世界银行-几内亚自费卫生支付对贫困的影响以及公共和外部卫生融资的协调（英）-2024-59页_6mb

Out-of-Pocket Health Payments and Poverty Impact in Guinea: Key Findings

Out-of-pocket (OOP) health payments in Guinea significantly increase extreme poverty rates. Based on the 2018-2019 Living Standards Measurement Study (LSMS), OOPs raised the extreme poverty prevalence by 2.1 percentage points (pp), normalized poverty gap by 0.7 pp, and severity by 0.3 pp. The impacts varied by region, with the highest increases in N’Zérékoro, Labé, Faranah, and Kindia. Age groups aged 41-59 and children under one year were most affected.

Health OOP expenses had a substantial impact on poverty measures, ranking third among expenditure categories in terms of prevalence, first in normalized gap, and first in severity. Despite not being a top income category, health spending contributed significantly to impoverishment.

Public and external health financing (2020-2024) was misaligned with OOP impacts. Regions like N’Zérékoro, Faranah, Kindia, and Labé, which contributed most to OOP-related poverty, received only half of the total funding. Capital Conakry received disproportionate resources despite minimal OOP impact. This lack of alignment exacerbates inequalities and inefficiently uses funds.

The study emphasizes the urgency of Universal Health Coverage (UHC) to reduce financial risks and improve allocative efficiency. Increasing public health funding, enhancing domestic resource allocation, and exploring innovative financing mechanisms are recommended to prioritize vulnerable groups and align health financing with poverty-reduction goals.