Method of estimation of global and regional aggregates: These approaches are also part of WHO regional monitoring frameworks in addition to SDG indicator 3.8.2. These approaches relate health expenditures (out-of-pocket payments) to income or consumption less a deduction for necessities. Other approaches can be used to monitor catastrophic health spending. 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. With this definition health expenditures are labelled Out-Of-Pocket (OOP) payments in the classification of health care financing schemes (HF) of the international Classification for Health Accounts (ICHA). They might be financed by income, including remittance, savings or borrowings. These payments include the part not covered by a third party such as the government, health insurance fund or private insurance but exclude insurance premiums as well as any reimbursement by a third party. Household expenditures on health are defined as formal and informal payments made at the time of getting any type of care (promotive, curative, rehabilitative, palliative or long term care) provided by any type of provider.
If the sample is self-weighting then only the household size is used as the weight. Household’s sample weight multiplied by the household size is used to obtain representative numbers per person. Large is defined as health expenditures exceeding 10% or 25% total household expenditure or income.
Within the SDG monitoring framework (SDG indicator 3.8.2), the proportion of the population facing catastrophic expenditures is measured as the population weighted average of the number of households with “large household expenditures on health” as a share of total household expenditure or income (household’s budget). When this happens they are characterized as being catastrophic. Method of estimation: Health expenditures are likely to expose households to financial hardship in particular when they exceed a pre-defined threshold of a household's ability to pay.
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