Purpose The purpose of this paper is to examine the determinants of health expenditure at the household level in Nigeria with specific focus on the household and individual unique characteristics. It presents some stylised facts about the Nigerian health system and its financing options. It went further to show that household is the major financial organ of healthcare in Nigeria. The study aims to expand the domain of household health expenditure by analysing at national, urban and rural levels. Design/methodology/approach It adopted Engel curve approach, which was estimated using ordinary least squares technique. The model was structured to take care of life-cycle implications by examining effects of age in years and age groups (0-9, 10-19, 20-39, 40-59 and 60+) on healthcare spending. Data were drawn from the 2010 Harmonised Nigeria Living Standards Survey (HNLSS) conducted by the National Bureau of Statistics and analyses were conducted nationally, for urban and rural locations. Findings The result shows that individual characteristics like age, religion, education and household characteristics like income, size and headship commonly influence healthcare expenditure in Nigeria significantly. The household-level variables possess stronger significant effects among the rural households while marital status and employment had differential effects in both urban and rural locations. It also confirmed that Nigeria engages in intergenerational transfer of healthcare by the working population to the young and older generations. Research limitations/implications HNLSS was only limited to those who were sick or injured in the last two weeks preceding the survey, leaving out those whose sickness preceded the two weeks before the survey. Also, the scope of health expenditure is limited to curative care spending that exclude expenses on preventive care, rehabilitative care as well as other cost-saving services. Originality/value This paper fulfils an identified need to examine the determinants of household health expenditure at the national, urban and rural locations.

Abstract

PurposeThis study investigates the effect of user fees on access and waiting time in Nigeria. For access, the effect of user fees on both preventive and curative care; and the effect of user fees on waiting time at public healthcare facilities were examined. User fees are vital for the fiscal sustainability of healthcare provision for most African economies. Its imposition could debar healthcare access by the poor while its removal can reduce quality of care and induce longer waiting time.Design/methodology/approachThe wave 3 of the Nigerian General Household Survey (2015/16) data was used for users of public health facilities. Access to healthcare was modelled using utilization data in a logistic regression model while waiting time was through the Negative Binomial Regression Model (NBRM).FindingsThe analyses showed significant effects of user fees on access to both preventive and curative care and on time spent waiting to make use of healthcare services. Individuals were able to access healthcare services regardless of amounts paid. Also, there was a non-negative effect of user fee imposition on waiting time.Practical implicationsNigeria should improve healthcare facilities to address the enormous demand for healthcare services when designing policy for health sector.Originality/valueThis paper shows that even with the imposition of user fees, healthcare facilities could still not cater for the rising healthcare needs of the populace but cautioned that its abolition may not be a preferred option.

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The economic and social desirability of marital stability is shown by its promotion of di-vision of labor, risk pooling, and encouragement of healthy behavior, while unstable mar-riages are linked to negative outcomes such as psychological and financial distress, im-paired child development, and long-term health challenges. It is worth noting that, while previously high divorce rates in developed countries appear to be slowing down, the op-posite might occur in developing countries. However, few studies have empirically ex-amined the causes of marital instability in developing countries. This study sought to em-pirically investigate marital instability in Nigeria by focusing on its key influencing fac-tors. The study collected data from 186 individuals in the urban and rural areas of Ibadan, the third most populous city in Nigeria, and used multivariate logistic regression analysis to investigate three marital states: divorce, separation, and widowhood. The results show that marriage duration, number of children, and marriage entry age have a substantial in-fluence on marital instability. The risk of divorce follows a U-shaped pattern, with the risk falling from age 26 to 30 and rising again until age 46. Thus, addressing the causes of ear-ly and late marriage entry could improve marital stability in Nigeria. Keywords: Household economics; Marital instability; Marriage market