Social health protection

The ILO’s ultimate objective in the field of social health protection is to achieve universal access to affordable health care of adequate quality and financial protection in case of sickness.



Social health protection is designed to alleviate the burden caused by ill health and reduce the indirect costs of disease and disability, such as lost years of income due to short and long-term disability, care of family members, lower productivity, and the impaired education and social development of children. Better health enables persons to work and generate income, and as such has the potential to break the cycle of ill health and poverty.

It also has positive impacts on economic growth and development. Healthier workers are more productive, labour supply increases and morbidity and mortality rates are lower. Conversely, the lack of access to medically necessary health care has significant social and economic repercussions, often driving people into poverty and out of the workforce.

An effective social health protection system provides universal access to needed health care that is affordable, available, of adequate quality and offers financial protection in times of illness, injury and maternity. Key issues relate to gaps in coverage and financial protection. Thus, in many countries out-of-pocket expenditure constitutes a large share of national health expenditure. Frequently, this forces people to choose between paying for care and paying for other family and business necessities, especially when private expenditure reaches catastrophic levels of more than 40 per cent of household income net of subsistence.

The ILO strategy towards universal access to health care addresses the gaps in coverage and financial barriers to access through the development of efficient and effective social health protection systems. This aims to ensure that persons in need will not face hardship and an increased risk of poverty due to the financial consequences of accessing essential health care. The ILO strategy is founded on the Human Right to health and social security, and emphasizes the significance of social health protection with regard to work and employment.  It is directly relevant to achieving the Millennium Development Goals, in due course and aims at implementing the Decent Work Agenda.

A country’s national social protection floor, defined in ILO Recommendation concerning national floors of social protection, 2012 (No. 202), should guarantee access to essential health care including financial protection and basic income security for all in need.  The guarantees should be defined with a view to equity, solidarity and social justice. They should be applied regardless of age, gender, ethnicity, income, employment status or geography and avoid inequities between formal and informal economy workers and between the rich and poor.