This commentary, Time to Fully Account for Cost in Monitoring Financial Protection and Universal Health Coverage in Low- and Middle-Income Settings, published in Health Policy and Planning (18 November 2025) by Peter Binyaruka and Josephine Borghi, challenges current approaches to tracking financial protection in LMICs.
The authors argue that monitoring frameworks focus too narrowly on direct medical costs while overlooking major cost drivers such as transport expenses and the indirect time costs associated with seeking care.
These hidden burdens fall disproportionately on poorer and rural populations, limiting access, deepening inequities, and causing many to forgo essential health services.
The paper outlines five priority areas for action, including improving household survey measurement, advancing methods to value time, strengthening primary health care to reduce access barriers, adapting financing and social protection schemes to cover non-medical costs, and adopting multisectoral strategies to address structural determinants.
Fully integrating these dimensions into financial protection metrics is essential for equitable progress toward UHC.
