Over the past two decades, the World Health Organization and the World Bank have been tracking financial protection using household survey data to compare how much people spend out of pocket on health care with their household’s ability to pay. For the first time, this joint report establishes global and regional 2015 baselines for an SDG indicator of catastrophic health spending and infers from previous trends the challenges to come in protecting people from the financial consequences of paying out of pocket for the health services they need. To better understand who experiences financial hardship when paying out of pocket for health, the report presents a first set of findings on rural–urban inequalities to support discussions about the eradication of rural poverty under the SDGs and of gender inequalities from selected countries in the Americas. Evidence on which services drive financial hardship is available for the World Health Organization European Region and South-East Asia Region and selected countries in the African continent.

More in-depth discussion is also available from the WHO global monitoring report on universal health coverage published at the same time as this report.