Experts from 9 countries in eastern Europe and central Asia (EECA) are gathering this week at a workshop in Tbilisi, Georgia to measure the financial hardship people experience when they have to pay out of pocket for health care. Led by the WHO Barcelona Office for Health Systems Financing, the meeting is part of a new collaboration with countries in EECA to monitor financial protection – a key dimension of universal health coverage.
The workshop brings together a network of national experts – officials from national statistical offices, ministries of health and health insurance funds, and independent analysts – to measure 2 common indicators of financial hardship in health systems: catastrophic and impoverishing out-of-pocket payments for health care.
Catastrophic payments exceed 40% of a household’s capacity to pay for health care, while impoverishing payments push households below, or further below, the poverty line. Households incurring catastrophic or impoverishing out-of-pocket payments may not be able to meet other basic needs, such as food, housing and electricity.
The network is also producing up-to-date information on the design of coverage policies in each country: national decisions about who has access to publicly financed health services, the scope of the public benefits package, and whether or not people have to pay user charges (co-payments) for covered health services, including medicines. This information allows countries to identify gaps in health care coverage, which lead to financial hardship for households.
Workshop participants come from Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan , the Republic of Moldova, Tajikistan, Ukraine and Uzbekistan.
Generating new evidence on financial protection
Many of these countries are generating equity-sensitive and actionable information on financial hardship for the first time. The workshop is an opportunity for them to share and interpret their findings. This is particularly relevant because out-of-pocket payments are the main source of health financing in most of the countries taking part in the workshop, slowing progress towards universal health coverage.
Financial protection – affordable access to health care – is an indicator of the Sustainable Development Goals, part of the European Pillar of Social Rights and at the centre of the European Programme of Work, WHO/Europe’s strategic framework. Through the WHO Barcelona Office, WHO/Europe monitors financial protection in over 40 countries. The WHO Barcelona Office also provides tailored technical assistance to countries to reduce financial hardship and unmet need for health services by identifying and addressing gaps in coverage.