In the fiscal year 2011/12, the total national health expenditure of Afghanistan reached USD1.5billion dollars, accounting for 8% of the country’s gross domestic product. Below is a summary of the national health expenditure in three tables.
Who pays the USD1.5 billion?
|Who pays||How much|
|Households||73.3% (1100 million dollars)|
|International community||20.8% (312 million dollars)|
|Central government||5.6% (84 million dollars)|
|Non-profits serving households||0.3% (5 million dollars)|
What are the expenses?
|What/who is it paid for?||How much (in Million USD)
|Retail sales (drugs) and medical goods||25.6% (388)|
|Outpatient care centers||25.3% (USD380 dollars)|
|Hospitals||24.4% (366 million dollars)|
|General Health Administration||9.8% (147 million dollars)|
|Public Health Programs||5% (75 million dollars)|
|All other industries||9.7% (145 million dollars)|
Where is the USD1.1billion of the Afghan household spent?
|Places of services||How much?|
|Public Health Facilities (mainly public hospitals and clinics including food and transportation)||38.2% (420 million dollars)|
|Private Health Facilities (private hospitals and clinics, and pharmacies including food and transportation)||35.8% (394 million dollars)|
|Abroad (Inpatient and outpatient services including transportation and food)||26.0% (286 million dollars)|
A few points need to be highlighted from Afghanistan national health account 2011/12.
- Afghan households pay around three quarters (75%) of the health expenditure out of their pocket despite the fact that health care is constitutionally free in the country. To get things straight, health care is NOT free in the country, and actual policy action is required to make it free.
- Three quarters of the expenditure (75%) go to drugs, diagnostics, hospitals and outpatient care centers. If policymakers are resolved to curb the cost of health expenditures, those are the areas to target. Reducing the high cost of private diagnostic services, controlling cost and quality of poor medications, and monitoring cost and quality of services at hospitals and clinics are the areas to focus.
- Around 26% of the out of pocket expenditure go to medical services outside the country. Regulating medical tourism with destination countries through health diplomacy can be a solution for low cost and high quality health services for Afghans abroad.