Analysis of the 2018 results has identified the main indicators for assessing healthcare spending. These are :
– Total healthcare expenditure (DTS) is estimated at 477.8 billion FCFA in 2018. It stood at 530.8 billion FCFA in 2017, down 10.0%. This fall in SDR is attributable to the fall in Current Healthcare Expenditure (CHE).
– Current health expenditure (DCS) is estimated at 441.7 billion in 2018 compared with 496.1 billion FCFA in 2017, a drop of 11.0%. The decline in DCS is attributable mainly to the low rate of budget execution and mobilization of external resources (78%) in 2018.
– Healthcare capital expenditure is estimated at more than 36.0 billion FCFA in 2018 compared with 34.7 billion FCFA in 2017, an increase of 3.0%. This expenditure is mainly allocated to gross fixed capital formation, which accounts for 86.8% of capital expenditure. There was, however, a relative increase in investment-related expenditure.
– Public schemes and compulsory contributory schemes contributed 55.5% of healthcare funding in 2018 compared with 60.6% in 2017 and 61.5% in 2016, a decline of almost 5.1 points in 2018 compared with 2017 and one point in 2017 compared with 2016. The share of direct household payments in DCS rose significantly in 2018 (36%) compared with 2017, whereas it remained virtually unchanged in 2017 (31.7%) and 2016 (31.8%).
– The funds used to finance healthcare came mainly from transfers from national government revenues in 2018. The volume of these funds fell significantly by 13.07% in 2018 compared with 2017, compared with an increase of 19% in 2017 compared with 2016. The contributory share of transfers from national government revenues in DCS in 2017 (42.4%) was also down on 2017 (43.3%).
– Hospitals and ambulatory care providers are the main consumers of current healthcare expenditure in 2018, accounting for 29.4% and 33.0% respectively. The increase in hospital spending and spending by ambulatory healthcare providers in 2017 and 2018 was at the expense of spending by preventive healthcare providers, and would still be explained by the free healthcare policy.
– In terms of healthcare consumption, current healthcare expenditure was mainly spent on curative and preventive care, with 49.1% and 20.2% respectively, compared with 44.8% and 20.1% in 2017. On the other hand, “governance, administration of the healthcare system and financing” has seen a decline in recent years, with an absolute share of 10.3% in 2018.
– Per capita healthcare expenditure has shown irregular growth over the past five years, with a phase of continuous growth between 2013 and 2017, rising from 22,331 FCFA ($38 USD) to 27,885 FCFA ($47 USD) and a 13.1% decline in 2018. However, it is still below the standard of 64,960 FCFA ($112 USD). Spending as a percentage of GDP, has grown irregularly over the last five years rising from 5.6% in 2013 to 6.1% in 2018.