Publication:
Who Pays? Out-of-Pocket Health Spending and Equity Implications in the Middle East and North Africa

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dc.contributor.authorElgazzar, Heba
dc.contributor.authorRaad, Firas
dc.contributor.authorArfa, Chokri
dc.contributor.authorMataria, Awad
dc.contributor.authorSalti, Nisreen
dc.contributor.authorChaaban, Jad
dc.contributor.authorSalehi-Isfahani, Djavad
dc.contributor.authorFesharaki, Sanaz
dc.contributor.authorMajbouri, Mehdi
dc.date.accessioned2013-05-29T13:34:38Z
dc.date.available2013-05-29T13:34:38Z
dc.date.issued2010-11
dc.description.abstractEnsuring affordable, effective health care and financial protection against the adverse effects of household out-of-pocket (OOP) health expenditures represents an important policy objective in most countries, yet relatively little evidence exists regarding patterns and implications of household health expenditures in the Middle East and North Africa (MENA) region. This paper examines the scope of out-of-pocket expenditures and their implications on living standards and policy reforms in six MENA countries including Yemen, the West Bank and Gaza, Egypt, Iran, Tunisia, and Lebanon. Results show that OOP payments represent a relatively high share of total national health care financing at 49 percent on average in the MENA region as of 2006. Households pay an average of 6 percent of their total household expenditure on health. Most of this OOP is spent on medications, doctor visits and diagnostic services. Lower-income and rural households generally face greater financial risk; yet this is reversed where private health services are utilized and paid for more frequently by higher-income groups. 7 to 13 percent of households face particularly high OOP payments, or catastrophic expenditures equal to at least 10 percent of household spending. Poverty rates tend to increase by up to 20 percent after health care spending is accounted for. Results are discussed in light of ongoing policy efforts to strengthen social protection for health care.en
dc.identifierhttp://documents.worldbank.org/curated/en/2010/11/13179390/pays-out-of-pocket-health-spending-equity-implications-middle-east-north-africa
dc.identifier.doi10.1596/13606
dc.identifier.urihttps://hdl.handle.net/10986/13606
dc.languageEnglish
dc.language.isoen_US
dc.publisherWorld Bank, Washington, DC
dc.relation.ispartofseriesHealth, Nutrition and Population (HNP) discussion paper;
dc.rightsCC BY 3.0 IGO
dc.rights.holderWorld Bank
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/igo
dc.subjectABILITY TO PAY
dc.subjectACCESS TO HEALTH CARE
dc.subjectACCESS TO HEALTH SERVICES
dc.subjectANTENATAL CARE
dc.subjectBASIC HEALTH CARE
dc.subjectBASIC HEALTH SERVICES
dc.subjectBASIC SERVICES
dc.subjectCATASTROPHIC EXPENDITURES
dc.subjectCATASTROPHIC HEALTH SPENDING
dc.subjectCHILD HEALTH
dc.subjectCHILD HEALTH SERVICES
dc.subjectCLINICS
dc.subjectCOSTS OF CARE
dc.subjectCOSTS OF HEALTH CARE
dc.subjectDECISION MAKING
dc.subjectDELIVERY OF HEALTH CARE
dc.subjectDEMAND FOR HEALTH
dc.subjectDEMAND FOR HEALTH CARE
dc.subjectDENTAL CARE
dc.subjectDETERMINANTS OF HEALTH
dc.subjectDIABETES
dc.subjectDIAGNOSTIC SERVICES
dc.subjectDISADVANTAGED COMMUNITIES
dc.subjectDRUGS
dc.subjectECONOMIC GROWTH
dc.subjectELIGIBLE BENEFICIARIES
dc.subjectEMPOWERMENT
dc.subjectEXPOSURE
dc.subjectFAMILY PLANNING
dc.subjectFEE-FOR-SERVICE
dc.subjectFEE-FOR-SERVICE BASIS
dc.subjectFINANCE OF HEALTH CARE
dc.subjectFINANCIAL BARRIERS
dc.subjectFINANCIAL CONSEQUENCES
dc.subjectFINANCIAL PROTECTION
dc.subjectFINANCIAL RISK
dc.subjectHEALTH CARE
dc.subjectHEALTH CARE ACCESS
dc.subjectHEALTH CARE COSTS
dc.subjectHEALTH CARE COVERAGE
dc.subjectHEALTH CARE EXPENDITURE
dc.subjectHEALTH CARE EXPENDITURES
dc.subjectHEALTH CARE FACILITIES
dc.subjectHEALTH CARE FINANCE
dc.subjectHEALTH CARE FINANCING
dc.subjectHEALTH CARE NEEDS
dc.subjectHEALTH CARE PERSONNEL
dc.subjectHEALTH CARE PROFESSIONALS
dc.subjectHEALTH CARE PROVIDERS
dc.subjectHEALTH CARE RESOURCES
dc.subjectHEALTH CARE SERVICES
dc.subjectHEALTH CARE SPENDING
dc.subjectHEALTH CARE SYSTEM
dc.subjectHEALTH CARE USE
dc.subjectHEALTH CONDITIONS
dc.subjectHEALTH ECONOMICS
dc.subjectHEALTH EXPENDITURE
dc.subjectHEALTH EXPENDITURES
dc.subjectHEALTH FINANCING
dc.subjectHEALTH FINANCING SCHEME
dc.subjectHEALTH INDICATORS
dc.subjectHEALTH INSURANCE
dc.subjectHEALTH INSURANCE COVERAGE
dc.subjectHEALTH INSURANCE SCHEME
dc.subjectHEALTH INTERVENTIONS
dc.subjectHEALTH NEEDS
dc.subjectHEALTH ORGANIZATION
dc.subjectHEALTH OUTCOMES
dc.subjectHEALTH POLICY
dc.subjectHEALTH PROJECT
dc.subjectHEALTH SECTOR
dc.subjectHEALTH SECTOR REFORM
dc.subjectHEALTH SERVICE
dc.subjectHEALTH SERVICE DELIVERY
dc.subjectHEALTH SERVICE USE
dc.subjectHEALTH SERVICE UTILIZATION
dc.subjectHEALTH SERVICES
dc.subjectHEALTH SPENDING
dc.subjectHEALTH STATUS
dc.subjectHEALTH SYSTEM
dc.subjectHEALTH SYSTEMS
dc.subjectHEALTH WORKERS
dc.subjectHEALTHCARE
dc.subjectHOSPITAL CARE
dc.subjectHOSPITALS
dc.subjectHOUSEHOLD EXPENDITURE
dc.subjectHR
dc.subjectHUMAN DEVELOPMENT
dc.subjectILLNESS
dc.subjectIMMUNIZATION
dc.subjectINCOME
dc.subjectINCOME COUNTRIES
dc.subjectINCOME GROUPS
dc.subjectINCOME HOUSEHOLDS
dc.subjectINEQUITY IN HEALTH
dc.subjectINFANT MORTALITY
dc.subjectINFANT MORTALITY RATE
dc.subjectINFANTS
dc.subjectINFORMAL SECTOR
dc.subjectINFORMATION SYSTEMS
dc.subjectINPATIENT CARE
dc.subjectINPATIENT HOSPITAL
dc.subjectINPATIENT HOSPITAL CARE
dc.subjectINSURANCE PLANS
dc.subjectINSURANCE PREMIUMS
dc.subjectINTERNATIONAL COMPARISONS
dc.subjectINTERVENTION
dc.subjectLABOR MARKETS
dc.subjectLIVING STANDARDS
dc.subjectLOW INCOME
dc.subjectLOW-INCOME COUNTRIES
dc.subjectMALNUTRITION
dc.subjectMEDICAL ASSOCIATION
dc.subjectMEDICAL COSTS
dc.subjectMEDICATION
dc.subjectMORTALITY
dc.subjectNATIONAL HEALTH
dc.subjectNATIONAL HEALTH EXPENDITURES
dc.subjectNATIONAL HEALTH INSURANCE
dc.subjectNATIONAL HEALTH INSURANCE FUND
dc.subjectNATIONAL HEALTH SPENDING
dc.subjectNUTRITION
dc.subjectOUTPATIENT SERVICES
dc.subjectPATIENTS
dc.subjectPAYMENTS FOR HEALTH CARE
dc.subjectPERFORMANCE INDICATORS
dc.subjectPHARMACEUTICAL EXPENDITURES
dc.subjectPHARMACEUTICAL SERVICES
dc.subjectPHYSICIAN
dc.subjectPHYSICIANS
dc.subjectPOCKET PAYMENTS
dc.subjectPOCKET PAYMENTS BY HOUSEHOLDS
dc.subjectPOCKET PAYMENTS FOR HEALTH CARE
dc.subjectPOLICY RESEARCH
dc.subjectPOVERTY REDUCTION
dc.subjectPRIMARY CARE
dc.subjectPRIMARY HEALTH CARE
dc.subjectPRIMARY HEALTH CARE SERVICES
dc.subjectPRIVATE CLINICS
dc.subjectPRIVATE HEALTH CARE SERVICES
dc.subjectPRIVATE HEALTH INSURANCE
dc.subjectPRIVATE HEALTH SERVICES
dc.subjectPRIVATE INSURANCE
dc.subjectPRIVATE SECTOR
dc.subjectPRIVATE SPENDING
dc.subjectPROTECTION MECHANISMS
dc.subjectPROTECTIONS
dc.subjectPROVIDER INCENTIVES
dc.subjectPROVISION OF SERVICES
dc.subjectPUBLIC COVERAGE
dc.subjectPUBLIC EXPENDITURE
dc.subjectPUBLIC HEALTH
dc.subjectPUBLIC HEALTH INSURANCE
dc.subjectPUBLIC HEALTH INSURANCE SCHEMES
dc.subjectPUBLIC INSURANCE
dc.subjectPUBLIC INSURANCE SCHEMES
dc.subjectPUBLIC PROVIDERS
dc.subjectPUBLIC SECTOR
dc.subjectPUBLIC SECTORS
dc.subjectQUALITY OF CARE
dc.subjectQUALITY OF HEALTH
dc.subjectQUALITY OF HEALTH CARE
dc.subjectREHABILITATION
dc.subjectREPRODUCTIVE HEALTH
dc.subjectRURAL AREAS
dc.subjectRURAL HOUSEHOLDS
dc.subjectRURAL REGIONS
dc.subjectSAFETY NETS
dc.subjectSOCIAL EXCLUSION
dc.subjectSOCIAL HEALTH INSURANCE
dc.subjectSOCIAL HEALTH INSURANCE SCHEMES
dc.subjectSOCIAL SECURITY
dc.subjectSOCIAL SECURITY SCHEMES
dc.subjectSOCIAL WELFARE
dc.subjectSUSTAINABILITY
dc.subjectUSE OF HEALTH CARE SERVICES
dc.subjectVACCINATION
dc.subjectVISITS
dc.subjectWORKERS
dc.titleWho Pays? Out-of-Pocket Health Spending and Equity Implications in the Middle East and North Africaen
dspace.entity.typePublication
okr.date.disclosure2010-11-30
okr.date.doiregistration2025-05-05T12:13:58.958155Z
okr.doctypePublications & Research::Working Paper
okr.doctypePublications & Research
okr.docurlhttp://documents.worldbank.org/curated/en/2010/11/13179390/pays-out-of-pocket-health-spending-equity-implications-middle-east-north-africa
okr.globalpracticeSocial, Urban, Rural and Resilience
okr.globalpracticeHealth, Nutrition, and Population
okr.globalpracticeGovernance
okr.globalpracticeHealth, Nutrition, and Population
okr.guid464431468276384167
okr.identifier.externaldocumentum000333038_20101130215933
okr.identifier.internaldocumentum13179390
okr.identifier.report58014
okr.language.supporteden
okr.pdfurlhttp://www-wds.worldbank.org/external/default/WDSContentServer/WDSP/IB/2010/11/30/000333038_20101130215933/Rendered/PDF/580140revised0155B01PUBLIC10WhoPays.pdfen
okr.region.administrativeMiddle East and North Africa
okr.region.geographicalNorth Africa
okr.region.geographicalMiddle East
okr.topicLaw and Development::Health Law
okr.topicHealth Economics and Finance
okr.topicHealth Monitoring and Evaluation
okr.topicHealth Systems Development and Reform
okr.topicRural Development::Regional Rural Development
okr.topicHealth, Nutrition and Population
okr.unitHealth, Nutrition & Population (MNSHH)
okr.volume1 of 1
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