With the introduction of the universal health insurance scheme Aasandha in January 2012, the Government of Maldives aimed at achieving five key objectives, namely: (i) to enhance affordability of health care and to promote access to health care; (ii) to mitigate health care related financial risk for households and protect the citizens from health care related impoverishment; (iii) to contribute to improving the quality and reliability of health care; (iv) to improve the efficiency of health insurance provision via good governance and effective use of fiscal resources; and (v) to ensure long-term sustainability of health insurance provision through an effective design of the health insurance system, cost containment measures and reforms in the payment mechanisms. The objective of this note is two-fold. First, the note aims at discussing some of the equity issues related to health expenditure and health access in the Maldives. In particular, through the analysis of the trends in household expenditure on health, the note will provide an empirical benchmark against which to assess Aasandha's strengths and weaknesses. Second, the note will discuss the equity implication of some cost containment measures previously suggested for Government consideration (Nagpa l and Redaelli 20 13).