Who pays for health care in eight East African countries?

Direct payments use the health bill as their denominator

The out-of-pocket share describes households’ direct spending on health goods and services relative to all current health expenditure. It includes payments such as fees or purchases. The share measures how care was financed, rather than the fraction of households paying for care. Source 1 Source 4

The two financing sources cover only part of the bill

Kenya’s domestic government share was 44.91%, while its out-of-pocket share was 24.25% in 2023. Other sources can include external funding and other private financing. Adding the two displayed shares leaves room for those sources. Source 1 Source 2 Source 5

A larger GDP share can coexist with a small government share

South Sudan’s current health expenditure was 11.61% of GDP in 2023. Its domestic government spending represented 4.32% of current health expenditure. Those percentages have different denominators and describe different aspects of the country’s accounts. Source 3 Source 2

The historical series shows changes in financing mix

Uganda’s out-of-pocket share moved from 39.47% in 2015 to 32.17% in 2023. Its domestic government share moved from 15.15% to 21.80%. These shares can move when spending by any funding source changes. Source 1 Source 2

Sources

• WHO Global Health Expenditure Database, out-of-pocket share via WDI
• WHO Global Health Expenditure Database, domestic government share via WDI
• WHO Global Health Expenditure Database, current spending as a share of GDP via WDI
• World Bank and WHO, out-of-pocket health expenditure definition
• World Bank and WHO, domestic government expenditure definition
• Natural Earth, populated places