Tracking out-of-pocket health expenditure under System of Health Accounts 2011

Overview

Out-of-pocket (OOP) spending by households is a major way of financing health expenditure in many countries, often linking access to care with the ability to pay. This document supports efforts to improve the estimation of OOP spending within countries’ health accounts (HA), recognizing its importance for understanding health financing patterns and assessing progress toward Universal Health Coverage (UHC).

It introduces the concept of OOP as defined in the System of Health Accounts 2011 (SHA 2011), provides an overview of relevant data sources and estimation methods, and offers recommendations tailored to diverse national health information systems. Accurate OOP estimates help countries better monitor health system performance and inform more equitable policy decisions.