Health financing for universal coverage

Financing long-term care programmes in health systems: with a situation assessment in selected high-, middle- and low-income countries

Discussion Paper 06/2007


Jorine Muiser and Guy Carrin


This document explores how long-term care is financed in high- and middle-income countries. It also discusses possibilities for low-income countries to increase the level of funding to important programmes of this kind. Following the guidelines of the system of National Health Accounts, long-term care services are considered part of the health or the social system. Health system related long term care services include nursing and personal care or support with activities of daily living, like bathing, eating and dressing; those related to the social system are instrumental activities of daily living, like cleaning, preparing meals, transport and other social activities.

The discussion about long-term care financing presented in this document is based on the WHO health financing framework. It helps to explore how the financing functions (collection, pooling, purchasing) can support the development of long-term care programmes based on actual need. The framework is applicable in high-, middle- and low-income countries. Case studies are presented that apply the framework to two countries in each of these groups.