Determinants of catastrophic health spending among rural households in Nigeria

Authors

  • Paul Oladapo Ajayi Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria. https://orcid.org/0000-0003-0747-9969
  • Tope Michael Ipinnimo Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria.
  • Deborah T Esan Afe Babalola University Ado Ekiti, Ekiti State, Nigeria.
  • Oluremi Olayinka Solomon Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria.
  • Temitope Moronkeji Olanrewaju Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria.

DOI:

https://doi.org/10.60787/tnhj.v22i3.587

Keywords:

Determinant, household, catastrophic health spending, rural, Nigeria

Abstract

Background: Globally, over “150 million individuals” suffer annually from catastrophic health spending mainly as a result of direct spending on healthcare services. According to the World Health Organization, “household catastrophic health spending is health spending greater than or equal to 40% of the household’s non-subsistence income”. Little is known about the determinants of household catastrophic health spending in developing countries.

Objectives: The study aims to find the determinants of household catastrophic health spending in rural Nigeria.

Methods: The study used a cross-sectional survey design to recruit 496 rural households within selected communities in Gbonyin Local government Area of Ekiti State, Nigeria. Data was collected using a pretested, interviewer-administered, and semi-structured questionnaire from 496 household heads. A multistage sampling technique was used over a period of 4month. Data analysis conducted includes univariate, bivariate, and multivariate (binary logistic analysis) analysis using STATA 12 software package and principal component analysis done to derive the wealth quartiles. Statistical significance level was set at p<0.05 and 95%CI calculated for the adjusted OR.

Results: The significant predictors associated with household catastrophic spending include the presence of a hospitalized Household member (OR=50.38, 95%CL (7.11 – 59.62) P 0.042) and the number of employed Household members greater than three (OR=0.001 95%CL (0.00-0.15), P 0.009), which were statistically significant.

Conclusion: The predictors of household catastrophic spending in the rural areas were the presence of hospitalized household members and the presence of employed household member(s). Informed targeted intervention could help reduce the burden of financial catastrophe among rural households.

Downloads

Download data is not yet available.

Author Biographies

Paul Oladapo Ajayi, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria.

LECTURER 1 and Department of Community Medicine, Faculty of Clinical Sciences, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria. Orcid number: https:0000-0003-0747-9969

Tope Michael Ipinnimo, Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria.

Department of Community Health, Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria. and consultant community physician

Deborah T Esan, Afe Babalola University Ado Ekiti, Ekiti State, Nigeria.

Reader in the Department of Nursing Science, Afe Babalola University Ado Ekiti, Ekiti State, Nigeria.

Oluremi Olayinka Solomon, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria.

Lecture 1 in the Department of Community Medicine, Faculty of Clinical Sciences, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria.

Temitope Moronkeji Olanrewaju, Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria.

Consultant Family Physician in the Department of Family Medicine, Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria.

References

Olatunya OS et al. Financial burden of sickle cell disease on household in Ekiti, southwest Nigeria. Clinicoecon Outcomes Res. 2015; 7:545-553. DOI: 10.2147/CEOR.S86599

Ke X, David BE, Guy C and Ana MA. Designing health financing systems to Reduce Catastrophic health expenditure. Technical brief for policy-makers. World Health Organization. Report number: 02, 2005. http://www.who.int/iris/handle/10665/70005. (Assessed on 12 March 2017).

Xu K, Evans DB, Kawabata K, Zeramdini R, Klavus RJ, Murray JLC. Household Catastrophic health expenditure: a multi-country analysis. THE LANCET 2003; 362(9378):111-117.

DOI: 10.1016/S0140-6736(03)13861-5

World Health Organization. New report shows that 400million do not have access to essential health services. / (Accessed on 5th March 201). Weblog. http://www.who.int/mediacentre/news/release/2015/uhc-report/en

Gulland A. Some 400million people lack access to essential health services. BMJ 2015; 350:h3263 doi: http://dx.doi.org/10.1136/bmj.h3263. (Accessed on 7th February 2017).

World Health Organization. Universal health coverage. Weblog. http://www.who.int/mediacentre/factsheet/fs395/en/. (Downloaded on October 6, 2016).

World Health Organization. Media centre: Medical costs push millions of people into poverty across the globe. (accessed on 31st March 2017). Weblog. http://www.who.int/mediacentre/news/releases/2005/pr65/en/.

Bennett S, Ozawa S, Rao KD. Which path to Universal Health Coverage? Perspectives on the World health report 2010. PLoS Med. 2010; 7(11):e1001001. Doi:10.137/journal.pmed.1001001. (accessed on 31st March 2017).

Su TT, Kouyate B, Flessa S. Catastrophic Household expenditure for healthcare in a low income society: a study from Nouna District, Burkina Faso. Bulletin of the World Health Organization. 2006; 84(1):21-27. DOI: 10.2471/blt.05.023739

Ilesanmi OS, Adebiyi AO, Fatiregun AA. National health insurance scheme: how protected are household in Oyo State, Nigeria from catastrophic health expenditure? International Journal of Health policy and management 2014; 2(4): 175-180. DOI: 10.15171/ijhpm.2014.39.

Ukwaja KN, Alobu I, Abimbola S, Hopewell PC. Household Catastrophic payments for tuberculosis care in Nigeria: incidence, determinants and policy implications for universal health coverage. Infectious Disease of Poverty 2013; 2(1): 21. doi: 10.1186/2049-9957-2-21.

Aditi AB. Catastrophic health expenditures: Why leave out the non-users. International Journal for Research in Management and Pharmacy. 2014; 3 (3):73-78. (ISSN: 2320-0901).http://www.raijmr.com/wp-content/uproads/2014/15/10_73-78-Aditi-A-Bansal. Pdf

Famojuro TI. and Moody JO. Survey of Medicinal Plants used in the management of Sickle Cell Disease by Traditional Medical Practitioners of Gbonyin local government area of Ekiti State, Nigeria. Nig. J. Nat. Prod. and Med. 2015;19: 78-84.

National population commission-NPC/Nigeria and Inner City Fund (ICF) International 2014. Nigeria demographic and health survey 2013.Abuja, Nigeria: NPC/Nigeria and ICF International. 2013_ndhs-final-report.pdf.page 39(downloaded March 10, 2017).

Knaul FM, Wong R, Arreola-ornelas H, Mendez O; Network on health financing and Social protection in Latin America and the Caribbean (LANET). Household catastrophic health expenditures: a comparative analysis of twelve Latin American and Caribbean countries. Salud publica Mexico 2011; 53(2): s85-95. https://pubmed.ncbi.nlm.nih.gov/21877097/

Kirkwood BR, Sterne JAC. Calculating the required sample size. Essential medical statistics, 2nd Ed Massachusetts: Blackwell science; 2003: 413-428. Essential Medical Statistics, 2nd Edition | Wiley

Ilesanmi OS, Adebiyi AO, Fatiregun AA. Contribution of household health care expenditure to poverty in Oyo State, South West Nigeria: A rural and urban comparison. J Health Man & Info. 2017; 4(3):64-70. article_42691_2cb36554d976dcb4bdbdc5aa14f5116c.pdf (sums.ac.ir)

Onwujekwe OE, Uzochukwu BS, Obikeze EN, Okoronkwo I, Ochonma OG, Onoka CA et al. Investigating determinants of out-of-pocket spending and strategies for coping with payment for health in southeast, Nigeria. BMC Health Service Research 2010; 10: 67. (Electronic supplementary material 12913 2009 1204 MOESMI ESM.DOC. Additional file:household questionnaire) https://doi.org/10.1186/1472-6963-10-67

World Health Organization. World health survey 2002. A Household Questionnaire. whslonghouseholdlow.pdf. Weblog. (Downloaded 2 March 2017)

World Bank Group. Living Standards Survey; State statistics of the Republic of Armenia. Household Questionnaire–English-World Bank Group (electronic copy/PDF).Weblog Siteresources.worldbank.org/INTLSMS.arm01pdf (Assessed 5 February, 2018)

Douglas GB and Thomas AW. Cronbach’s alpha reliability: Interval estimation, hypothesis tesing and sample size planning.Journal of organisational behavior.2014;36(1):1-13. https://doi.org/10.1002/job.1960

Vyas S, Kumaranayake L. Constructing Socio-Economic Status indices: how to use principal component analysis. Health policy and planning, 2006; 21 (6):459-68. DOI: 10.1093/heapol/czl029

Central Bank of Nigeria. Monthly Average Exchange Rates of the Naira (Naira Per Unit of Foreign Currency) – 2018. Central Bank of Nigeria, 2018.

https://www.cbn.gov.ng/rates/exrate.asp?year=2018. (Assessed on 1st March, 2018).

Ghiasvand H, Shabaninejad H, Arab M, Rashidian A. Hospitalization and catastrophic medical payment; Evidence from hospital located in Tehran. Achieves of Iranian medicine 2014; 17(7):507-513. https://pubmed.ncbi.nlm.nih.gov/24979565/

Li X, Shen JJ, Lu J, Wang Y, Sun M, Li C et al. Household catastrophic medical expenses in eastern China: determinants and policy implication. BMC Health services research 2013,13: 506.

https://doi.org/10.1186/1472-6963-13-506

Kavosi Z et al. inequality in household catastrophic health care expenditure in a low-income society of Iran. Health policy plan. 2012; 27(7):613-23. Doi:10.1093/heapol/czs001.

Yang T, Chu J, Zhou C, Medina A, Li C, Jiang S et al. Catastrophic health expenditure: A comparative analysis of empty-nest and non-empty-nest household with seniors in Shandong, China. BMJ open 2016;6:e010992. doi:101136/bmjopen-2015-010992.

Buiqut S, Ettarh R, Amenda DD. Catastrophic health expenditure and its determinant in Kenya Slum Communities. International Journal for Equity in Health 2015; 14:46.

https://doi.org/10.1186/s12939-015-0168-9

World Bank. Basics of Heath Economics, Self paced module 8 page 6 https://olc.worldbank.org/content/basis-health-economics-self-paced? module 8 page 6. (Accessed on 15 March, 2017).

Boerma T, Eozenou P, Evans D, Evans T, Kieny MP, Wagstaff A. Monitoring progress towards universal health coverage at country and global levels. PLoS Medicine 2014; 11(9):e1001731. doi:10.137/journal.pmed.1001731 (accessed on 1st February, 2017).

Downloads

Published

2022-10-21

How to Cite

Ajayi, P. O., Ipinnimo, T. M., Esan, D. T., Solomon, O. O., & Olanrewaju, T. M. (2022). Determinants of catastrophic health spending among rural households in Nigeria. The Nigerian Health Journal, 22(3), 278–287. https://doi.org/10.60787/tnhj.v22i3.587
Abtract Views | PDF Download | EPUB Download: 373 / 187

Similar Articles

<< < 4 5 6 7 8 9 10 11 12 13 > >> 

You may also start an advanced similarity search for this article.