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Health Systems and Policy Monitor (HSPM)

An innovative platform that provides a detailed description of health systems and provides up-to-date information on reforms and changes that are particularly policy relevant.
For detailed information on country policy responses to the COVID-19 pandemic during 2020-2021, see our separate COVID-19 Health Systems Response Monitor (HSRM).

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Luxembourg

Health Systems in Transition (HiT) profile

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  1. Country Overview

  2. Health Systems in Transition (HiT) profile

    1. Introduction
      1. Introduction
      2. Geography and sociodemography
      3. Economic context
      4. Political context
      5. Health status
    2. Organization and governance
      1. Introduction
      2. Historical background
      3. Organization
      4. Decentralization and centralization
      5. Planning
      6. Intersectorality
      7. Health information systems
      8. Regulation
      9. Person-centred care
    3. Financing
      1. Introduction
      2. Health expenditure
      3. Sources of revenue and financial flows
      4. Overview of the statutory financing system
      5. Out of pocket payments
      6. Voluntary health insurance
      7. Other financing
      8. Payment mechanisms
    4. Physical and human resources
      1. Introduction
      2. Physical resources
      3. Human resources
    5. Provision of Services

      Updated: 07 August 2025
      1. Introduction
      2. Public health

        Updated: 07 August 2025
      3. Patient pathways
      4. Primary care
      5. Specialized care
      6. Urgent and emergency care
      7. Pharmaceutical care
      8. Rehabilitation / intermediate care
      9. Long term care
      10. Services for informal carers
      11. Palliative care
      12. Mental health care

        Updated: 07 August 2025
      13. Dental care
    6. Principal health reforms
      1. Introduction
      2. Analysis of recent reforms
      3. Future developments
    7. Assessment of the health system
      1. Introduction
      2. Health system governance
      3. Accessibility
      4. Financial protection
      5. Health care quality
      6. Health system outcomes
      7. Health system efficiency
    8. Conclusions
      1. Introduction

Public health

The M3S and the Health Directorate are responsible for population health as well as the organization and monitoring of the health care system (see section 2.2). These institutions work closely with national and international public health organizations and research centres to govern public health services. Their collaboration aims to plan statistical studies and documentation of the population’s health status and health determinants. The LIH, the National Health Laboratory (Laboratoire National de Santé) and the National Health Observatory (Observatoire national de la santé) (see section 2.2) are integral parts of the public health ecosystem. The Health Inspectorate (Inspection Sanitaire) is responsible for disease outbreak notification and surveillance. The organization and financing of specific preventive programmes often vary from one intervention to another (see section 3.7.1). Furthermore, the Scientific Council for Health Care, which regularly publishes recommendations from its 22 working groups (Conseil Scientifique, 2024), has initiated promotional and awareness initiatives focused on its recently issued recommendations for optimal medical practices and caregiving. These recent initiatives consist of video campaigns highlighting selected key messages, all aiming to increase the national guidelines’ visibility and foster their adherence by health professionals.

Public health services are delivered through a variety of channels as the Health Directorate either directly administers the services or collaborates with external partners through conventional agreements (see sections 2.2, 3.3.4 and 3.7.1). Preventive programmes, such as breast cancer screening, are integrated within standard care and service billing, which is facilitated by agreements between the Health Directorate, the CNS and specialized health professionals (CSS Art. 17).

Additional services, in part provided through contracted partners/stakeholders, range from health education and health promotion to providing free health services and patient support (Ministère de la Santé, 2022).

Public health programmes encompass vaccination for primary prevention, as well as maternal, neonatal, infant and child screening programmes, including school health services and cancer screening.

In Luxembourg, the Health Directorate oversees the universal vaccination programme based on the recommendations of the Infectious Diseases Council (Conseil supérieur des maladies infectieuses) (see section 2.2) (Mémorial A562, 2023). Even though vaccination is not mandatory in Luxembourg, the Infectious Diseases Council provides recommended vaccination schedules for various pathologies (for example, diphtheria, tetanus and pertussis (DTP)) and the new immunization to protect infants and young children from bronchiolitis has been available since September 2023. Vaccines are procured by the Health Directorate through state-funded tenders and distributed free of charge to health care providers. Flu vaccines and pneumococcal vaccines for people aged 65 years and over, as well as for other at-risk populations, are available in pharmacies upon prescription and fully reimbursed by the SHI. In 2022, the National eHealth Agency (Agence eSanté) was tasked with developing an electronic vaccination record (Sante.lu, 2024c). However, this record is not yet operational; hence, vaccination coverage in Luxembourg cannot be estimated. The Health Directorate monitors the vaccination rates of 25- to 30-month-old children through surveys conducted every five years (Sante.lu, 2024d) and the latest results showed an over 90% coverage for the recommended vaccines up to the age of 24 months in 2018 (Pivot & Leite, 2018).

Systematic medical and dental check-ups are provided, by regulation, for pregnant women and children up to the age of 4 years, with fully reimbursed tariffs and financial incentives (namely, birth allowance of €1740.90 in 2024) (see section 5.12).

Universal screenings during early life years encompass non-invasive prenatal testing for chromosomic anomalies, neonatal screening, cyanogenic cardiac defects and hearing defects, followed by visual screenings at 10 and 40 months of age, and speech and language assessment with hearing tests at 30 months of age (Sante.lu, 2023a).

The 2011 regulation on school health services ensures a comprehensive approach to school-aged children’s health (Mémorial A219, 2011a). It operates through both “Health promotion and education” and “Medical–social–school monitoring”. The former involves collaboration between schools, municipalities and extracurricular organizations, focusing on specific health domains and based on an intersectoral approach. The latter includes school medical measures and examinations, which are carried out systematically, or as needed, in primary and (partially) secondary school-aged children (for example, oral and dental examinations (see section 5.12) or visual and auditory assessments).

Furthermore, the Health Directorate runs two organized screening programmes for breast and colorectal cancer.

  • The Mammography Programme, first launched in 1992, was designed for women aged between 45 and 74 years, affiliated with the SHI, and residing in Luxembourg (Luxembourg Government, 2024a).
  • The colorectal cancer screening pilot programme, launched in 2016 and followed by an organized screening programme in 2021, targets all men and women aged 45–74 years, affiliated with the SHI, and residing in Luxembourg (Luxembourg Government, 2024a).

A summary of these screening programmes is provided in Table5.1.

Table5.1.

Screening programmes in Luxembourg

In Luxembourg, there is no formal legislation or dedicated overarching strategic plan defining public health objectives and activities. Political priorities for public health are included in the government coalition policy programmes (see sections 6.2 and 7.1).

The government finances national action plans, aiming to assess both intervention programmes and their implementation. The government collaborates with various stakeholders on strategic documents to produce actionable measures. National plans are disease-specific, including chronic diseases, cancer, cardio-neuro-vascular diseases, rare diseases, infectious diseases (for example, HIV infection and hepatitis) and mental health conditions, as well as specific to health status, health determinants and/or risk factors (including tobacco, alcohol, illicit drugs) (Sante.lu, 2023b) or specific to certain types of services (for example, palliative care and antibiotic consumption). Although these plans are not legally binding, they highlight important challenges not only for health care service provision, resource allocation (financial and non-monetary), access to care and quality of care in Luxembourg, but also in terms of population health status and determinants (see sections 1.4 and 7.5).

An example of the impact of these public health interventions in Luxembourg is discussed in Box5.1.

Box5.1

Are public health interventions making a difference?

In April 2025, Luxembourg’s Ministry of Education introduced new rules to limit the use of smartphones and similar devices in schools as part of its Screen-Life-Balance campaign, aimed at reducing negative effects of excessive screen time on students’ mental health, academic performance and social development. Under the new regulation, primary schools and after-school care facilities must ban device use throughout the day, including breaks. Exceptions are only allowed for educational or medical purposes. From June 2025, public secondary schools must implement a minimum requirement ensuring physical separation between students and devices during lessons. Each secondary school can define its own policy in consultation with its school community. While 16% of secondary schools apply the minimum requirement, 71% adopted stricter measures (for example, limits by location or age), and 13% have implemented full-day bans. Additional measures include content filters, age-based Wi-Fi access and guided iPad use in educational settings. The pilot project Digital Well-being am Lycée in high schools supports teens in managing social media responsibly.
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HPV vaccination has been recommended for girls in Luxembourg since 2007 and for boys since 2018. However, due to a lack of recent data, a national cross-sectional survey was conducted in 2024 to assess vaccination coverage among youth aged 9 to 20. Results were promising: 83.9% had received at least one dose by age 15, and 77.4% had completed the full schedule—figures aligning well with WHO and CDC targets for 2030. Nonetheless, disparities remain, particularly among boys and older adolescents, likely linked to their later inclusion in vaccination guidelines. The survey also highlighted vaccine hesitancy, especially among unvaccinated 15–20-year-olds, pointing to the need for enhanced communication efforts and targeted catch-up strategies. While participation rates were modest, the sample was adequate to provide reliable estimates and offered useful insights into population engagement with health surveys. As a one-time snapshot, the findings underline the importance of sustained monitoring. The forthcoming Electronic Vaccination Record is expected to improve the consistency and quality of routine immunization data.
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