Economic Burden of Non-communicable Diseases and Poverty in Nigeria: A Cross-sectional Study

Ibukun, Cleopatra Oluseye; Adebayo, AA

doi:10.1007/978-3-030-68836-3_37

Cited by 5 publications

(12 citation statements)

References 21 publications

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“…The poorest households were at a higher risk of CHE than richer households [ 28 , 43 , 46 , 51 , 53 , 81 , 87 , 91 ], as the following statement from a respondent reflects:…”

Section: Resultsmentioning

confidence: 99%

“…I collect the drugs at almost no cost , even when I pay 1000 , it doesn’t even matter because I know the drugs that I am given cost much more than that . The other day , they didn’t have the drugs I wanted , when I got to a pharmacy outside and I bought it with my money , then I realized I how much I have been enjoying” [ 51 ].…”

Section: Resultsmentioning

confidence: 99%

“…Overall, having a chronic diseases member in a household increased the likelihood of CHE incidence by 2.2% [ 80 ]. For households affected by NCDs, CHE incidence was significantly associated with poor socioeconomic status [ 48 , 49 , 51 , 57 , 80 , 96 , 100 , 101 ], employment status [ 51 , 57 , 80 , 96 , 100 , 101 ], old age [ 48 , 49 , 51 , 80 , 96 ], and disability [ 48 ]. However, household head’s sex [ 48 , 49 , 51 , 57 , 71 , 80 , 101 ], marital status [ 51 , 57 , 71 , 80 , 96 , 101 ], education status [ 48 , 49 , 51 , 57 , 71 , 80 , 101 ], employment status [ 51 , 57 , 80 , 96 , 100 , 101 ], household residence [ 48 , 49 , 57 ,…”

Section: Resultsmentioning

confidence: 99%

“…However, household head’s sex [ 48 , 49 , 51 , 57 , 71 , 80 , 101 ], marital status [ 51 , 57 , 71 , 80 , 96 , 101 ], education status [ 48 , 49 , 51 , 57 , 71 , 80 , 101 ], employment status [ 51 , 57 , 80 , 96 , 100 , 101 ], household residence [ 48 , 49 , 57 , 71 , 80 , 100 , 101 ], and religion [ 101 ] were not associated with CHE incidence ( Table 4 ). Having health insurance was protective of catastrophic costs [ 51 , 71 , 80 ]–as in the population level.…”

Section: Resultsmentioning

confidence: 99%

“…Also, despite the progress SSA countries have made towards universal health insurance, households are still exposed to CHE [ 46 , 66 , 84 ]. Yet, it is likely that many low-income uninured households in SSA countries without universal insurance choose not to seek health care rather than face the financial hardship associated with out-of-pocket healthcare payments [ 46 , 51 , 99 ].…”

Section: Discussionmentioning

confidence: 99%

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Factors associated with catastrophic health expenditure in sub-Saharan Africa: A systematic review

et al. 2022

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Objective A non-negligible proportion of sub-Saharan African (SSA) households experience catastrophic costs accessing healthcare. This study aimed to systematically review the existing evidence to identify factors associated with catastrophic health expenditure (CHE) incidence in the region. Methods We searched PubMed, CINAHL, Scopus, CNKI, Africa Journal Online, SciELO, PsycINFO, and Web of Science, and supplemented these with search of grey literature, pre-publication server deposits, Google Scholar®, and citation tracking of included studies. We assessed methodological quality of included studies using the Appraisal tool for Cross-Sectional Studies for quantitative studies and the Critical Appraisal Skills Programme checklist for qualitative studies; and synthesized study findings according to the guidelines of the Economic and Social Research Council. Results We identified 82 quantitative, 3 qualitative, and 4 mixed-methods studies involving 3,112,322 individuals in 650,297 households in 29 SSA countries. Overall, we identified 29 population-level and 38 disease-specific factors associated with CHE incidence in the region. Significant population-level CHE-associated factors were rural residence, poor socioeconomic status, absent health insurance, large household size, unemployed household head, advanced age (elderly), hospitalization, chronic illness, utilization of specialist healthcare, and utilization of private healthcare providers. Significant distinct disease-specific factors were disability in a household member for NCDs; severe malaria, blood transfusion, neonatal intensive care, and distant facilities for maternal and child health services; emergency surgery for surgery/trauma patients; and low CD4-count, HIV and TB co-infection, and extra-pulmonary TB for HIV/TB patients. Conclusions Multiple household and health system level factors need to be addressed to improve financial risk protection and healthcare access and utilization in SSA. Protocol registration PROSPERO CRD42021274830

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“…The poorest households were at a higher risk of CHE than richer households [ 28 , 43 , 46 , 51 , 53 , 81 , 87 , 91 ], as the following statement from a respondent reflects:…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Factors associated with catastrophic health expenditure in sub-Saharan Africa: A systematic review

et al. 2022

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The financial burden of noncommunicable diseases from out-of-pocket expenditure in sub-Saharan Africa: a scoping review

Odunyemi,

Islam,

Alam

2024

Health Promotion International

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The growing financial burden of noncommunicable diseases (NCDs) in sub-Saharan Africa (SSA) hinders the attainment of the sustainable development goals. However, there has been no updated synthesis of evidence in this regard. Therefore, our study summarizes the current evidence in the literature and identifies the gaps. We systematically search relevant databases (PubMed, Scopus, ProQuest) between 2015 and 2023, focusing on empirical studies on NCDs and their financial burden indicators, namely, catastrophic health expenditure (CHE), impoverishment, coping strategies, crowding-out effects and unmet needs for financial reasons (UNFRs) in SSA. We examined the distribution of the indicators, their magnitudes, methodological approaches and the depth of analysis. The 71 included studies mostly came from single-country (n = 64), facility-based (n = 52) research in low-income (n = 22), lower-middle-income (n = 47) and upper-middle-income (n = 10) countries in SSA. Approximately 50% of the countries lacked studies (n = 25), with 46% coming from West Africa. Cancer, cardiovascular disease (CVD) and diabetes were the most commonly studied NCDs, with cancer and CVD causing the most financial burden. The review revealed methodological deficiencies related to lack of depth, equity analysis and robustness. CHE was high (up to 95.2%) in lower-middle-income countries but low in low-income and upper-middle-income countries. UNFR was almost 100% in both low-income and lower-middle-income countries. The use of extreme coping strategies was most common in low-income countries. There are no studies on crowding-out effect and pandemic-related UNFR. This study underscores the importance of expanded research that refines the methodological estimation of the financial burden of NCDs in SSA for equity implications and policy recommendations.

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The Baseline Self-Efficacy Scores to Manage Chronic Diseases Amongst Nigerian Patients with Non-Communicable Diseases are Sub-Optimal

Ezenwaka,

Nwankwo,

Analike

et al. 2024

INQUIRY

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Nigeria is one of the developing countries with a major burden of non-communicable diseases (NCDs) without a disease self-management program in its healthcare system. Thus, this study was aimed to assess the baseline self-efficacy levels of Nigerian patients with chronic NCDs at tertiary level hospitals. This is a cross sectional study of 286 NCD patients attending tertiary level clinics from 26 July to 27 October 2023. Patients were interviewed on a 10 Self-Efficacy to Manage Chronic Disease (SEMCD) item scales that were considered suitable for the Nigerian population. The 10 SEMCD questions covered: (i) Exercise regularly scale, (ii) Help from community, family and friends scale, (iii) Communication with Physician scale, (iv) Manage disease scale and (v) Manage symptom self-efficacy domains. Data were analyzed both descriptively and statistically using Student’s t-tests and Chi-square tests as appropriate. The results showed that more female (59.4%) than males (40.6%) attended clinics during the study, and the mean age of the patients did not differ between gender ( P > .05). About 40% of all the patients manage their NCDs with medications alone, a trend that is similar in male and female patients ( P > .05). While all the patients had a relatively lower self-efficacy scores under regular exercise scale (52%-55%) and manage disease symptoms scale (53%-55%), they tended toward higher self-efficacy scores under getting assistance from community, family, and friends (79%-80%) and communication with attending physicians (81%-85%). It is concluded that Nigeria literate NCD patients registered at tertiary level institution routine clinics are less than optimal in disease self-management care. We recommend that this study population will benefit from introduction and implementation of disease self-management program in the healthcare system.

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Economic Burden of Non-communicable Diseases and Poverty in Nigeria: A Cross-sectional Study

Cited by 5 publications

References 21 publications

Factors associated with catastrophic health expenditure in sub-Saharan Africa: A systematic review

Factors associated with catastrophic health expenditure in sub-Saharan Africa: A systematic review

The financial burden of noncommunicable diseases from out-of-pocket expenditure in sub-Saharan Africa: a scoping review

The Baseline Self-Efficacy Scores to Manage Chronic Diseases Amongst Nigerian Patients with Non-Communicable Diseases are Sub-Optimal

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