Background: Universal Health Coverage seeks to assure that everyone can obtain the health services they need
without financial hardship. Countries which rely heavily on out-of-pocket (OOP) payments, including informal
payments (IP), to finance total health expenditures are not likely to achieve universal coverage. The Republic of
Moldova is committed to promoting universal coverage, reducing inequities, and expanding financial protection. To
achieve these goals, the country must reduce the proportion of total health expenditures paid by households. This
study documents the extent of OOP payments and IP in Moldova, analyses trends over time, and identifies factors
which may be driving these payments.