Proportion of population facing financial hardship due to out-of-pocket health expenditure (%) by country
Proportion of population spending more than 40% of household discretionary budget on out-of-pocket health expenditure (%) The discretionary budget is defined as the total household budget, measured by consumption expenditure or income, minus the societal poverty line (SPL ). Using 2017 purchasing power parities...
What the numbers show
Proportion of population facing financial hardship due to out-of-pocket health expenditure (%) is currently reported for 80 countries. The highest value is 47.4% in Nigeria; the lowest is 5.6% in Andorra.
The median across all reporting countries is 16.2%, and the mean is 20.3%.
The gap between the highest and lowest reporting country is a factor of about 8.
Over the past decade 33 countries rose and 46 fell. The largest increase was in El Salvador (up 146.1%), and the largest decrease in Ghana (down 50.0%).
Proportion of population facing financial hardship due to: full country ranking
| # | Country | Latest | Year | 10-year change | Trend |
|---|---|---|---|---|---|
| 1 | Nigeria | 47.4% | 2022 | up 8.7% | rising |
| 2 | Malawi | 43.0% | 2019 | up 12.2% | falling |
| 3 | Bangladesh | 41.7% | 2022 | up 40.4% | rising |
| 4 | Mali | 40.1% | 2022 | down 19.2% | falling |
| 5 | Cameroon | 38.8% | 2022 | down 4.1% | falling |
| 6 | Burkina Faso | 38.6% | 2021 | down 30.2% | rising |
| 7 | Niger | 38.6% | 2021 | down 29.1% | falling |
| 8 | Tanzania, United Republic of | 37.5% | 2020 | up 78.0% | falling |
| 9 | Egypt | 36.9% | 2019 | up 36.2% | rising |
| 10 | Uganda | 36.1% | 2019 | down 19.8% | falling |
| 11 | Benin | 35.6% | 2021 | down 33.9% | falling |
| 12 | Nicaragua | 34.7% | 2014 | down 3.4% | rising |
| 13 | Pakistan | 33.9% | 2018 | down 17.9% | falling |
| 14 | Togo | 31.3% | 2021 | down 24.2% | falling |
| 15 | Tunisia | 31.2% | 2021 | up 27.5% | rising |
| 16 | Philippines | 31.0% | 2023 | down 15.9% | falling |
| 17 | India | 30.9% | 2022 | down 27.7% | falling |
| 18 | Senegal | 30.9% | 2021 | down 30.8% | falling |
| 19 | Tajikistan | 30.8% | 2019 | up 28.7% | rising |
| 20 | Mongolia | 29.0% | 2023 | up 80.3% | rising |
| 21 | Côte d'Ivoire | 28.9% | 2021 | down 9.2% | flat |
| 22 | Peru | 28.5% | 2022 | up 17.5% | falling |
| 23 | Georgia | 27.9% | 2024 | down 12.1% | rising |
| 24 | Indonesia | 26.6% | 2023 | down 18.7% | falling |
| 25 | Nepal | 24.9% | 2022 | down 18.3% | falling |
| 26 | Ethiopia | 24.2% | 2021 | down 24.5% | falling |
| 27 | Viet Nam | 23.6% | 2020 | down 26.5% | falling |
| 28 | Armenia | 23.5% | 2020 | up 7.3% | rising |
| 29 | Palestine, State of | 22.3% | 2023 | up 39.4% | rising |
| 30 | Cambodia | 22.1% | 2023 | up 13.4% | falling |
| 31 | Jamaica | 21.5% | 2021 | up 1.3% | falling |
| 32 | Ghana | 21.1% | 2016 | down 50.0% | falling |
| 32 | South Africa | 21.1% | 2014 | down 34.2% | falling |
| 34 | Paraguay | 21.1% | 2023 | up 3.1% | falling |
| 35 | Greece | 18.9% | 2023 | up 35.2% | flat |
| 36 | Bulgaria | 18.8% | 2023 | up 5.7% | rising |
| 37 | Latvia | 18.6% | 2019 | up 38.1% | rising |
| 38 | Chile | 17.4% | 2021 | up 17.3% | flat |
| 39 | Hungary | 17.1% | 2007 | up 93.5% | rising |
| 40 | Israel | 16.6% | 2021 | down 11.9% | flat |
| 41 | Mexico | 15.9% | 2022 | up 33.5% | falling |
| 42 | Iran, Islamic Republic of | 15.7% | 2022 | down 5.2% | falling |
| 43 | Romania | 15.6% | 2016 | up 29.4% | rising |
| 44 | Russian Federation | 15.4% | 2014 | down 29.3% | falling |
| 45 | Albania | 14.8% | 2017 | down 22.0% | falling |
| 46 | Ukraine | 14.6% | 2019 | up 0.8% | falling |
| 47 | Portugal | 14.6% | 2022 | down 14.7% | rising |
| 48 | Luxembourg | 14.1% | 2023 | down 9.4% | rising |
| 49 | Poland | 14.1% | 2019 | down 15.5% | falling |
| 50 | Zambia | 14.1% | 2015 | down 46.1% | falling |
| 51 | Kosovo (UNSCR 1244) | 13.9% | 2016 | down 10.5% | falling |
| 51 | Kosovo | 13.9% | 2016 | down 10.5% | falling |
| 53 | Bolivia, Plurinational State of | 13.4% | 2021 | down 32.8% | rising |
| 54 | Türkiye | 12.7% | 2016 | down 2.0% | rising |
| 55 | Spain | 12.7% | 2023 | up 19.6% | rising |
| 56 | Mauritius | 12.6% | 2023 | up 3.5% | rising |
| 57 | Colombia | 12.5% | 2021 | down 39.0% | falling |
| 58 | Belarus | 12.2% | 2020 | down 19.2% | falling |
| 59 | Montenegro | 12.1% | 2015 | down 11.4% | rising |
| 60 | Thailand | 11.9% | 2017 | down 32.2% | falling |
| 61 | Sri Lanka | 11.3% | 2019 | down 35.1% | falling |
| 62 | Serbia | 11.0% | 2022 | up 2.0% | flat |
| 63 | Japan | 10.9% | 2024 | up 13.5% | rising |
| 64 | Lithuania | 10.6% | 2021 | down 13.3% | falling |
| 65 | El Salvador | 10.5% | 2019 | up 146.1% | rising |
| 66 | Switzerland | 10.3% | 2017 | down 8.8% | flat |
| 67 | Czechia | 10.0% | 2023 | up 56.7% | rising |
| 68 | Slovakia | 10.0% | 2022 | up 18.2% | falling |
| 68 | North Macedonia | 10.0% | 2024 | down 11.0% | falling |
| 70 | Republic of Moldova | 9.8% | 2023 | down 44.3% | flat |
| 71 | Kazakhstan | 9.8% | 2018 | down 26.4% | falling |
| 72 | Kyrgyzstan | 9.6% | 2022 | up 37.3% | falling |
| 73 | Bhutan | 9.0% | 2022 | up 68.5% | falling |
| 74 | Estonia | 8.9% | 2011 | down 15.6% | falling |
| 75 | Bosnia and Herzegovina | 8.6% | 2022 | down 30.0% | falling |
| 76 | Croatia | 8.4% | 2010 | down 9.3% | rising |
| 77 | United Kingdom of Great Britain and Northern Ireland | 7.5% | 2021 | up 18.9% | rising |
| 78 | United States of America | 6.8% | 2023 | down 20.4% | falling |
| 79 | Slovenia | 6.0% | 2022 | up 27.1% | falling |
| 80 | Andorra | 5.6% | 2023 | — | falling |
Regions and income groups
Aggregates are excluded from the country ranking above so that a region can never outrank a country.
- Sub-Saharan Africa 35.2%
- Low income 34.7%
- South Asia 31.7%
- Lower middle income 31.5%
- Middle East, North Africa, Afghanistan & Pakistan 27.5%
- East Asia & Pacific 26.5%
- World 26.0%
- Upper middle income 24.9%
- Latin America & Caribbean 20.3%
- Europe & Central Asia 12.9%
- High income 9.7%
- North America 7.5%
About this data
Proportion of population spending more than 40% of household discretionary budget on out-of-pocket health expenditure (%) The discretionary budget is defined as the total household budget, measured by consumption expenditure or income, minus the societal poverty line (SPL ). Using 2017 purchasing power parities (PPPs), the SPL corresponds to whichever is greater: $2.15 (the international poverty line) or $1.15 + 50% of median household consumption expenditure or income, excluding out-of-pocket household expenditure on health. Out-of-pocket health expenditure is defined as any spending incurred by a household when any member uses a health good or service to receive any type of care (preventive, curative, rehabilitative, long-term or palliative care); provided by any type of provider; for any type of disease, illness or health condition; in any type of setting (outpatient, inpatient, at home).