The Determinants of Catastrophic Health Expenditure and Coping Strategies for Households with People Living With HIV/AIDS in the Nkambe District Hospital, Cameroon

Abstract

Purpose: Despite free distribution of HIV/AIDs medication to patients, the expenditures on HIV/AIDS care and treatment can still be catastrophic to patients and their households due to the costs of other components (indirect cost) of care. This work was aimed at investigating the determinants of catastrophic health expenditure and the coping strategies for households with people living with HIV/AIDS in the Nkambe District Hospital, Cameroon.
 Methodology: Data were collected using an administered questionnaire and secondary data from patients’ files, analyzed using frequencies and logistic regression. A convenient and purposive sample of 346 participants were enrolled (281 outpatients and 65 inpatients).
 Results: Results show that the incidence of CHE was 20.3% for outpatient and 66.7% for inpatient visits, considering a 40% threshold. Factors that determine CHE identified were: use of motorbike as mode of transport (OR = 2.058, p-value = 0.05), divorced (OR 4.354, p-value = 0.033), borrowing (OR = 2.229, p-value = 0.027) and support from family members (OR = 2.367, p-value = 0.001). The most common coping strategies adopted by participants were increasing working hours and support from friends and relatives with half of the participants seeing these strategies as sustainable.
 Conclusion: It was concluded that the subsidization of ART services is not sufficient to eliminate the economic burden of treatment on HIV patients as many households still experienced CHE.
 Recommendations: The study recommends implementing effective community dispensation of ARVs, Multimonth dispensation as measures to curb transportation cost. Also, implementation of the elimination of user fee policy for other HIV services. Finally, accelerating the process of universal health coverage in Cameroon will go a long way to help HIV patients and their households.