Examining inequities in incidence of catastrophic health expenditures on different healthcare services and health facilities in Nigeria

PLoS One. 2012;7(7):e40811. doi: 10.1371/journal.pone.0040811. Epub 2012 Jul 16.

Abstract

Objective: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Family Characteristics
  • Female
  • Health Expenditures / statistics & numerical data*
  • Health Facilities / economics*
  • Health Facilities / statistics & numerical data*
  • Health Services / economics*
  • Health Services / statistics & numerical data*
  • Humans
  • Incidence
  • Insurance, Health / economics
  • Insurance, Health / statistics & numerical data
  • Male
  • Nigeria / epidemiology
  • Patient Acceptance of Health Care
  • Risk
  • Socioeconomic Factors