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Analytical summary - Health financing system

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In 2008, the Government of Liberia's total health expenditure reached over US$ 100 million (or US$ 29 per person), i.e. 15% of gross domestic product. This was an unprecedented level of expenditure for Liberia and was in line with the West and Central African regional average of US$ 28 per person in 2006 (WHO figures).

External donors and households accounted for the largest part of health expenditure (47% and 35%, respectively), while Government spending accounted for 15%. Government spending has remained stable as a percentage of the national budget (between 7% and 8%), but it has nearly doubled in absolute terms. Donor funds are predominantly used to support service delivery at the primary care level, while referral hospitals consume the largest portion of Government expenditure.

The high level of household expenditure was largely on private goods and services. Of the US$ 37.9 million from other sources, 93% of those funds came from out-of-pocket (or household) funds, which were spent overwhelmingly (85%) on private providers. If donor funds were excluded from the equation, household funds would in fact represent two thirds of all domestic sources of funds used for health care.

Figure 1. Government budgetary allocation on health. FY, fiscal year, Source: Ministry of Health and Social Welfare
Figure 2. Percentage of national budget spent on health and per capita health expenditure. FY, fiscal year. Source: Ministry of Health and Social Welfare

The Government's budgetary allocation to the Ministry of Health and Social Welfare has increased over the past six fiscal years (2006–2012) (see Figure 1). In 2006, budgetary appropriation to the health sector was US$ 10 913 584 compared with US$ 48 999 191 in fiscal year 2011–2012. This increment in budgetary allocations of US$ 38 million from fiscal year 2006–2007 to 2011–2012 reflects the Government’s commitment to improving the health status of the population.

The per capita health expenditure is encouraging, although Liberia is still far from achieving the required target that will influence its attainment of Millennium Development Goals 4, 5 and 6.

Excluding donors’ funds, the per capita health expenditure in 2006 was US$ 3.86 per person compared with US$ 9.34 per person in 2011 (see Figure 2). Thus, the Government spent less than US$ 4 towards the health of each citizen in fiscal year 2006–2007 compared with almost US$ 10 in 2011. Investments by the Government and its partners have contributed to the improvement of health sector indicators, especially Millennium Development Goals 4 and 6.[1]


  1. Annual report. Monrovia, Government of Liberia, Ministry of Health and Social Welfare, 2011