Despite more than three-quarters of the region’s population being legally entitled to health protection, pervasive gaps in legal coverage, lack of awareness on rights coupled with practical difficulties and impediments to accessing services leaves huge numbers across Asia and the Pacific needing to pay to receive healthcare, often plunging them into poverty.

The first ever report on the extension of social health protection in Asia and the Pacific, “Extending social health protection: Accelerating progress towards Universal Health Coverage in Asia and the Pacific” highlights progress, challenges and coverage gaps in the region. Drafted against backdrop of the COVID-19 pandemic, the report also reveals the crucial role of social health protection to protect people’s heath, jobs and income in times of crisis and beyond. 

Commenting on the launch of the report, ILO Director General Guy Ryder said, “Investing in social health protection makes a key contribution to reaching universal health coverage. The COVID-19 pandemic has reminded us of its critical importance in supporting people’s health, jobs and incomes, and its role as a key element of an inclusive recovery. It is the ethical and rational policy choice, paving the way to sustainable development and social justice”. 

The report identifies significant inequalities in health protection coverage within and across countries in Asia and the Pacific. Less than half the region’s work force has their income security legally guaranteed when sick while just 45.9 percent of women are protected in case of loss of income during maternity. 

Gaps in coverage also disproportionately affect women and men with unstable or irregular employment and incomes such as the self-employed, informal economy workers as well as migrant workers and their families. Agricultural and domestic workers and their families are especially hard hit. 

The report recognises that while many countries have made significant progress in terms of increasing social health protection coverage, the adequacy of benefits remains a challenge with underfunding or unpredictable funding a major issue.  Meanwhile, a growing middle-class demand for higher quality services particularly from private providers who remain out of the scope of social health protection policies was also driving up out-of-pocket expense. 

Recommendations include institutional strengthening as well as more efficient scheme design and administration to boost coverage and benefit adequacy. The report also calls for more public resources to make solidarity in financing a reality.

The report was launched during a regional conference ‘Extending Social Health Protection in the Asia Pacific region: towards Universal Health Coverage’, organised by the UN Issue-Based Coalition for Empowerment and Inclusion and CONNECT on 7^th and 9^th December 2021./.