Table 5 Recommendations

Recommendations for future investigations

• Improved study designs and metrics for measuring healthcare costs and expenditures

• Controlling for confounders in the relationship between health insurance and out of pocket expenditures

• Standardization of measures of affordability and house-hold capacity to pay using WHO methods

• Further studies on how house-holds cope with making out-pocket payments for healthcare

• Adjusting for inflation/deflation to allow for more time specific comparisons in order to provide better descriptions of acceptable health costs and living standards at any given time period

Policy recommendations

• Reducing the risk of OOPEs for medicines with a focus on improving the medical supply chain system

• UHC policies need to clearly articulate the organization and standardization of health services that guarantee a minimum package.

• Monitoring for effectiveness: Robust and sensitive indicators need to be collected routinely to inform timely interventions for the poor. This could include input costs of services, patient perspectives on quality of care, and human resource monitoring