The government has not responded to questions on how it plans to act on recommendations made in a new audit report calling for major reforms to Aasandha.
Aasandha and the National Social Protection Agency (NSPA) spend billions each year to provide healthcare services, including treatment abroad. The performance audit of the social health insurance scheme, released on Tuesday, said the system needs to be better targeted and more financially sustainable.
One of the key recommendations was to limit Aasandha benefits to those in need and to introduce co‑payments for patients receiving treatment overseas.
When asked whether these recommendations would be implemented, Aasandha Managing Director Aiminath Zeenya said the scheme is administered by NSPA and directed queries to the agency. Both Aasandha and NSPA fall under the Ministry of Social and Family Development. Attempts to reach Minister Dr. Aishath Shiham for comment were unsuccessful.
Minister of Social and Family Development Dr. Aishath Shiham inaugurates key programs by NSPA on December 31, 2025. (Sun Photo/Moosa Nadheem)
The audit report noted that many patients continue to be sent abroad for treatment despite the establishment of relevant facilities in the Maldives. It attributed this to delays in implementing agreements with overseas hospitals to develop local services, as well as a lack of public confidence in treatment available domestically.
Aasandha and NSPA’s spending continues to rise. Last year, the scheme exceeded its allocated MVR 1.8 billion budget by a significant margin. Between 2019 and 2024, a total of MVR 1.6 billion was spent on overseas medical treatment alone.
Expenditure has increased every year, peaking in 2023, the year of the presidential election, when MVR 448 million was spent on treatment abroad. This was a 35 percent increase compared to 2022, when spending stood at MVR 333 million.
International financial institutions have long recommended that subsidies and medical assistance be targeted only at low‑income households. Although the government previously considered such measures, it later decided not to proceed.