Expanding Financial Protection to Underserved and Socially Excluded Populations: A Global Evidence Review

Financial catastrophe resulting from medical expenses, particularly out-of-pocket expenditures, remains a widespread concern globally, and is most prevalent within low- and middle-income countries (LMICs) where inadequate investments, allocative inefficiencies, and poor targeting mechanisms within state-provided health systems result in excessive out-of-pocket expenditure. Evidence points to approximately 100 million people being pushed below the poverty line annually due to out-of-pocket health care costs.

This report provides results and lessons learned from the LHSS Project’s review of existing literature on expanding financial protection to underserved and socially excluded populations in LMICs. The project identified different barriers to targeting these populations (in addition to financial barriers), schemes or interventions used to overcome these barriers, the effect of these interventions, and the strength of the evidence.