The role of evidence in the journey towards universal health coverage is paramount. Financial risk protection monitoring, the major focus of this report, informs where the WHO African Region stands in reducing the financial hardship people face due to health expenses. This report details the status of financial risk protection and related trends, the drivers of out-of-pocket (OOP) payments and the impact of the COVID-19 pandemic on financial risk protection. As such, it provides evidence coutries can draw on to develop health financing systems and reforms that mitigate financial barriers to accessing health services. Through analysis of country data, cross-country learning and drawing on the published literature, this report proposes recommendations that countries may adapt to their contexts.

As we move towards 2030, tracking financial risk protection is important for applying remedial measures where they are most needed. To this end, data availability remains the major challenge because of the irregularity of the population-based surveys that generate the required data. Also, the varied data collection methods, the different levels of comprehensiveness and specificity and the lack of standards within and across countries limit the extent to which the components of OOP health spending can be disaggregated and compared over time and across countries. Furthermore, the weak collaboration between ministries of health and national statistics offices presents a missed opportunity to track financial risk protection.