Abstract We explore the potential impacts of being a female head of household (FH) or a family member in a female-headed household (MFH) in terms of budget expenditures and socio-economic determinants. Female household leaders in Palestine Refugee Camps find themselves with more barriers to provide the basic needs to their families. However, there is yet no analysis on the different household typologies, nor whether these translate into differences in healthcare spending and well-being outcomes. We perform a cross section analysis using two-part models (probit and glm) to understand correlations between household composition and spending decisions, as well as healthcare indicators. The data are from AUB Socioeconomic Surveys from 2010 and 2015 with household and individual level information. Our preliminary results follow the evidence in the literature and show that expenditure in healthcare as a percentage of total spending is 2.3%*** higher in 2010 and 3.3%*** in 2015 in female headed households. This difference is higher in families headed by widows or single women. Comparing 2010 to 2015 female-headed households are better off financially and belonging to these families is a significant determinant of receiving remittances from family abroad or in Lebanon and being self-employed. Our results suggest that family remittances for female-headed households, heads of households having their own business and better budget management may be helping these families to cope with financial distress. These families are also target of special social support, but further research is needed to understand whether this support should target the gender of the household head or a more specific issue, that might be common to most of these households, but not the female leadership itself. Key messages Female-headed households are related to higher household budget spending on healthcare, are more likely to receive remittances from abroad and most of female heads of households are self-employed. We contribute to the discussion on whether special social support should target specifically female headed households or other specific poverty related issues.