A new report by the World Health Organization (WHO) Regional office for Africa finds that most African countries continue to rely heavily on out-of-pocket payments to fund their health services, and urges countries to reduce the financial strains that high health-care costs place on their population.
The practice of out-of-pocket payments, warns the report, continues to; place a financial burden on over 200 million people, including pushing over 150 million people into or deeper into poverty across the WHO Africa Region; exact a heavy price on people’s health; and hamper progress in attaining universal health coverage.
“Having to pay for medicines and other health-care costs out of their own pocket can instantly bend the trajectory of someone’s life toward financial hardship and ill health. Such payments force many people to spend less on other basic needs such as food, housing and utilities, which, in turn, may worsen their conditions. This also creates a major barrier for the poorest and the most vulnerable who cannot get, as a result, the care they need,” said Dr Matshidiso Moeti, WHO’s Regional Director for Africa.
“Despite countries’ efforts to build more sustainable health financing systems, more needs to be done so that people across Africa have access to the quality health services they need, when and where they need them, without having to fall into financial hardship,” added Dr Moeti.
Between 2000 and 2019, the period analysed by the report, the number of people making ‘catastrophic’ out-of-pocket payments rose every year by 2.5 million people from 52 million in 2000 to 95 million in 2019.
That said, progress, albeit at a slower pace than globally, has been made during the same period, with the overall number of people pushed into or deeper into poverty because of out-of-pocket payments having halved between 2000 and 2019.
The report, the only one of its kind, helps countries track progress on financial protection in health and make evidence-based decisions to accelerate efforts to attain universal health coverage.
The report highlights good practices by several countries to address the burden of out-of-pocket payments by, for example, abolishing patients’ fees at the point of care, introducing health insurance schemes, and progressively increasing reliance on government-funded health services.
“I hope this report will strengthen countries’ resolve to improve financial protection in health for their populations and to invest in better data generation, analysis and use to inform better decision-making,” said Dr Moeti
