Determinants of household health expenditure in Nigeria

Abstract

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.

Healthcare Seeking Behavior in Nigeria

“…The difference in annual growth, therefore, accounted for by LEB between a typical high income country and a typical least-developed country is about 1.6 percentage points per year (Commission on Macroeconomics and Health, 2001). Globally, it is the responsibility of governments to provide for the health of citizens (Craigwell, Bynoe & Lowe, 2012), especially poor households, which are not usually financially protected, particularly against substantial costs of ill health (Olasehinde & Olaniyan, 2017). Such costs include both direct expenses, such as out-of-pocket payments (OOP), which refers to the cost borne by beneficiaries at the time of use of a particular healthcare service.…”

“…It also includes institutions and the workforce that provide these services as well as individuals, government, private organizations and other agencies that finance different services. Summarily, a healthcare system is made up of all the sources from which an individual seeks healthcare and upon which payments are usually made accordingly (Olasehinde & Olaniyan, 2017).…”

Paying for Health Care by Households in Ghana: The Effects of Poverty Status and Location

“…In this paper, we use the logarithm of total household health expenditures to control for heteroscedasticity. Following from the literature Malik and Syed [9], Olasehinde and Olaniyan [10] the explanatory variables considered in this study are: the age head of the household, household size, the poverty status of the household, the educational attainment of the head of the household, sex of the household head, household possession of TV and radio and locality (urban versus rural; and north versus south) in the health care expenditure model (see Table 1 for description of these variables).With scarce resources, the intra-household competition for resources can be an important factor that explains health care spending. The study includes household size to capture the competition for household resources effect in the demand for health care.…”

“…While substantial literature exists on the determinants of public health expenditure at the macro level Pan and Liu [4]; Samadi and Homaie [5]; Bilgel and Tran [6]; Chaabouni and Abednnadher [7]; Rezaei et tal [8], analysis of household healthcare expenditure has received very little attention especially in developing countries. To the best of my knowledge, the very few studies that exist at the micro level include Malik and Syed [9] in Pakistan, Olasehinde and Olaniyan [10] in Nigeria and Zeng [11] in China. Besides, most of the researches on health care demand have concentrated on the individual as the consumer of health, however focusing on the household as the main producer and consumer of health care has far-reaching policy implications.…”

“…Besides, most of the researches on health care demand have concentrated on the individual as the consumer of health, however focusing on the household as the main producer and consumer of health care has far-reaching policy implications. This is because basic decisions of life such as accommodation, income generation, investment and consumption, as well as children composition, constitute common dilemmas facing households Olasehinde and Olaniyan [10]. Besides, the intrahousehold dynamics of decision making and resource allocation have greatly impacted on the well-being of its members and the community it belongs Yusof and Duasa [12].…”