issue":"12","key":"pone.0324880.ref173","doi-asserted-by":"crossref","first-page":"1682","DOI":"10.3390\/ijerph21121682","article-title":"Sector-Wide Approach (SWAp) in Healthcare-A Mixed-Methods Assessment of Health SWAps in Nepal and Bangladesh","volume":"21","author":"S Flessa","year":"2024","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"pone.0324880.ref174","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/s12939-025-02395-5","article-title":"Political economy analysis of health financing reforms in times of crisis: findings from three case studies in south-east Asia","volume":"24","author":"S Witter","year":"2025","journal-title":"Int J Equity Health"},{"key":"pone.0324880.ref175","article-title":"Corruption and underdevelopment in Nepal: a content analysis","volume":"16","author":"DK Ghimire","year":"2022","journal-title":"Dhaulagiri J Sociol Anthropol"},{"key":"pone.0324880.ref176","doi-asserted-by":"crossref","first-page":"115168","DOI":"10.1016\/j.socscimed.2022.115168","article-title":"Addiction to a bad idea, especially in low- and middle-income countries: Contributory health insurance","volume":"320","author":"AS Yazbeck","year":"2023","journal-title":"Soc Sci Med"},{"issue":"3","key":"pone.0324880.ref177","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1002\/hec.4635","article-title":"The effect of health financing systems on health system outcomes: A cross-country panel analysis","volume":"32","author":"J Gabani","year":"2023","journal-title":"Health Econ"},{"issue":"2","key":"pone.0324880.ref178","doi-asserted-by":"crossref","first-page":"132","DOI":"10.2471\/BLT.19.234153","article-title":"Pooling financial resources for universal health coverage: options for reform","volume":"98","author":"I Mathauer","year":"2020","journal-title":"Bull World Health Organ"},{"key":"pone.0324880.ref179","first-page":"4954095","article-title":"Universal Health Coverage in Bangladesh: Activities, Challenges, and Suggestions","volume":"2019","author":"T Joarder","year":"2019","journal-title":"Psyche (Camb Mass)"},{"key":"pone.0324880.ref180","doi-asserted-by":"crossref","DOI":"10.1596\/978-1-4648-0297-3","volume-title":"Universal health coverage for inclusive and sustainable development: a synthesis of 11 country case studies","author":"A Maeda","year":"2014"},{"key":"pone.0324880.ref181","volume-title":"Health System in the Republic of Indonesia: Reforms, Transformations, and Challenges (CSEP Working Paper 43)","author":"M Nundy","year":"2022"},{"issue":"6","key":"pone.0324880.ref182","doi-asserted-by":"crossref","first-page":"415","DOI":"10.2471\/BLT.18.223693","article-title":"Universal health coverage and primary care, Thailand","volume":"97","author":"K Sumriddetchkajorn","year":"2019","journal-title":"Bull World Health Organ"},{"key":"pone.0324880.ref183","volume-title":"Financing mechanisms applied for successful Universal Health Coverage in Malaysia, Thailand and Singapore-lessons for Pakistan","author":"R Jabeen","year":"2021"},{"key":"pone.0324880.ref184","doi-asserted-by":"crossref","first-page":"12","DOI":"10.3126\/ejon.v41i3-4.35927","article-title":"Informal Economy and Poverty in Urban Nepal","volume":"41","author":"DB Adhikari","year":"2018","journal-title":"Economic Journal of Nepal"},{"issue":"9","key":"pone.0324880.ref185","doi-asserted-by":"crossref","DOI":"10.1016\/S2214-109X(20)30278-3","article-title":"Mapping geographical inequalities in access to drinking water and sanitation facilities in low-income and middle-income countries, 2000\u201317","volume":"8","author":"A Deshpande","year":"2020","journal-title":"The Lancet Global Health"},{"issue":"0","key":"pone.0324880.ref186","doi-asserted-by":"crossref","first-page":"3700","DOI":"10.36922\/ghes.3700","article-title":"Achieving universal health coverage inSub-Saharan Africa through the reformation of mental health financing","volume":"0","author":"E Otieno","year":"2024","journal-title":"GHES"},{"issue":"12","key":"pone.0324880.ref187","doi-asserted-by":"crossref","first-page":"1505","DOI":"10.1007\/s00103-018-2833-9","article-title":"Cancer screening and early diagnosis in low and middle income countries\u00a0: Current situation and future perspectives","volume":"61","author":"R Mandal","year":"2018","journal-title":"Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz"},{"issue":"10134","key":"pone.0324880.ref188","doi-asserted-by":"crossref","first-page":"2029","DOI":"10.1016\/S0140-6736(18)30667-6","article-title":"Investing in non-communicable disease prevention and management to advance the Sustainable Development Goals","volume":"391","author":"R Nugent","year":"2018","journal-title":"Lancet"},{"issue":"1","key":"pone.0324880.ref189","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s12916-020-01876-4","article-title":"Mapping subnational HIV mortality in six Latin American countries with incomplete vital registration systems","volume":"19","author":"Local Burden of Disease HIV Collaborators","year":"2021","journal-title":"BMC Med"},{"issue":"1","key":"pone.0324880.ref190","doi-asserted-by":"crossref","first-page":"1963069","DOI":"10.1080\/16549716.2021.1963069","article-title":"Barriers and facilitators to the implementation of a national multisectoral action plan for the prevention and control of noncommunicable diseases in Nepal: perspectives of stakeholders","volume":"14","author":"M Dhimal","year":"2021","journal-title":"Glob Health Action"},{"issue":"2","key":"pone.0324880.ref191","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2018-001343","article-title":"Designing and implementing an integrated non-communicable disease primary care intervention in rural Nepal","volume":"4","author":"A Kumar","year":"2019","journal-title":"BMJ Glob Health"},{"issue":"1","key":"pone.0324880.ref192","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/s13033-022-00530-1","article-title":"Applying systems approaches to stakeholder and community engagement and knowledge mobilisation in youth mental health system modelling","volume":"16","author":"L Freebairn","year":"2022","journal-title":"Int J Ment Health Syst"},{"issue":"3","key":"pone.0324880.ref193","doi-asserted-by":"crossref","first-page":"238","DOI":"10.4103\/2224-3151.206746","article-title":"Correlates of out-of-pocket spending on health in Nepal: implications for policy","volume":"3","author":"I Gupta","year":"2014","journal-title":"WHO South East Asia J Public Health"},{"issue":"1","key":"pone.0324880.ref194","doi-asserted-by":"crossref","first-page":"85","DOI":"10.3126\/jnhrc.v15i1.18027","article-title":"Governance and Purchasing Function under Social Health Insurance in Nepal: Looking Back and Moving Forward","volume":"15","author":"VP Sapkota","year":"2017","journal-title":"J Nepal Health Res Counc"},{"key":"pone.0324880.ref195","article-title":"Exploring the effects of digital technologies in health financing for universal health coverage: a synthesis of country experiences and lessons","volume":"2","author":"M Oranje","year":"2024","journal-title":"Oxf Open Digit Health"},{"key":"pone.0324880.ref196","doi-asserted-by":"crossref","first-page":"16006","DOI":"10.7189\/jogh.11.16006","article-title":"Technology and Universal Health Coverage: Examining the role of digital health","volume":"11","author":"D Wilson","year":"2021","journal-title":"J Glob Health"},{"issue":"1","key":"pone.0324880.ref197","doi-asserted-by":"crossref","first-page":"2375101","DOI":"10.1080\/23288604.2024.2375101","article-title":"The Consolidation of Risk Pools in the National Health Insurance Program of the Republic of Korea: Analysis of the Political Processes","volume":"10","author":"G Bae","year":"2024","journal-title":"Health Syst Reform"},{"issue":"5","key":"pone.0324880.ref198","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1093\/heapol\/czaa168","article-title":"Sin taxes and their effect on consumption, revenue generation and health improvement: a systematic literature review in Latin America","volume":"36","author":"A Miracolo","year":"2021","journal-title":"Health Policy Plan"},{"issue":"5","key":"pone.0324880.ref199","article-title":"Understanding why collective action resulted in greater advances for tobacco control as compared to alcohol control during the Philippines\u2019 Sin Tax Reform: a qualitative study","volume":"12","author":"C Hoe","year":"2022","journal-title":"BMJ Open"},{"issue":"2","key":"pone.0324880.ref200","doi-asserted-by":"crossref","DOI":"10.1787\/budget-v18-2-en","article-title":"Health financing and budgeting practices for health in the philippines","volume":"18","author":"J Capuno","year":"2018","journal-title":"OECD J Budget"},{"issue":"1","key":"pone.0324880.ref201","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1002\/hpm.2817","article-title":"Comparing selected countries using sin tax policy in sustainable health financing: Implications for developing countries","volume":"35","author":"H Javadinasab","year":"2020","journal-title":"Int J Health Plann Manage"},{"issue":"4","key":"pone.0324880.ref202","doi-asserted-by":"crossref","first-page":"248","DOI":"10.2471\/BLT.08.030408","article-title":"Flawed but fair: Brazil\u2019s health system reaches out to the poor","volume":"86","author":"C Jurberg","year":"2008","journal-title":"Bull World Health Organ"},{"issue":"1","key":"pone.0324880.ref203","doi-asserted-by":"crossref","first-page":"386","DOI":"10.3390\/su16010386","article-title":"The Impacts of Health Decentralization on Equity, Efficiency, and Effectiveness: A Scoping Review","volume":"16","author":"R Oliveira","year":"2023","journal-title":"Sustainability"},{"key":"pone.0324880.ref204","volume-title":"Financing for health system transformation: spending more or spending better (or both)?","author":"RP Forman","year":"2023"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0324880","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T17:40:49Z","timestamp":1748540449000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0324880"}},"subtitle":[],"editor":[{"given":"Himanshu Sekhar","family":"Rout","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,5,29]]},"references-count":204,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5,29]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0324880","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,29]]}}}