On average, the share of health spending paid out-of-pocket has fallen by around 2 percentage points to 21.4% and 25.6% in high- and upper-middle income Asia-Pacific countries since 2010, whereas it has increased from 47.1% to 48.2% in low and lower-middle income Asia-Pacific countries (Figure 6.8). The trend is quite diverse across the countries and the territories in the study. However, more than two thirds of the Asia-Pacific countries and territories reported a decrease, including between 7 and 10 percentage points for Papua New Guinea, Singapore and Indonesia, while Mongolia and Lao PDR reported a growth of around 10 percentage points in the same period. For each dollar spent on health, more than 60 centimes were “out-of-pocket” in Nepal, Bangladesh, Pakistan, India and Myanmar in 2015.
Figure 6.9 shows that health expenditure by voluntary payment schemes represented – on average – less than 10% of current expenditure on health in all country income groups in Asia-Pacific. This share increased in high-income countries, whereas it decreased in low and middle-income Asia-Pacific countries from 2010-15. Less than 3% of current health expenditure was from voluntary payment schemes in Bangladesh and Myanmar in 2015, while it was 14.5% or more in Singapore, Cambodia and the Philippines in the same year.
External funding for health care is quite relevant in many developing countries and territories in Asia-Pacific. In Solomon Islands more than one third of funds spent on health were from external resources in 2015 (Figure 6.10), whereas external resources accounted for between 15 and 25% of total health expenditure in Lao PDR, Cambodia and Papua New Guinea.
