Ecuador’s 2008 constitution established free and universal public health services and created a comprehensive public network made up of state and social security institutions.
In 2019 public spending on health was 4.8% of the gross domestic product and 13.3% of total public spending. Out-of-pocket expenditure accounted for 30.9% of total health expenditure. The sources of financing for the health sector are resources from the general state budget; contributions from workers and employers to social security; contributions from police and military schemes; direct household expenditure; and resources from donors.