Out-of-pocket Expenditures

Out-of-Pocket Expenditures (OOPE) are expenditures made by households. OOPE for health act as a barrier to the utilization of health care services in most of the developing and under developed world. The adverse effect of OOPE is also significant for Sexual and Reproductive Health (SRH), where occurrence of medical expenses is considered to be large and unexpected. These expenses often constitute a large share of household disposable income, and drive a family into poverty.

During 2005-2007, the UNFPA/NIDI Resource Flows project carried out OOPE surveys in India, Nepal and Ethiopia in cooperation with local research institutes. The studies revealed that OOPE expenditures for SRH, e.g. as a result of complications during delivery or treating infections among People Living With AIDS (PLWAs), can be significant. Whilst certain information on OOPE for SRH is available, a comprehensive picture of this topic remains limited and therefore special attention needs to placed upon obtaining reliable estimates of OOPE for SRH.

Looking at the importance of obtaining such information, the UNFPA/NIDI Resource Flows project organized an expert meeting on OOPE for SRH in  December, 2011 at NIDI, located in The Hague. The expert committee members were from the Netherlands Ministry of Foreign Affairs; OECD; WHO; University of Southampton; Centre for Research on Environment Health and Population Activities (CREPHA), Nepal; Institute of Social and Economic Change (ISEC), India; Navrongo Health Research Centre, Ghana; and University of Groningen, The Netherlands. The basic objective of this meeting was to discuss the current knowledge on the level of OOPE for SRH, to share experiences with the collection of data on OOPE for SRH and to determine optimal strategies for further research.

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