Person:
Nagpal, Somil
Author Name Variants
Fields of Specialization
health financing; health insurance; universal health coverage; national health accounts; health informatics; health policy; India; Maldives; Bhutan; South Asia
Degrees
Departments
Health, Nutrition & Population, South Asia region, World Bank
Externally Hosted Work
Contact Information
Last updated
January 31, 2023
Biography
Dr. Somil Nagpal is Senior Health Specialist with the South Asia region of the World Bank and is based at the New Delhi office of the Bank since 2009. Prior to this, he served the Insurance Regulatory and Development Authority, India, where he was responsible for setting up the country’s first-ever specialized health insurance regulation unit and headed the regulatory and developmental initiatives for the health insurance sector of the country from 2007 to 2009. As an officer in the Indian civil service, he has also served at the Indian ministry of Health and Family Welfare, the National Commission on Macroeconomics and Health (NCMH), the World Health Organization and the Ministry of Finance. He is associated with the Board of the National Accreditation Board for Hospitals and Healthcare Providers (NABH), is a member of the Governing Council of the Insurance Information Bureau and is on the Health Insurance Advisory Board constituted by the Federation of Indian Chambers of Commerce and Industry. A top-scoring scholar, having qualified as a medical doctor with his postgraduation in healthcare management, he is also an MBA in Financial Management and a Fellow of the Insurance Institute of India. His academic interests include ongoing research, training and publications on Health Financing, particularly Health Insurance and Health Accounts.
Publication Search Results
1 - 10 of 11
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Publication
Creating Evidence for Better Health Financing Decisions : A Strategic Guide for the Institutionalization of National Health Accounts
(Washington, DC: World Bank, 2012-06-18)One of the key constraints to improving health outcomes in the developing world relates to equitable and efficient health financing. In most developing countries, a large portion of health expenditure is private and out-of-pocket (Gottret and Schieber 2006). This book represents a synthesis of lessons learned from country experiences and is intended to serve as a strategic guide to countries as they design and implement their policy to develop nationally relevant and internationally comparable data, collected in a routine and cost-effective manner. National Health Accounts (NHA) substantially contribute to the effort of improving health financing policy at global and country levels and offer a globally recognized framework for collecting, compiling, and analyzing data on health expenditures to and within the health system. As part of this effort, a framework has emerged that presents NHA activities as a cycle of activities with a clear purpose to serve policy makers, extending beyond the production of data: it involves the broad dissemination of that data and their translation into insightful analysis that can form an evidence base for effective policy making, underpinned by the nature of a given country's governance structure, human resources, and financing abilities. This book makes a distinct contribution in the way it addresses each step in the cycle of activities, assisting countries take greater ownership of the process of producing evidence and to make greater use of that evidence for better health financing decisions. -
Publication
Private Voluntary Health Insurance : Consumer Protection and Prudential Regulation
(Washington, DC: World Bank, 2012-05-14)Health care expenditures can be financed through a mix of public resources and private spending. Private spending is a much larger share of total health spending in low- and middle-income countries than in higher income countries. Moreover, a significant percentage of private spending in those countries is out-of-pocket direct payments for health care services by individuals. Out of pocket expenditures account for more than 60 percent of the total health care spending in low-income countries and 40 percent of total health care spending in middle-income countries. A growing number of low- and middle-income governments are considering private health insurance as a way of both reducing the risk that individuals will have a catastrophic financial burden and achieving other public health care goals. Among these goals are reducing the financial burden on overstretched public health financing, achieving more equitable access to health care, and improving quality and efficiency in the delivery of health care services. An important component of a successful private health insurance market, however, is its legal framework. As discussed in detail later in this book, countries regulate insurance companies to counter systemic market failures that lead to an inefficient and inequitable market. In particular, insurance laws are designed to prevent insurers from becoming insolvent and from engaging in unfair practices and discriminatory behavior. When private health insurance serves as a significant source of financing in a nation's health care system, usually insurance laws also include a range of consumer protection laws that enhance both access to the services covered by private health insurers and the adequacy of the benefits provided by the insurer. This chapter provides a general overview of private health insurance. It begins with a discussion of the definition of private health insurance and the potential roles of private health insurance as part of a nation's health care financing system. In addition, the chapter reviews the variety of entities that sell private health insurance. -
Publication
Expanding Health Coverage for Vulnerable Groups in India
(World Bank, Washington, DC, 2013-01)India's health sector continues to be challenged by overall low levels of public financing, entrenched accountability issues in the public delivery system, and the persistent dominance of out-of-pocket spending. In this context, this case study describes three recent initiatives introduced by the central and state governments in India, aimed at addressing some of these challenges and improving the availability of and access to health services, particularly for the poor and vulnerable groups in the country. This includes two federal schemes introduced by the Government of India-the National Rural Health Mission (NRHM) of the Ministry of Health and Family Welfare and the Rashtriya Swasthya Bima Yojana (RSBY) of the Ministry of Labor and Employment-and the Rajiv Aarogyasri scheme launched by the state government of Andhra Pradesh. The three schemes discussed in this case study were designed and implemented by different agencies almost in parallel, over the same time period, and used different financing and delivery approaches. A discussion of the mechanics and operational features of these programs has been undertaken to unravel the underlying complexities, interactions, and interdependencies of these programs within the country's health system. The remainder of this case study on India's march toward universal health coverage focuses on three recent, prominent programs, and includes a discussion on the institutional structure of these programs and their interactions within the country's health system, their mechanisms for beneficiary targeting and enrolment, the benefits packages covered by them, accompanying innovations in public financial management, and their information environment. Annex one presents an overview of the health system and health financing in India, and annex two discusses the evolutionary context of India's Government sponsored health insurance schemes. The discussion of the mechanics and operational features of these programs has been undertaken to unravel the underlying complexities, interactions, and interdependencies within these programs. The case study also aims to contribute to the ongoing debate within the Indian health sector, with opinions divided between investments in traditional input-based health spending for publicly managed health facilities versus demand-side financing, purchasing of care, and involving private providers and intermediaries in delivering services financed by public money. The case study also aims to share how the lessons learned by one program can be applicable more widely within the Indian health system and beyond -
Publication
Government-Sponsored Health Insurance in India : Are You Covered?
( 2012-08-26)Since independence, India has struggled to provide its people with universal health coverage. Whether defined in terms of financial protection or access to and effective use of health care, the majority of Indians remain irregularly and incompletely covered. Finally, and most recently, a new generation of Government-Sponsored Health Insurance Schemes (GSHISs) has emerged to provide the poor with financial coverage. Briefly, the main objective of these new GSHISs was to offer financial protection against catastrophic health shocks, defined in terms of an inpatient stay. Between 2007 and 2010, six major schemes have emerged, including one sponsored by the Government of India (GOI) and five state-sponsored schemes. This new wave of schemes provides fully subsidized coverage for a limited package of secondary or tertiary inpatient care, targeting below poverty populations. Similar to the private voluntary insurance products in the country, ambulatory services including drugs are not covered except as part of an episode of illness requiring an inpatient stay. The schemes have organized hospital networks consisting of public and private facilities, and most care funded by these schemes is provided in private hospitals. Ostensibly, the objective of any health insurance scheme is to increase access, utilization, and financial protection, and ultimately improve health status. Due to lack of evaluations and analyses of household data, the authors of this book do not examine the impact of health insurance in terms of these objectives. This book is not meant to highlight problems of the GSHISs, but rather to raise potential challenges and emerging issues that should be addressed to ensure the long-term viability of these schemes and secure their place within the health finance and delivery system. -
Publication
Bhutan : Maternal and Reproductive Health at a Glance
(World Bank, Washington, DC, 2014-11)Bhutan is a small landlocked country in the Himalayas between China and India. Poverty reduction has been rapid from about 23 percent in 2007 to 12-13 percent in 2012. Gender equality and women's empowerment are important determinants of reproductive health. Contraceptive prevalence rate (CPR) is higher among the poorest quintile than the richest. Large disparities in access to skilled birth attendant remain by geography and wealth quintile. Poor nutrition is a serious issue for pregnant mothers, since 55 percent of women are anemic. Bhutan will need to focus on increasing the focus on quality along the continuum of care; improving access and equity; and ensuring sustainability of health financing. -
Publication
Maldives: Maternal and Reproductive Health at a Glance
(World Bank, Washington, DC, 2014-11)Maldives, a middle income country, is on track to meet most of the Millennium Development Goals (MDGs), while gender gap requires attention. Maldives has made great progress in improving maternal health and has achieved MDG. The total fertility rate has declined to 2.3 in 2012. Contraceptive use has increased but high unmet need of 28.1 percent is of concern. Skilled birth attendance is high at 95 percent. Access to maternal health services is fairly equitable by residence and wealth quintile, while geographical access to services remains challenging. Also, unwanted pregnancies among young women are on the rise. Maldives has initiated a number of interventions to increase adolescents needs for sexual and reproductive health services, improve quality of RMNCH services, and increase utilization of health services at local level. -
Publication
Going Universal: How 24 Developing Countries are Implementing Universal Health Coverage from the Bottom Up
(Washington, DC: World Bank, 2015-09-24)This book is about 24 developing countries that have embarked on the journey towards universal health coverage (UHC) following a bottom-up approach, with a special focus on the poor and vulnerable, through a systematic data collection that provides practical insights to policymakers and practitioners. Each of the UHC programs analyzed in this book is seeking to overcome the legacy of inequality by tackling both a “financing gap” and a “provision gap”: the financing gap (or lower per capita spending on the poor) by spending additional resources in a pro-poor way; the provision gap (or underperformance of service delivery for the poor) by expanding supply and changing incentives in a variety of ways. The prevailing view seems to indicate that UHC require not just more money, but also a focus on changing the rules of the game for spending health system resources. The book does not attempt to identify best practices, but rather aims to help policy makers understand the options they face, and help develop a new operational research agenda. The main chapters are focused on providing a granular understanding of policy design, while the appendixes offer a systematic review of the literature attempting to evaluate UHC program impact on access to services, on financial protection, and on health outcomes. -
Publication
Government Health Insurance for People Below Poverty Line in India: Quasi-Experimental Evaluation of Insurance and Health Outcomes
(BMJ Publishing, 2014-09-11)The objective of this study is to evaluate the effects of a government insurance program covering tertiary care for people below the poverty line in Karnataka, India, on out-of-pocket expenditures, hospital use, and mortality. -
Publication
Kingdom of Bhutan Human Development Public Expenditure Review
(World Bank, Washington, DC, 2013-03)Bhutan is situated between the Tibetan Plateau in the North and Indian plains in the south. The development philosophy in Bhutan is embedded in the concept of Gross National Happiness (GNH) that, as a public policy strategy, seeks to address a more meaningful purpose of development that goes beyond the fulfillment of material satisfaction. The concept is grounded in the four pillars of development; socio-economic, environment, culture, and good governance. Bhutan s record on growth and development has made it a top performer in the South Asian region. The average annual growth rate of GDP over 1980-2010 in country was more than 7.6 percent, one of the highest in the South Asian sub-continent (SAS). Bhutan, with a Gross Domestic Product (GDP) per capita of about US$2,000, is now classified as a lower-middle income country. However, one of the most notable features about Bhutan s macro economy is its lack of diversification, dependence on and exposure to external developments, and the high levels of year-to-year volatility in its economic growth. Public Expenditure Review (PER) begins with an overview of the macro-economic context (chapter two) and public sector management (chapter three) in Bhutan. This is followed by an analytical summary of achievements to date in the health and education sectors (chapters four and five). The PER concludes (chapter six) with policy options and recommendations which are intended to spur discussion and analysis among policy-makers in Bhutan as they look into different possibilities to increase fiscal space in domestic resources while enhancing the quality of expenditures and improving outcomes in the health and education systems. -
Publication
Vulnerability Map for Response to the COVID-19 Epidemic: A Case Study on Indonesia
(Washington, DC: World Bank, 2022-02-01)The COVID-19 pandemic has emerged as a threat to global health security. This paper uses geospatial analyses to create a COVID Vulnerability Mapping Dashboard that examines and displays social vulnerability indices at the national and subnational levels in Indonesia. The dashboard answers three main questions: 1. Where are the vulnerable populations 2. What is the capacity of local health systems and 3. What is the local trend in COVID cases The dashboard prototype presented herein was developed and used to direct attention to geographic areas where risks are expected to be greatest.