Private domestic financing accounts for a large share of current health spending in many countries, but the map is far from uniform. Among the 194 country or area observations dated 2023, the unweighted median is 34.1% and the simple mean is 37.4%. Thirty-nine observations are below 20%, while 28 are at 60% or more. Armenia, Myanmar, Turkmenistan and Bangladesh all exceed 80%, placing them at the far upper end of the synchronized 2023 distribution.
The indicator is the World Health Organization measure Domestic private health expenditure (PVT-D) as percentage of current health expenditure (CHE). It asks what share of current health spending is financed from private sources that originate inside the country. Those sources can include households, corporations and non-profit organizations, and can be prepaid or paid directly to health-care providers. That makes this broader than out-of-pocket spending alone.
Table of Contents
What counts as domestic private health financing?
WHO defines the measure as the share of current health expenditure funded from private domestic sources. The financing-source categories include compulsory prepayment outside the government financing categories, voluntary prepayment, other domestic revenues and unspecified domestic revenues of health-care financing schemes. WHO also explains that private domestic sources can originate from households, corporations and non-profit organizations. The formal definition and formula are available on the WHO Global Health Observatory indicator page.
A 70% value therefore does not mean that patients paid 70% of the country’s health bill directly from their pockets. Some of the financing can be pooled before care is used, including through private insurance or other private prepayment. To isolate direct household payments, the appropriate companion series is out-of-pocket expenditure as a percentage of current health expenditure.
The measure is also a share rather than an amount. A large health system and a small health system can both record 40% while involving very different sums of money. Questions about absolute resources require total or per-capita spending measures. This map is best used to compare the financing mix, not the size of national health spending.
The 2023 distribution centers in the 20% to 40% range
Using only the 194 observations dated 2023, the unweighted median is about 34.1% and the simple mean is about 37.4%. These are descriptive country-level statistics. Each row receives the same weight, so the figures are not a population-weighted global private-financing share and are not weighted by the size of national health expenditure.
Ten observations are below 10%, 29 are from 10% to under 20%, 36 are from 20% to under 30%, and another 36 are from 30% to under 40%. That means 111 of 194, or about 57.2%, are below 40%. At the other end, 28 observations are at 60% or more, 10 are at 70% or more, and four exceed 80%. The result is a broad middle with a smaller but substantial high-share tail.
Armenia, Myanmar, Turkmenistan and Bangladesh are above 80%
Armenia has the highest 2023 observation at about 83.9%. Myanmar follows at 82.8%, Turkmenistan at 82.6%, and Bangladesh at 82.0%. Afghanistan is 77.1%, Nigeria 73.6%, the Syrian Arab Republic 73.3%, Liberia 71.7%, Cameroon 70.6% and Yemen 70.5%. Togo and Venezuela are also near the upper end at 68.9% and 67.7% respectively.
| Country or area | Domestic private share of CHE, 2023 |
|---|---|
| Armenia | 83.9% |
| Myanmar | 82.8% |
| Turkmenistan | 82.6% |
| Bangladesh | 82.0% |
| Afghanistan | 77.1% |
| Nigeria | 73.6% |
| Syrian Arab Republic | 73.3% |
| Liberia | 71.7% |
| Cameroon | 70.6% |
| Yemen | 70.5% |
| Togo | 68.9% |
| Venezuela (Bolivarian Republic of) | 67.7% |
This is a ranking of financing shares, not a ranking of health-system privatization, household hardship or spending levels. Countries can reach a similar private share through very different combinations of out-of-pocket payments, private insurance, corporate financing and other domestic private revenues. Switzerland, for example, is also high at 66.9%, which is a useful reminder that countries in the same broad percentage band do not necessarily have the same financing arrangements.
South and Central Asia contain several of the highest values
South Asia forms one of the clearest high-share areas on the map. Bangladesh is at 82.0%, Afghanistan 77.1%, Nepal 61.7%, Sri Lanka 60.4%, India 58.6% and Pakistan 54.6%. Nearby Southeast Asia is more mixed: Myanmar is at 82.8% and Cambodia at 61.8%, while Thailand is 22.0% and Brunei Darussalam only 7.5%. Geographic proximity does not produce a single regional financing pattern.
A second high-share group appears across parts of the Caucasus and Central Asia. Armenia is 83.9%, Turkmenistan 82.6%, Azerbaijan 66.9%, Georgia 65.5%, Uzbekistan 64.5% and Tajikistan 62.5%. Kazakhstan is much lower at 34.0%, and Kyrgyzstan is 42.3%. The map is therefore most useful for identifying clusters and contrasts, not for treating a whole region as one category.
Africa spans both the high and low ends of the range
Several African countries sit near the top: Nigeria is 73.6%, Cameroon 70.6%, Togo 68.9%, Equatorial Guinea 66.7%, Guinea-Bissau 64.2%, Sudan 62.9%, Niger 61.4% and Guinea 60.0%. Mali is 58.6%, Senegal 55.6% and Sierra Leone 54.8%. These observations make parts of West and Central Africa appear dark on the choropleth.
Other African countries are at the opposite end. Zambia is 11.4%, Lesotho 13.2%, Mozambique 15.8%, Rwanda 16.0% and Botswana 18.0%. Malawi is 21.7%, Tanzania 29.0%, Kenya 35.0% and South Africa 36.3%. A continental label such as “Africa has high private financing” would therefore obscure the wide country-level variation visible in the data.
Several small Pacific states have very low private shares
The lowest observations are concentrated heavily among small Pacific states and areas. Tuvalu is at 0.06%, Niue 0.39%, the Marshall Islands 2.0%, Nauru 2.9%, the Solomon Islands 3.2% and the Cook Islands 4.0%. Papua New Guinea is 8.6% and Tonga 9.5%. Some of these places are too small to appear as a distinct polygon in the low-resolution global boundary layer even though they remain in every statistical calculation.
A low private share should not be interpreted as a low burden on households without checking other indicators. It simply means that domestic private sources finance a small part of current health expenditure. Government sources or external financing can account for more of the remainder. Separating those sources requires the corresponding government and external health-expenditure series.
South Korea is at 41.4%, between China and South Africa in this comparison
South Korea records 41.4% in 2023. The United States is at 46.0% and China at 42.9%, while France is 32.3%, Canada 29.7%, Australia 26.3%, Germany 20.9%, the United Kingdom 18.2% and Japan 15.2%. India is higher at 58.6%, Brazil 55.9%, Mexico 51.4%, Nigeria 73.6% and Bangladesh 82.0%.
| Country | Domestic private share of CHE, 2023 |
|---|---|
| Bangladesh | 82.0% |
| Nigeria | 73.6% |
| India | 58.6% |
| Brazil | 55.9% |
| Mexico | 51.4% |
| United States | 46.0% |
| China | 42.9% |
| South Korea | 41.4% |
| South Africa | 36.3% |
| France | 32.3% |
| Canada | 29.7% |
| Australia | 26.3% |
| Germany | 20.9% |
| United Kingdom | 18.2% |
| Japan | 15.2% |
The comparison should not be turned into a league table of “more public” versus “more private” health systems. The WHO series classifies financing sources, and countries can use very different institutional arrangements within the same percentage range. Assessing financial protection, access or public commitment requires additional measures such as out-of-pocket spending, domestic government health expenditure, per-capita spending and service-coverage indicators.
Ukraine is the only latest observation that is not from 2023
The latest-value table contains 195 country or area observations. A total of 194 are dated 2023. Ukraine is the single exception, with a latest retained observation of 47.9% in 2021. The world map keeps that latest value for geographic completeness and marks Ukraine with hatching, while the 2023 mean, median, band counts and rankings exclude it.
That distinction matters even when only one row is older. A latest-value map answers “what is the most recent level available for each place?” A synchronized ranking answers “how did places compare in the same year?” Keeping those questions separate avoids treating a 2021 value as if it had been observed in 2023.
A high private share is not a verdict on health-system performance
The indicator describes the source of financing, not whether a health system performs well. It does not measure waiting times, quality of care, service coverage, health outcomes, efficiency or the adequacy of total resources. A high private share can coexist with very different levels of financial protection depending on how the private funds are collected and pooled.
The reverse is equally important. A low private share does not prove that households face little financial risk or that the system is sufficiently funded. Current health expenditure could be financed more heavily from government or external sources, and the total amount of spending could still be high or low. To study household exposure directly, out-of-pocket expenditure and catastrophic health-spending measures are more informative.
The map should therefore be used as a starting point for geographic comparison. It identifies where the financing mix looks unusually high or low, but it does not establish causes. Income, insurance design, tax systems, donor funding and other institutional factors may matter, yet those variables are not contained in this single indicator and should be tested with separate evidence.
Data source and mapping method
The statistical source is WHO Global Health Observatory indicator GHED_PVT-DCHE_SHA2011. WHO reports the unit as percent and defines the measure as the share of current health expenditure funded from private domestic sources. The formal metadata and financing-source formula are available on the WHO indicator page. The broader health-accounts database is available through the WHO Global Health Expenditure Database.
The latest-value table contains 195 country or area rows: 194 from 2023 and Ukraine from 2021. The choropleth uses those latest observations, while every synchronized statistic and the distribution chart use only the 194 rows dated 2023. Missing values are not converted to zero and the older Ukraine observation is never relabeled as a 2023 value.
ISO-3 country codes are joined to a simplified global boundary layer for mapping. Small island states and separately reported areas may be absent as distinct polygons at this scale even though their values remain in the statistical sample. The color classes are designed to show large differences in financing structure rather than imply meaningful rank differences between countries separated by only a few decimal points.
Frequently Asked Questions
What does domestic private health expenditure as a share of current health expenditure mean?
It is the percentage of current health expenditure financed from private domestic sources such as households, corporations and non-profit organizations, including relevant prepaid and direct-payment financing.
Is domestic private health expenditure the same as out-of-pocket spending?
No. Out-of-pocket payments are only one component of domestic private financing. Private insurance and other private prepayment can also be included, so the OOP indicator should be used to isolate direct household payments.
Which country has the highest 2023 domestic private health expenditure share?
Among the 194 observations dated 2023, Armenia is highest at about 83.9%, followed by Myanmar at 82.8%, Turkmenistan at 82.6% and Bangladesh at 82.0%.
Are all values on the map from 2023?
Almost. Of the 195 latest observations, 194 are from 2023 and Ukraine uses its latest 2021 observation. The synchronized 2023 statistics and ranking exclude Ukraine.
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