Abbreviated Name:
Household expenditure on health as a share of total household consumption or income
Indicator Name:
Proportion of the population with large household expenditure on health as a share of total household consumption or income
Domain:
Health system, health finance
Related Terms:
Out-of-pocket health payments, SDG 3.8.2
Definition:
Proportion of the population the population with large household expenditure on health as a share of total household expenditure or income.
Measurment Method:
Within the SDG monitoring framework (SDG indicator 3.8.2), proportion of the population facing financial hardship is measured as the population weighted average of the number of households with “large household expenditures on health” (out-of-pocket payments) as a share of total household expenditure or income (household’s budget). Large is defined as out-of-pocket payments exceeding 10% or 25% total household expenditure or income. Household’s sample weight multiplied by the household size is used to obtain representative numbers per person. If the sample is self-weighting t only the household size is used as the weight. For more information about the SDG indicator 3.8.2 please see following
references Wagstaff et al.; Analyzing health equity using household survey data). To fully understand progress towards UHC within the SDG monitoring framework, SDG indicator 3.8.2 should be monitored jointly with SDG indicator 3.8.1 on coverage of essential health services. SDGs indicators are part of a broader UHC monitoring agenda often tailored to specific regions and countries to enable appropriate policy responses.
At the regional level and country level, there are other indicators used to measure catastrophic expenditures. At the regional level, there are other indicators used to measure financial hardship. These include a definition of catastrophic out-of-pocket payments (large health expenditures) in relation to non-subsistence spending in addition to indicator 3.8.2. For a definition of non-subsistence spending based on a normative level of food consumption see following references (Xu et al 2003; Xu 2005). For the WHO-EURO definition based on subsistence spending on food, housing and utilities and other regional refinements see reference (Thomson et al.)
references Wagstaff et al.; Analyzing health equity using household survey data). To fully understand progress towards UHC within the SDG monitoring framework, SDG indicator 3.8.2 should be monitored jointly with SDG indicator 3.8.1 on coverage of essential health services. SDGs indicators are part of a broader UHC monitoring agenda often tailored to specific regions and countries to enable appropriate policy responses.
At the regional level and country level, there are other indicators used to measure catastrophic expenditures. At the regional level, there are other indicators used to measure financial hardship. These include a definition of catastrophic out-of-pocket payments (large health expenditures) in relation to non-subsistence spending in addition to indicator 3.8.2. For a definition of non-subsistence spending based on a normative level of food consumption see following references (Xu et al 2003; Xu 2005). For the WHO-EURO definition based on subsistence spending on food, housing and utilities and other regional refinements see reference (Thomson et al.)
Numerator:
Total number of people with large household expenditure on health as a share of total household expenditure or income (i.e. greater than 10% and 25%).
Denominator
Total number of people.
Estimation method:
The global incidence of the proportion of the population with “large household expenditures on health” (out-of-pocket payments) as a share of total household expenditure or income (household’s budget) using both thresholds 10% and 25% is estimated as the population weighted average of the country level share of people with catastrophic expenditures for a reference year. Incidence at the country level for the reference year is estimated using different methods depending upon the availability of information for that country around or at the reference year.
Disaggregation:
Subnational variables available in survey data. Information on household location (urban vs rural); the gender, age and education of the head of the household; household composition (for example, the number of children under five years of age, people aged 60 or more years, the number of females); and other socio-economic variables are useful for equity analysis.
Primary data sources:
Key requirements for the selection of a data source is the availability of information on both household total expenditure and household expenditures on health, from a population based survey nationally representative; the three most common data sources are household budget surveys (HBS), household income and expenditure surveys (HIES), socio-economic or living standards surveys. These surveys are typically implemented by or in close collaboration with national statistical bureaus.
Alternate data sources:
Health surveys with a module collecting expenditure data on both household total expenditure (including on food, housing and utilities) and household expenditure on health
Measurment frequency:
Survey implemented ever 3-5 years