IRIN examines a Health Affairs report that found “one in four families living in the world’s poorest countries borrows money or sells assets in order to afford health care” (7/15).

The study authors used information about low- and middle-income countries obtained by the World Health Survey (WHS) – “a set of nationally representative, standardized household surveys designed to assess health status, health care financing, health care use, and levels of satisfaction with countries’ health systems” – to calculate how people paid for health care. The data, the authors write, “represented a combined population of 3.66 billion, or 58 percent of the world’s population” (Kruk et. al, Health Affairs, 7/09).

From 2002 to 2004, 26 percent of those represented by the survey – “most often the poorest households with little or no health insurance – used ‘hardship financing’ … to cover health costs,” IRIN/allAfrica.com reports. Health Affairs cites a 2007 study of global health insurance programs that shows “out-of-pocket payments accounted for 70 percent of health payments in low-income countries compared to less than 15 percent in richer countries.” The IRIN article also examines recent efforts by the governments of Liberia, Ghana and Burkina Faso to lessen the burden of health services on the poor, including the implementation of a national insurance program in Ghana and free health services for children under age five with “severe forms of malaria” in Burkina Faso (7/15).