Examining Inequities in Incidence of Catastrophic Health Expenditures on Different Healthcare Services and Health Facilities in Nigeria
Identifieur interne : 002993 ( Pmc/Curation ); précédent : 002992; suivant : 002994Examining Inequities in Incidence of Catastrophic Health Expenditures on Different Healthcare Services and Health Facilities in Nigeria
Auteurs : Obinna Onwujekwe [Nigeria] ; Kara Hanson [Royaume-Uni] ; Benjamin Uzochukwu [Nigeria]Source :
- PLoS ONE [ 1932-6203 ] ; 2012.
Abstract
There 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.
The 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.
The 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.
The 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.
Url:
DOI: 10.1371/journal.pone.0040811
PubMed: 22815828
PubMed Central: 3397929
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<author><name sortKey="Onwujekwe, Obinna" sort="Onwujekwe, Obinna" uniqKey="Onwujekwe O" first="Obinna" last="Onwujekwe">Obinna Onwujekwe</name>
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<front><div type="abstract" xml:lang="en"><sec><title>Objective</title>
<p>There 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.</p>
</sec>
<sec><title>Methods</title>
<p>The 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.</p>
</sec>
<sec><title>Results</title>
<p>The 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.</p>
</sec>
<sec><title>Conclusion</title>
<p>The 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.</p>
</sec>
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</author>
<author><name sortKey="Fonta, W" uniqKey="Fonta W">W Fonta</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Lagarde, M" uniqKey="Lagarde M">M Lagarde</name>
</author>
<author><name sortKey="Palmer, N" uniqKey="Palmer N">N Palmer</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Uzochukwu, Bsc" uniqKey="Uzochukwu B">BSC Uzochukwu</name>
</author>
<author><name sortKey="Onwujekwe, Oe" uniqKey="Onwujekwe O">OE Onwujekwe</name>
</author>
<author><name sortKey="Akpala, Co" uniqKey="Akpala C">CO Akpala</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Ogunbekun, I" uniqKey="Ogunbekun I">I Ogunbekun</name>
</author>
<author><name sortKey="Adeyi, O" uniqKey="Adeyi O">O Adeyi</name>
</author>
<author><name sortKey="Wouters, A" uniqKey="Wouters A">A Wouters</name>
</author>
<author><name sortKey="Morrow, Rh" uniqKey="Morrow R">RH Morrow</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Soyibo, A" uniqKey="Soyibo A">A Soyibo</name>
</author>
<author><name sortKey="Lawanson, O" uniqKey="Lawanson O">O Lawanson</name>
</author>
<author><name sortKey="Olaniyan, L" uniqKey="Olaniyan L">L Olaniyan</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Soyibo, A" uniqKey="Soyibo A">A Soyibo</name>
</author>
<author><name sortKey="Lawanson, O" uniqKey="Lawanson O">O Lawanson</name>
</author>
<author><name sortKey="Olaniyan, L" uniqKey="Olaniyan L">L Olaniyan</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Velenyi, E" uniqKey="Velenyi E">E Velenyi</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Sadoh, We" uniqKey="Sadoh W">WE Sadoh</name>
</author>
<author><name sortKey="Nwaneri, Du" uniqKey="Nwaneri D">DU Nwaneri</name>
</author>
<author><name sortKey="Owobu, Ac" uniqKey="Owobu A">AC Owobu</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Onwujekwe, O" uniqKey="Onwujekwe O">O Onwujekwe</name>
</author>
<author><name sortKey="Hanson, K" uniqKey="Hanson K">K Hanson</name>
</author>
<author><name sortKey="Uzochukwu, B" uniqKey="Uzochukwu B">B Uzochukwu</name>
</author>
<author><name sortKey="Ichoku, H" uniqKey="Ichoku H">H Ichoku</name>
</author>
<author><name sortKey="Ikeh, E" uniqKey="Ikeh E">E Ikeh</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Onwujekwe, O" uniqKey="Onwujekwe O">O Onwujekwe</name>
</author>
<author><name sortKey="Dike, N" uniqKey="Dike N">N Dike</name>
</author>
<author><name sortKey="Chukwuka, C" uniqKey="Chukwuka C">C Chukwuka</name>
</author>
<author><name sortKey="Uzochukwu, B" uniqKey="Uzochukwu B">B Uzochukwu</name>
</author>
<author><name sortKey="Onyedum, C" uniqKey="Onyedum C">C Onyedum</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Feder, J" uniqKey="Feder J">J Feder</name>
</author>
<author><name sortKey="Moon, M" uniqKey="Moon M">M Moon</name>
</author>
<author><name sortKey="Scanlon, W" uniqKey="Scanlon W">W Scanlon</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Xu, K" uniqKey="Xu K">K Xu</name>
</author>
<author><name sortKey="Evans, D" uniqKey="Evans D">D Evans</name>
</author>
<author><name sortKey="Kawabata, K" uniqKey="Kawabata K">K Kawabata</name>
</author>
<author><name sortKey="Zeramdini, R" uniqKey="Zeramdini R">R Zeramdini</name>
</author>
<author><name sortKey="Klavus, J" uniqKey="Klavus J">J Klavus</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="World, Bank" uniqKey="World B">Bank World</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Preker, As" uniqKey="Preker A">AS Preker</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Ranson, K" uniqKey="Ranson K">K Ranson</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Pradhan, M" uniqKey="Pradhan M">M Pradhan</name>
</author>
<author><name sortKey="Prescott, N" uniqKey="Prescott N">N Prescott</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Wagstaff, A" uniqKey="Wagstaff A">A Wagstaff</name>
</author>
<author><name sortKey="Van Doorslaer, E" uniqKey="Van Doorslaer E">E Van Doorslaer</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="O Onnell, O" uniqKey="O Onnell O">O O’Donnell</name>
</author>
<author><name sortKey="Van Doorslaer, E" uniqKey="Van Doorslaer E">E Van Doorslaer</name>
</author>
<author><name sortKey="Rannan Eliya, R" uniqKey="Rannan Eliya R">R Rannan-Eliya</name>
</author>
<author><name sortKey="Somanathan, A" uniqKey="Somanathan A">A Somanathan</name>
</author>
<author><name sortKey="Charu, C" uniqKey="Charu C">C Charu</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Castillo Riquelme, M" uniqKey="Castillo Riquelme M">M Castillo-Riquelme</name>
</author>
<author><name sortKey="Mcintyre, D" uniqKey="Mcintyre D">D McIntyre</name>
</author>
<author><name sortKey="Barnes, K" uniqKey="Barnes K">K Barnes</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Yardim, Ms" uniqKey="Yardim M">MS Yardim</name>
</author>
<author><name sortKey="Cilingiroglu, N" uniqKey="Cilingiroglu N">N Cilingiroglu</name>
</author>
<author><name sortKey="Yardim, N" uniqKey="Yardim N">N Yardim</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Onoka, Ca" uniqKey="Onoka C">CA Onoka</name>
</author>
<author><name sortKey="Hanson, K" uniqKey="Hanson K">K Hanson</name>
</author>
<author><name sortKey="Onwujekwe, O" uniqKey="Onwujekwe O">O Onwujekwe</name>
</author>
<author><name sortKey="Uzochukwu, B" uniqKey="Uzochukwu B">B Uzochukwu</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Filmer, D" uniqKey="Filmer D">D Filmer</name>
</author>
<author><name sortKey="Pritchett, Lh" uniqKey="Pritchett L">LH Pritchett</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Ichoku, He" uniqKey="Ichoku H">HE Ichoku</name>
</author>
<author><name sortKey="Fonta, W" uniqKey="Fonta W">W Fonta</name>
</author>
<author><name sortKey="Onwujekwe, O" uniqKey="Onwujekwe O">O Onwujekwe</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Huffman, Md" uniqKey="Huffman M">MD Huffman</name>
</author>
<author><name sortKey="Rao, Kd" uniqKey="Rao K">KD Rao</name>
</author>
<author><name sortKey="Pichon Riviere, A" uniqKey="Pichon Riviere A">A Pichon-Riviere</name>
</author>
<author><name sortKey="Zhao, D" uniqKey="Zhao D">D Zhao</name>
</author>
<author><name sortKey="Harikrishnan, S" uniqKey="Harikrishnan S">S Harikrishnan</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Goudge, J" uniqKey="Goudge J">J Goudge</name>
</author>
<author><name sortKey="Russell, S" uniqKey="Russell S">S Russell</name>
</author>
<author><name sortKey="Gilson, L" uniqKey="Gilson L">L Gilson</name>
</author>
<author><name sortKey="Molyneux, C" uniqKey="Molyneux C">C Molyneux</name>
</author>
<author><name sortKey="Hanson, K" uniqKey="Hanson K">K Hanson</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Nguyen, Ht" uniqKey="Nguyen H">HT Nguyen</name>
</author>
<author><name sortKey="Rajkotia, Y" uniqKey="Rajkotia Y">Y Rajkotia</name>
</author>
<author><name sortKey="Wang, H" uniqKey="Wang H">H Wang</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Saksena, P" uniqKey="Saksena P">P Saksena</name>
</author>
<author><name sortKey="Antunes, Af" uniqKey="Antunes A">AF Antunes</name>
</author>
<author><name sortKey="Xu, K" uniqKey="Xu K">K Xu</name>
</author>
<author><name sortKey="Musango, L" uniqKey="Musango L">L Musango</name>
</author>
<author><name sortKey="Carrin, G" uniqKey="Carrin G">G Carrin</name>
</author>
</analytic>
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<article-id pub-id-type="doi">10.1371/journal.pone.0040811</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
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<subj-group subj-group-type="Discipline-v2"><subject>Medicine</subject>
<subj-group><subject>Epidemiology</subject>
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<subj-group><subject>Global Health</subject>
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<subj-group><subject>Infectious Diseases</subject>
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<subj-group><subject>Non-Clinical Medicine</subject>
<subj-group><subject>Health Care Policy</subject>
<subj-group><subject>Health Systems Strengthening</subject>
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<subj-group><subject>Health Economics</subject>
<subject>Health Services Research</subject>
<subject>Socioeconomic Aspects of Health</subject>
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<subj-group><subject>Primary Care</subject>
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<subj-group><subject>Socioeconomic Aspects of Health</subject>
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<subj-group><subject>Economics</subject>
<subj-group><subject>Health Economics</subject>
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<subj-group><subject>Psychology</subject>
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<title-group><article-title>Examining Inequities in Incidence of Catastrophic Health Expenditures on Different Healthcare Services and Health Facilities in Nigeria</article-title>
<alt-title alt-title-type="running-head">Inequities in Catastrophic Health Expenditures</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Onwujekwe</surname>
<given-names>Obinna</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
<xref ref-type="corresp" rid="cor1"><sup>*</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hanson</surname>
<given-names>Kara</given-names>
</name>
<xref ref-type="aff" rid="aff3"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Uzochukwu</surname>
<given-names>Benjamin</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
<xref ref-type="aff" rid="aff4"><sup>4</sup>
</xref>
</contrib>
</contrib-group>
<aff id="aff1"><label>1</label>
<addr-line>Health Policy Research Group, Department of Pharmacology and Therapeutics, University of Nigeria Enugu-Campus, Enugu, Nigeria</addr-line>
</aff>
<aff id="aff2"><label>2</label>
<addr-line>Department of Health Administration and Management, University of Nigeria Enugu-Campus, Enugu, Nigeria</addr-line>
</aff>
<aff id="aff3"><label>3</label>
<addr-line>Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom</addr-line>
</aff>
<aff id="aff4"><label>4</label>
<addr-line>Department of Community Medicine, College of Medicine, University of Nigeria Enugu-Campus, Enugu, Nigeria</addr-line>
</aff>
<contrib-group><contrib contrib-type="editor"><name><surname>Shiff</surname>
<given-names>Clive</given-names>
</name>
<role>Editor</role>
<xref ref-type="aff" rid="edit1"></xref>
</contrib>
</contrib-group>
<aff id="edit1">Johns Hopkins University, United States of America</aff>
<author-notes><corresp id="cor1">* E-mail: <email>Obinna.Onwujekwe@unn.edu.ng</email>
</corresp>
<fn fn-type="con"><p>Conceived and designed the experiments: OO KH. Performed the experiments: OO KH BU. Analyzed the data: OO KH BU. Wrote the paper: OO KH BU.</p>
</fn>
</author-notes>
<pub-date pub-type="collection"><year>2012</year>
</pub-date>
<pub-date pub-type="epub"><day>16</day>
<month>7</month>
<year>2012</year>
</pub-date>
<volume>7</volume>
<issue>7</issue>
<elocation-id>e40811</elocation-id>
<history><date date-type="received"><day>16</day>
<month>2</month>
<year>2012</year>
</date>
<date date-type="accepted"><day>13</day>
<month>6</month>
<year>2012</year>
</date>
</history>
<permissions><copyright-statement>Hanson et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</copyright-statement>
<copyright-year>2012</copyright-year>
</permissions>
<abstract><sec><title>Objective</title>
<p>There 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.</p>
</sec>
<sec><title>Methods</title>
<p>The 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.</p>
</sec>
<sec><title>Results</title>
<p>The 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.</p>
</sec>
<sec><title>Conclusion</title>
<p>The 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.</p>
</sec>
</abstract>
<counts><page-count count="6"></page-count>
</counts>
</article-meta>
</front>
</pmc>
</record>
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