Bring money with you to the hospital! Albania, last in the region for public spending in the healthcare sector

The organization “Together for Life”, which works for social justice in the country, has published the findings of a report titled “Monitoring of Health Sector Expenditures” for the year 2025.

The report aims to shed light on deviations from the plan and objectives of the National Health Strategy 2021–2030, as well as to present a clear overview of the actual health-related expenditures made during 2025 by the Ministry of Health and Social Protection.

One of the most concerning findings of the report highlights that public spending on health and social protection in 2025 in Albania reached the lowest level recorded in the past 9 years.

Actual health expenditures in 2025, including revenues from the Health Insurance Fund, reached 76.6 billion lek, accounting for 2.9% of Gross Domestic Product (GDP) and 9.6% of total public expenditure, which the report categorizes as the lowest levels since 2016.

According to experts from “Together for Life”, this downward trend suggests that budget priorities have gradually shifted toward other sectors.

The analyzed data also reflects another declining trend: per capita health spending.

Albania shows the lowest level of health expenditure per capita in the region, at around 590 USD per person, significantly below other Western Balkan countries.

This low level of per capita health financing results in citizens covering their health-related costs out of pocket.

Out-of-pocket spending remains very high (around 48% in 2022–2023), signaling that public coverage of healthcare services and medicines remains insufficient.

This reliance on personal spending significantly increases the risk of catastrophic health expenses for families and deepens inequalities in access to healthcare, especially for low-income and vulnerable groups.

Another concerning finding is that budget planning for Primary Health Care did not allocate any funds for home-based healthcare services.

Experts note that this omission is problematic, especially since this nationwide service is a key component for providing care to vulnerable groups.

Regarding the “check-up beneficiaries” program, the report states that expenditures are fixed and paid according to concession agreements, even though the initially planned number of patients was not met.

From the state budget, 35.3 million lek were paid despite 19,151 patients not attending the service.

Transparency regarding the use of funds, especially public investments, also remains low.

Experts from “Together for Life” emphasize that institutional reports do not provide sufficient information on costs, achievements, and project impacts, making it difficult to assess the effectiveness of public investments in healthcare.

The lack of reporting on factors leading to cancellations, delays, or budget revisions weakens institutional accountability and limits the ability to improve future planning and management of public investments.

Another challenge is gender reporting, which is almost entirely absent from public health institutions’ documentation.

Despite being a clear legal obligation, gender reporting is completely missing from the Ministry of Health and Social Protection, the lead institution responsible for implementing the Gender Equality Strategy.

“KORÇA BOOM”