Social health protection

The ILO promotes a rights-based approach to social health protection, with the objective of ensuring effective access to quality health care without hardship and impoverishment. This rights-based approach is rooted in the body of human rights and ILO standards which represent a global consensus to guide the development of social health protection systems. Read more on the work of the ILO in the field of social health protection

The right to social health protection is not yet a universal reality. Despite laudable progress, barriers to accessing healthcare remain in the form of out-of-pocket (OOP) payments on health services, physical distance, limitations in the range, quality and acceptability of health services, long waiting times, and opportunity costs such as lost working time.

Significant progress has been achieved in increasing population coverage, with almost two thirds of the global population protected by a health scheme. Still, people in the lowest income quintile and in rural areas often face challenges in meeting their health needs without hardship. While population coverage has increased, less attention has been paid to adequacy in some contexts. The COVID‑19 crisis highlighted the limitations of benefit adequacy and the need to reduce OOP payments.

Collective financing, broad risk-pooling and rights-based entitlements are key principles in supporting effective access to healthcare for all in a shock-responsive manner. The principles set out in international social security standards are more relevant than ever in making progress towards universal health coverage (UHC), especially within the current public health context. More and better data collection on legal coverage is a priority for monitoring progress on coverage and equity.

Investing in the availability of quality healthcare services is crucial. The COVID‑19 pandemic has further revealed the need to invest in healthcare services and to improve coordination within health systems. The pandemic is drawing attention to the challenges faced in deploying, retaining and protecting well-trained, supported and motivated health workers to ensure the delivery of quality healthcare services.

Stronger linkages and better coordination between access to medical care and income security are urgently needed to address key determinants of health. The COVID‑19 crisis has thrown into sharp focus the critical preventive role of the social protection system, and the complementarity of healthcare and sickness benefit schemes. Coordinated approaches are particularly needed with respect to special and emerging needs, including human mobility and the increasing burden of long-term and chronic diseases, as well as population ageing. The impact of the pandemic on older people has also starkly revealed the need for better coordination between health and social care.