Elgazzar, HebaRaad, FirasArfa, ChokriMataria, AwadSalti, NisreenChaaban, JadSalehi-Isfahani, DjavadFesharaki, SanazMajbouri, Mehdi2013-05-292013-05-292010-11https://hdl.handle.net/10986/13606Ensuring 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-USCC BY 3.0 IGOABILITY TO PAYACCESS TO HEALTH CAREACCESS TO HEALTH SERVICESANTENATAL CAREBASIC HEALTH CAREBASIC HEALTH SERVICESBASIC SERVICESCATASTROPHIC EXPENDITURESCATASTROPHIC HEALTH SPENDINGCHILD HEALTHCHILD HEALTH SERVICESCLINICSCOSTS OF CARECOSTS OF HEALTH CAREDECISION MAKINGDELIVERY OF HEALTH CAREDEMAND FOR HEALTHDEMAND FOR HEALTH CAREDENTAL CAREDETERMINANTS OF HEALTHDIABETESDIAGNOSTIC SERVICESDISADVANTAGED COMMUNITIESDRUGSECONOMIC GROWTHELIGIBLE BENEFICIARIESEMPOWERMENTEXPOSUREFAMILY PLANNINGFEE-FOR-SERVICEFEE-FOR-SERVICE BASISFINANCE OF HEALTH CAREFINANCIAL BARRIERSFINANCIAL CONSEQUENCESFINANCIAL PROTECTIONFINANCIAL RISKHEALTH CAREHEALTH CARE ACCESSHEALTH CARE COSTSHEALTH CARE COVERAGEHEALTH CARE EXPENDITUREHEALTH CARE EXPENDITURESHEALTH CARE FACILITIESHEALTH CARE FINANCEHEALTH CARE FINANCINGHEALTH CARE NEEDSHEALTH CARE PERSONNELHEALTH CARE PROFESSIONALSHEALTH CARE PROVIDERSHEALTH CARE RESOURCESHEALTH CARE SERVICESHEALTH CARE SPENDINGHEALTH CARE SYSTEMHEALTH CARE USEHEALTH CONDITIONSHEALTH ECONOMICSHEALTH EXPENDITUREHEALTH EXPENDITURESHEALTH FINANCINGHEALTH FINANCING SCHEMEHEALTH INDICATORSHEALTH INSURANCEHEALTH INSURANCE COVERAGEHEALTH INSURANCE SCHEMEHEALTH INTERVENTIONSHEALTH NEEDSHEALTH ORGANIZATIONHEALTH OUTCOMESHEALTH POLICYHEALTH PROJECTHEALTH SECTORHEALTH SECTOR REFORMHEALTH SERVICEHEALTH SERVICE DELIVERYHEALTH SERVICE USEHEALTH SERVICE UTILIZATIONHEALTH SERVICESHEALTH SPENDINGHEALTH STATUSHEALTH SYSTEMHEALTH SYSTEMSHEALTH WORKERSHEALTHCAREHOSPITAL CAREHOSPITALSHOUSEHOLD EXPENDITUREHRHUMAN DEVELOPMENTILLNESSIMMUNIZATIONINCOMEINCOME COUNTRIESINCOME GROUPSINCOME HOUSEHOLDSINEQUITY IN HEALTHINFANT MORTALITYINFANT MORTALITY RATEINFANTSINFORMAL SECTORINFORMATION SYSTEMSINPATIENT CAREINPATIENT HOSPITALINPATIENT HOSPITAL CAREINSURANCE PLANSINSURANCE PREMIUMSINTERNATIONAL COMPARISONSINTERVENTIONLABOR MARKETSLIVING STANDARDSLOW INCOMELOW-INCOME COUNTRIESMALNUTRITIONMEDICAL ASSOCIATIONMEDICAL COSTSMEDICATIONMORTALITYNATIONAL HEALTHNATIONAL HEALTH EXPENDITURESNATIONAL HEALTH INSURANCENATIONAL HEALTH INSURANCE FUNDNATIONAL HEALTH SPENDINGNUTRITIONOUTPATIENT SERVICESPATIENTSPAYMENTS FOR HEALTH CAREPERFORMANCE INDICATORSPHARMACEUTICAL EXPENDITURESPHARMACEUTICAL SERVICESPHYSICIANPHYSICIANSPOCKET PAYMENTSPOCKET PAYMENTS BY HOUSEHOLDSPOCKET PAYMENTS FOR HEALTH CAREPOLICY RESEARCHPOVERTY REDUCTIONPRIMARY CAREPRIMARY HEALTH CAREPRIMARY HEALTH CARE SERVICESPRIVATE CLINICSPRIVATE HEALTH CARE SERVICESPRIVATE HEALTH INSURANCEPRIVATE HEALTH SERVICESPRIVATE INSURANCEPRIVATE SECTORPRIVATE SPENDINGPROTECTION MECHANISMSPROTECTIONSPROVIDER INCENTIVESPROVISION OF SERVICESPUBLIC COVERAGEPUBLIC EXPENDITUREPUBLIC HEALTHPUBLIC HEALTH INSURANCEPUBLIC HEALTH INSURANCE SCHEMESPUBLIC INSURANCEPUBLIC INSURANCE SCHEMESPUBLIC PROVIDERSPUBLIC SECTORPUBLIC SECTORSQUALITY OF CAREQUALITY OF HEALTHQUALITY OF HEALTH CAREREHABILITATIONREPRODUCTIVE HEALTHRURAL AREASRURAL HOUSEHOLDSRURAL REGIONSSAFETY NETSSOCIAL EXCLUSIONSOCIAL HEALTH INSURANCESOCIAL HEALTH INSURANCE SCHEMESSOCIAL SECURITYSOCIAL SECURITY SCHEMESSOCIAL WELFARESUSTAINABILITYUSE OF HEALTH CARE SERVICESVACCINATIONVISITSWORKERSWorld Bank10.1596/13606