Health Affairs

Health Affairs, 28, no. 4 (2009): 1056-1066 doi: 10.1377/hlthaff.28.4.1056 © 2009 by Project HOPE	New Online   Getting Health Reform Done   After the State of the Union   Incremental Reform   E-Health in Developing World   Most-Read Articles in 2009

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Public Spending

Borrowing And Selling To Pay For Health Care In Low- And Middle-Income Countries

Margaret E. Kruk, Emily Goldmann and Sandro Galea

Many families around the world make sizable out-of-pocket payments for health care. We calculated the frequency of borrowing money or selling assets to buy health services in forty low- and middle-income countries and estimated how various factors are associated with these coping strategies. The data represented a combined population of 3.66 billion, or 58 percent of the world’s population. On average, 25.9 percent of households borrowed money or sold items to pay for health care. The risk was higher among the poorest households and in countries with less health insurance. Health systems in developing countries are failing to protect families from the financial risks of seeking health care.

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