Introduction

Introduction

Nepal, a landlocked country home to the world’s highest mountains and rugged terrain, has long faced geographical hurdlesinaccessinggoodsandservices,includinghealthcare.Its diverse topographical and sociological state results in periodic epidemicsofinfectiousdiseases,epizooticsandnaturalhazards such as floods, forest fires, landslides, and earthquakes.112 Around 22% of Nepalis do not have access to basic health facilities,andonly61.8%haveaccesstohealthcarewithina30minute radius. This is partly caused by a shortage of human resourcesforhealthwithonly0.67doctorsandnursesper1,000 people.113 In 2015, to resolve its geographical hurdles, its government transformed into a three-level federal government: a federal level,sevenprovincesand753localgovernments.114 Ithassince achieved improvements of overall health: the human developmentindexvalueincreasedto0.602in2019,mortality rateduringchildbirthdecreasedto186outof100,000in2017, mortality under the age of 5 decreased to 32.2 per 1,000 live birthsin2018,andlifeexpectancuroseto71.5in2018.115,116,117 Currently, majority of its healthcare expenditure is from domesticprivatehealthproviders,63.28%,118 butout-of-pocket expenses remain a large portion of it, 57.91%.119 Its health expenditureisonly4.45%ofitsGDP.120 Compared to the other countries in the Fintech for Health program, Nepal’s digital and fintech environments are still nascent. Its room and potential for growth, given the ability of digital technologies to transcend geographical barriers, should notbeunderestimated.