// THESIS GUIDANCE PORTAL · Health

Health Insurance Enrollment Behavior Under Nepal's National Health Insurance Program

Level: Bachelor, MasterDifficulty: Intermediate

1. Introduction & Problem Statement

Overview: Study of why enrollment and renewal rates stay low despite the government scheme.

Background Context (Nepal): Nepal's Health Insurance Board (HIB) introduced a social health insurance scheme to achieve Universal Health Coverage, yet dropout and low renewal rates threaten financial viability.

2. Research Objectives

›Identify primary household behavioral factors (perceived service quality, drug availability, premium affordability) driving enrollment and dropouts
›Assess satisfaction levels regarding empirical service quality at impaneled public vs private hospitals
›Analyze demographic variation (income, chronic illness presence, household size) in renewal decision-making
›Evaluate administrative bottlenecks in claim reimbursement facing empanelled health facilities
›Formulate strategic policy recommendations for HIB to increase scheme retention and enrollment

3. Proposed Methodology

Cross-sectional survey covering 200 enrolled and previously enrolled households in Pokhara and Chitwan municipalities
Andersen's Behavioral Model of Health Services Use adopted as conceptual research framework
Binary Logistic Regression in SPSS estimating probability of insurance policy annual renewal
Key Informant Interviews (KIIs) with Health Insurance Board (HIB) enrollment officers and hospital administration
Likert scale measurement of service satisfaction and out-of-pocket expenditure (OOPE) reductions

$ Worked Example / Sample Scenario

Sample Scenario: Surveying 200 households in Pokhara shows that while 82% enrolled initially, 41% allowed their policy to lapse, citing medicine stock-outs at impaneled hospital pharmacies as the primary reason for non-renewal.

4. Thesis Chapter-by-Chapter Outline

Chapter 1: IntroductionTU/KU standard

Background, problem statement, research questions, objectives, scope, limitations, and significance of the study

Chapter 2: Literature ReviewTU/KU standard

Theoretical framework, conceptual models, previous empirical studies in Nepal and developing nations, Andersen's Health Utilization Model, social health insurance literature, and HIB policy frameworks, and gap analysis

Chapter 3: Research MethodologyTU/KU standard

Research design, population/sampling framework, data collection instruments, analytical tools, and ethical considerations

Chapter 4: Data Analysis & ResultsTU/KU standard

Empirical findings, statistical testing, model estimations, renewal logistic regression tables, service satisfaction charts, and OOPE comparison figures, and detailed discussion

Chapter 5: Conclusion & RecommendationsTU/KU standard

Summary of key findings, theoretical contributions, policy recommendations, and future research directions

5. Recommended Tools & Technologies

To implement the practical, technical, or analytical portions of this thesis topic, the following software tools, libraries, or APIs are recommended:

SPSSMS ExcelGoogle Forms

6. Core References & Academic Sources

[1]Health Insurance Board (HIB Nepal) — Annual Reports & Enrollment Performance Data
[2]Ministry of Health and Population (Nepal) — Nepal Health Sector Strategic Plan
[3]Health Policy and Planning / Elsevier / NepJOL — National health insurance studies in Nepal

7. Frequently Asked Questions (FAQs)

Q: What is the current annual premium for Nepal's National Health Insurance?

Under HIB guidelines, the standard contribution is NPR 3,500 per year for a family of up to 5 members, providing coverage up to NPR 100,000.

Q: What model explains health insurance uptake?

Andersen's Behavioral Model of Health Services Use categorizes Predisposing characteristics, Enabling resources, and Perceived Need.

Q: Where can I get official HIB enrollment statistics?

The Health Insurance Board (HIB Nepal) publishes annual reports detailing district-wise enrollment numbers and claim payouts.

Q: What is out-of-pocket expenditure (OOPE)?

OOPE refers to direct payments made by individuals for medical services at the time of care not covered by insurance.