Examining Inequities in Incidence of Catastrophic Health Expenditures on Different Healthcare Services and Health Facilities in Nigeria

Abstract

ObjectiveThere is limited evidence about levels of socio-economic and other differences in catastrophic health spending in Nigeria and in many sub-Saharan African countries. The study estimated the level of catastrophic healthcare expenditures for different healthcare services and facilities and their distribution across socioeconomic status (SES) groups.MethodsThe study took place in four Local Government Areas in southeast Nigeria. Data were collected using interviewer-administered questionnaires administered to 4873 households. Catastrophic health expenditures (CHE) were measured using a threshold of 40% of monthly non-food expenditure. We examined both total monthly health expenditure and disaggregated expenditure by source and type of care.ResultsThe average total household health expenditure per month was 2354 Naira ($19.6). For outpatient services, average monthly expenditure was 1809 Naira ($15.1), whilst for inpatient services it was 610 Naira ($5.1). Higher health expenditures were incurred by urban residents and the better-off SES groups. Overall, 27% of households incurred CHE, higher for poorer socioeconomic groups and for rural residents. Only 1.0% of households had a member that was enrolled in a health insurance scheme.ConclusionThe worse-off households (the poorest SES and rural dwellers) experienced the highest burden of health expenditure. There was almost a complete lack of financial risk protection. Health reform mechanisms are needed to ensure universal coverage with financial risk protection mechanisms.

The role of civil society organisations (CSOs) in healthcare delivery system: A case study of child immunisation in Kabarole district, Uganda

“…56% of the respondents as revealed from the descriptive statistical analysis. Contrary to the study done in Nigeria [21] where bicycles, and motorcycle cars and generators were least commonly owned assets, this study showed that at least more than half of the study population owned a bicycle as mode of transport to access healthcare services including immunization of children.…”

“…The study therefore brings out clearly that socio-economic status of the individuals greatly determines the level of access to CSO healthcare. These findings relate to the study done in Nigeria [21] that found most households owned functional radios, kerosene lamps. Bicycles and motorcycle cars and generators were least commonly owned assets.…”

National health insurance scheme: how protected are households in Oyo State, Nigeria from catastrophic health expenditure?

“…A higher proportion of 14.8% was reported by Onoka et al among household studied in South Eastern Nigeria (19). Onwujekwe et al also found CHE at 40% non-food expenditure in urban South Eastern Nigeria to be 15% (23). This study has shown that some measures of financial risk protection is available to the enrolees of NHIS in Nigeria.…”

“…Limiting this study to urban areas where the NHIS enrolees are more could be responsible. Only few households in South East Nigeria are also on the NHIS and only 51 (1.0%) households had a resident who was a primary enrolee in a health insurance scheme (23). This study showed a prevalence of CHE of 6.6% in urban South Western Nigeria.…”

Análisis del gasto de los hogares en salud en Argentina, como componente de la cobertura universal de salud

“…Previous studies reported that in 1997 catastrophic spending on healthcare was observed in 5.77% of household in the country 14 , whereas in 2004 this type of spending affected 3.6% of households 15 . Compared to other countries, the spending of argentine households on health-related events may be considered low, since some countries exhibit an incidence of catastrophic spending be- tween 10% and 27% of households, estimated on the basis of a cut-off point of 40% of expenditure exclusive of food ( [16][17][18] ). As to factors that determine household spending on healthcare, those having members below 14 years of age show the highest spending, and the same applies for those having members above 65 years.…”