Africa Scorecard on Domestic Financing for Health 2024

(2021 data)

Select Year

AU Member States		UHC (2021)	How much does government spend on health? (Current expenditure, 2021)						Sources of health spending, by percentage (Current expenditure, 2021)					Fiscal space (Latest available data)
		#1	#2	#3	#4	#5	#6	#7	#8	#9	#10	#11	#12	#13	#14	#15
		UHC service coverage index	Per Capita		As a % of GDP		As a % of Govt budget		Government	Voluntary pre-paid insurance	Out-of-pocket WHO (World Health Report 2010, Table 5.2, page.98) advises that "Where out-of-pocket health payments… is lower than 15–20%, there is little financial catastrophe or impoverishment." (Note: McIntyre & Meheus calculate that reducing OOP expenditure to <20% equates to Govt spending 6% of GDP on health)	Other private health spending	Development Partners	Annual GDP growth rate	Government debt (Total)	Tax collected as a % of GDP
Benchmark:		100% SDG indicator 3.8.1 is part of the indicator for SDG Goal 3.8 of "Achieving universal health coverage".	>$86.3 per capita USD Di McIntyre & Filip Meheus (2017) updated the 2005 HLTF estimate to 2015 U$ dollars, accounting for variable inflation rates and exchange rate changes across the countries included in the HLTF. [Pg. 11, Footnote 3 in Mcintyre, D. & Meheus, F. (2017)]	vs. 2023	>5% GDP Mcintyre, D. & Meheus, F. (2017). Fiscal Space for Domestic Funding of Health and Other Social Services. Chatham House Centre on Global Health Security Working Group Papers	vs. 2023	>15% Abuja declaration target (2001) (The Abuja Declaration on HIV/AIDS, Tuberculosis and other related infectious diseases)	vs. 2023	Add up to 100% of total (current) health expenditure					GDP growth rate 2014 - 2024	As a % of GDP 2024	>15% in LIC + LMIC >18% in UMIC The International Monetary Fund (IMF) recommended targets. >15% for low-income countries (LICs) and low-middle income countries (LMICs); >18% for upper-middle-income countries (UMICs). [Note: This indicator is related to SDG target 17.1.1].

Countries are grouped into quartiles based on per capita spending on health (indicator #2). They are then ranked within these quartiles according to UHC service coverage (indicator #1)

1st Quartile

1	Seychelles	75	$550	▼	4.0	▼	10.2	=	77	1	22	1	0		59.0	30.6 (2020)
2	Algeria	74	$121	▼	3.3	▼	8.8	▼	31	1	39	28	1		58.8	No Data
3	Cabo Verde	71	$169	▲	4.7	▲	15.8	▲	57	1	19	12	11		109.7	17.8 (2017)
4	South Africa	71	$352	▲	5.0	▼	15.3	=	60	32	6	0	1		75.8	25.9 (2021)
5	Egypt	70	$68	▲	1.7	▲	6.8	▲	32	3	55	8	1		88.1	12.5 (2015)
6	Morocco	69	$86	▲	2.2	▼	7.2	▼	21	1	45	30	4		69.1	22.1 (2022)
7	Tunisia	67	$157	▲	4.1	▼	12.4	▼	35	5	34	24	2		77.1	20.1 (2012)
8	Mauritius	66	$278	▼	3.1	▼	10.2	=	49	5	43	1	1		78.9	19.0 (2022)
9	Namibia	63	$217	▲	4.5	▲	11.2	▲	47	36	8	0	8		66.8	28.0 (2021)
10	São Tomé and Príncipe	59	$80	▲	3.4	▲	13.1	▲	42	0	12	2	44		54.4	No Data
11	Eswatini	56	$149	▲	3.7	▲	12.3	▲	53	11	10	2	24		41.9	No Data
12	Botswana	55	$350	▲	4.8	▲	14.6	▲	76	14	4	0	5		18.1	22.3 (2021)
13	Gabon	49	$137	▲	1.6	▼	9.6	=	45	10	22	18	4		64.5	11.5 (2019)

2nd Quartile

14	Zambia	56	$32	▼	2.8	▼	9.3	▼	37	0	7	7	49		No Data	16.8 (2021)
15	Zimbabwe	55	$21	▲	0.9	▲	5.2	=	33	7	10	5	45		56.9	7.2 (2018)
16	Kenya	53	$46	▲	2.2	▲	9.3	▲	47	9	23	2	18		68.3	13.3 (2021)
17	Lesotho	53	$47	▲	4.2	▼	8.0	▼	41	0	14	0	44		60.4	32.0 (2022)
18	Rwanda	49	$25	▲	3.0	▼	9.5	▲	29	2	10	23	36		72.1	15.1 (2020)
19	Ghana	48	$54	▲	2.2	▲	8.2	▲	51	1	27	12	9		81.5	11.3 (2020)
20	Equatorial Guinea	46	$51	▼	0.7	▼	5.4	▲	18	0	77	5	0		33.7	5.4 (2021)
21	Djibouti	44	$29	▼	1.0	▼	4.2	▼	24	1	20	11	45		41.9	No Data
22	Côte d'Ivoire	43	$27	▼	1.0	▼	5.1	▼	28	8	32	17	15		57.0	12.6 (2021)
23	Congo Republic	41	$39	▲	1.9	=	8.2	=	49	3	24	17	7		91.0	8.3 (2020)
24	Mauritania	40	$35	▲	1.6	▲	8.3	▲	31	1	33	10	24		48.2	No Data
25	Burkina Faso	40	$24	▲	2.7	▼	9.8	▼	43	2	35	2	18		61.2	16.0 (2021)
26	Angola	37	$37	▲	1.7	▲	8.8	▲	58	4	23	0	5		77.1	10.1 (2019)

3rd Quartile

27	Senegal	50	$18	▼	1.1	▼	4.4	▼	21	6	47	8	18		72.1	18.7 (2022)
28	Uganda	49	$10	▲	1.1	▲	4.9	▲	23	3	31	1	42		47.7	12.5 (2021)
29	Malawi	48	$9	▼	1.4	▼	5.8	▼	18	5	14	1	62		77.4	11.4 (2021)
30	Comoros	48	$15	▼	0.9	▼	4.7	▼	14	3	56	2	26		36.9	No Data
31	Gambia	46	$12	▼	1.6	▼	7.5	▼	51	2	20	10	0		65.5	No Data
32	Mozambique	44	$13	▲	2.6	▲	8.2	▲	28	0	9	5	58		92.4	22.8 (2021)
33	Tanzania	43	$10	▼	0.9	▲	5.1	▲	18	1	26	9	46		41.8	11.7 (2018)
34	Mali	41	$12	▲	1.3	▼	5.0	▼	27	0	34	10	30		52.6	14.2 (2020)
35	Sierra Leone	41	$10	▲	1.9	▲	6.8	▲	23	0	51	0	26		82.6	No Data
36	Guinea	40	$8	▼	0.7	▼	4.5	▼	18	1	53	5	23		31.5	No Data
37	Nigeria	38	$11	▲	0.5	▲	4.1	▼	12	1	76	3	8		41.3	No Data
38	Guinea-Bissau	37	$10	▲	1.1	▼	4.6	▼	14	0	60	0	23		71.4	9.5 (2019)
39	Niger	35	$13	▼	2.1	▼	8.8	▼	36	3	43	3	14		46.3	No Data

4th Quartile

40	Eritrea	45	$5	▲	0.9	▲	2.4	=	21	0	50	0	29		No Data	No Data
41	Liberia	45	$7	▲	1.1	▲	3.7	▲	7	47	25	4	18		52.7	12.5 (2013)
42	Togo	44	$5	▼	0.6	▼	2.6	▼	6	5	69	4	16		67.6	13.6 (2019)
43	Cameroon	44	$8	▼	0.5	▼	2.9	▼	13	3	67	0	17		39.6	11.3 (2021)
44	South Sudan	44	$6	▼	0.8	▼	7.9	▼	27	3	57	0	10		238.8	7.4 (2016)
45	Congo Republic	42	$4	▲	0.6	▼	4.3	▼	16	3	39	5	38		11.1	No Data
46	Burundi	41	$6	▲	2.2	▲	7.3	=	24	2	25	2	47		65.8	No Data
47	Benin	38	$4	▲	0.3	▲	1.6	▲	10	5	49	4	32		52.4	No Data
48	Ethiopia	35	$8	▼	1.0	=	7.1	▲	31	2	37	3	28		31.2	6.2 (2020)
49	Madagascar	35	$4	▲	0.7	▲	5.3	▲	21	1	33	4	40		53.5	10.2 (2021)
50	South Sudan	34	$5	▲	0.9	▲	2.1	=	16	4	27	3	50		50.9	No Data
51	Central African Republic	32	$6	▲	1.3	▲	6.4	▲	14	1	49	0	36		49.6	8.2 (2021)
52	Chad	29	$6	▲	0.9	▼	4.9	=	17	1	59	1	22		38.7	No Data

No Data

53	Libya	62	No Data	/	No Data	/	No Data	=	0	0	0	0	0		No Data	No Data
54	Sahrawi Republic (Western Sahara)	No Data	No Data	/	No Data	/	No Data	=	0	0	0	0	0		No Data	No Data
55	Somalia	27	No Data	/	No Data	/	No Data	=	0	0	0	0	0		No Data	0.0 (2020)