Appraisal of the payment coping mechanism of households affected by cancer among patients attending Jos University Teaching Hospital, Plateau State, Nigeria

Abstract

Cancer is a major public health issue that has impoverishing effects on households. This study assessed the payment coping mechanism of households affected by cancer among patients attending Jos University Teaching Hospital, Plateau State, Nigeria. This is a descriptive cross-sectional survey involving 179 cancer patients attending Jos University Teaching Hospital, Plateau State, Nigeria during the year 2015. They were recruited using systematic sampling technique. Questionnaire was used to collect data assisted by two research assistants from the oncology clinic. Data were analyzed descriptively using frequencies, percentages, mean, standard deviation and Chi-square was used to test for association between payment coping mechanism utilized by the patients across different socio-economic groups. The payment coping mechanism utilized by majority (78%) of the respondents was own money (salary, earnings, savings), followed by family members (46.6%), gifts from friends and neighbours (29.6%), borrowed money/loan (27.4%) and sale of lands (12.3%). Few respondents (14%) utilized payment coping mechanism from sales of household assets, community based support, cancer association, temporary stoppage of children education, social welfare/social worker, skip appointments and other unidentified mechanisms. This study also revealed that, majority (79.33%) of the respondents were among the lower socio-economic group, 15.64% were among the middle socio-economic group while only 5.03% belong to the upper socio-economic group. The Chi-square test of association revealed that, there is a significant difference p-value of 0.000 < 0.05 between the payment coping mechanisms utilized by cancer patients and their households across different socio-economic groups (lower, middle and upper). Out of pocket spending is the major payment coping mechanism for cancer treatment in the study population. The study recommends that, since cancer management is critical to the survival of the patient, Nigerian health insurance coverage should be expanded to include cancer treatment in order to protect patients and their households from ill-health mediated insolvency.