Trade in Health Services in South Asia by Arindam Banik

Author:Arindam Banik
Language: eng
Format: epub
ISBN: 9789811521911
Publisher: Springer Singapore

Trends in Global Health Spending Towards UHC

The WHO special reports and policy papers show that global health expenditure is rapidly increasing, faster than the gross domestic product of countries and the growth is higher in low- and middle-income countries (6% on average as compared to 4% in high income countries). Globally, OOP expenditure has gone down1 and pooled funds from governments’ sources have increased quite a bit. If we look into the type of global health spending, low- and medium-income countries spend more than 50% of their health spending on primary health care (PHC), however, public spending is less than 40% of total PHC spending. Surprisingly, immunisation spending still remains to be heavily dependent on external funding for many low-income countries. Over time, many low- and middle-income countries have taken health expenditure as priorities and have increased expenditure to a remarkable extent. If we make an intra-regional comparison, Sri Lanka’s current health expenditure, among its peer low–middle-income countries, is remarkably high and increasing overtime (Fig. 4.1c). The global health expenditure database 2016 published by WHO shows that the world spent 10% of GDP in health, average per capita was $1000 but 50% of the world spent less than $350 per person (Fig. 4.2). This implies that inequality in global spending has increased to a very large extent. Countries define primary healthcare services in different ways; therefore, categorisation of data for comparison purpose is difficult and one of the biggest hurdles in creating large or global health database. Public spending in all type of countries has increased in per capita terms. However, health spending as a share has not increased to a noticeable extent in LICs (Fig. 4.3).

Fig. 4.1Health expenditure pattern across the globe. a Out-of-pocket expenditure as % of total expenditure. b Out-of-pocket expenditure as % of total expenditure—world map. c Intra-regional comparison of health expenditure

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