By Gift Briton
As the world marked Universal Health Coverage (UHC) Day on 12th Dec 2024, a new report from the World Health Organization (WHO) Regional Office for Africa has revealed an alarming impact of out-of-pocket payments for healthcare across the continent.
An out-of-pocket cost is the difference between the amount a doctor charges for a medical service and what any health insurer pays, including formal and informal expenses directly related to the cost of seeking care.
According to the WHO report, most African countries still rely heavily on out-of-pocket payments to fund their health services. However, this funding method continues to plunge millions into financial hardship and impede progress toward universal health coverage.
“Having to pay for medicines and other health-care costs out of their 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.
This practice, as highlighted in the report, continues to place a financial burden on over 200 million Africans into poverty. Alarmingly, half of the global population impoverished by out-of-pocket healthcare payments resides in Africa, a trend that has worsened since 2000.
WHO has urged countries to reduce the financial strains that high healthcare costs place on their population, with Dr Moeti adding that “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.”
As demonstrated in the report, out-of-pocket payments accounted for over 25% of health spending in 31 African countries in 2019. In 11 of these countries, such payments exceeded half of all health spending, with three countries reporting levels over 70%.
Furthermore, the number of Africans spending over 10% of their household budgets on healthcare rose by 2.5 million annually between 2000 and 2019, reaching 95 million.
While the overall number of people pushed into poverty due to healthcare costs halved from 2000 to 2019, the pace of decline was slower in Africa compared to global trends. Also, medicines and outpatient care were identified as the primary drivers of financial hardship from healthcare costs.
Despite some progress, the report underscores the urgent need for action. Countries investing more in government-funded health services experienced lower levels of catastrophic healthcare spending. Several nations have implemented reforms, such as abolishing patient fees at the point of care and introducing health insurance schemes. However, the pace of improvement remains insufficient.
The WHO urged African governments to exempt the poorest populations from out-of-pocket payments and to expand domestic funding for health services. Investments in better data collection and analysis are also crucial to inform evidence-based policies and monitor progress.
“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.
