Self-Reported Serious Illnesses in Rural Cambodia: A Cross-Sectional Survey

Abstract

BackgroundThere is substantial evidence that ill-health is a major cause of impoverishment in developing countries. Major illnesses can have a serious economic impact on poor households through treatment costs and income loss. However, available methods for measuring the impact of ill-health on household welfare display several shortcomings and new methods are thus needed. To understand the potential complex impact of major illnesses on household livelihoods, a study on poverty and illness was conducted in rural Cambodia, as part of an international comparative research project. A cross-sectional survey was performed to identify households affected by major illness for further in-depth interviews.Methodology and Principal Findings5,975 households in three rural health districts were randomly selected through a two-stage cluster sampling and interviewed. 27% of the households reported at least one member with a serious illness in the year preceding the survey and 15% of the household members reported suffering from at least one serious illness. The most reported conditions include common tropical infectious diseases, chronic diseases (notably hypertension and heart diseases) and road traffic accidents. Such conditions were particularly concentrated among the poor, children under five, women, and the elderly. Poor women often reported complications related to pregnancy and delivery as serious illnesses.Conclusions and SignificanceDespite some methodological limitations, this study provides new information on the frequency of self-reported serious illnesses among the rural Cambodia's population, which serves as a basis for further in-depth investigation on ‘major illnesses’ and their economic consequences on poor households. This can in turn help policy makers to formulate appropriate interventions to protect the poor from the financial burden associated with ill-health. Our findings suggest that every year a considerable proportion of rural population in Cambodia, especially the poor and vulnerable, are affected by serious illnesses, both communicable and non-communicable diseases.

Self-reported illness and household strategies for coping with health-care payments in Bangladesh

“…The similarity in the conditions recorded in the present study across the five quintiles of household wealth was less expected, since poverty often appears to help to perpetuate illness. 1,2,5 Although the members of the households that we surveyed were able to obtain care for most of their episodes of illness, 13% of them were forced to adopt "distress" financing to cope with the costs of the care. In Bangladesh, where an estimated 65% of health-care expenditure is financed from out-of-pocket payments, illness is a major cause of economic hardship and poverty.…”

“…Data on sociodemographic status, household expenditure and illness experienced in the previous 30 days were collected. All illnesses were coded according to a disease list that had been developed in previous studies 2,7,10,22,23 and finalized after pilot testing in 100 households (Appendix A). Data were collected on the time of onset and, if possible, duration of illness, diagnosis, treatment response, treatment cost and coping strategies.…”

“…[1][2][3][4] In these countries, poverty and illness are closely linked: poverty leads to ill health and ill health perpetuates poverty. 1,2,5 Noncommunicable and infectious diseases cause financial hardship both directly, via out-of-pocket spending on treatment, and indirectly, by limiting participation in income-generating activities.…”

“…[1][2][3][4] In these countries, poverty and illness are closely linked: poverty leads to ill health and ill health perpetuates poverty. 1,2,5 Noncommunicable and infectious diseases cause financial hardship both directly, via out-of-pocket spending on treatment, and indirectly, by limiting participation in income-generating activities. [6][7][8][9] In low-and middle-income countries where public funding for health services is inadequate and mechanisms for "risk-pooling", such as "demand-side" financing and formal health insurance, are limited or unavailable, out-of-pocket payments and illness-related loss of income can lead to asset depletion, debt and reductions in essential consumption that, together, can result in financial catastrophe.…”

The prevalence and associated factors for prehypertension and hypertension in Cambodia

“…With recent evidence highlighting the prevalence of hypertension and related metabolic disorders in Cambodia,1 2 attention is now being given to initiating evidence-based prevention and control strategies. A national survey in 2010 revealed that hypertension had an urban prevalence of approximately 16.90%, a rural prevalence of 10.00%, and overall country prevalence of 11.20% among persons aged 25–64 years 3…”