Catastrophic Health Expenditure and Household Impoverishment: a case of NCDs prevalence in Kenya

Mwai, Daniel; Muriithi, Moses Kinyanjui

doi:10.2427/11519

Cited by 5 publications

(1 citation statement)

References 20 publications

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“…, 2015; Brinda et al. , 2014; Xu et al ., 2006; David et al ., 2017; Rashad and Sharaf, 2015; Mwai and Murithi, 2016) have employed logistic regression to measure determinants of catastrophic health expenditure in different countries, while probit model was used in the first estimation procedure of Heckman's two step and double hurdle model/two-part model in other studies like Kim and Yang, 2011, Wang et al . (2016) and Brown et al .…”

Section: Review Of Theoretical Methodological and Empirical Issuesmentioning

confidence: 99%

Determinants of catastrophic household health expenditure in Nigeria

Opeloyeru

Lawanson

2023

IJSE

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PurposeThe purpose of this paper is to examine the determinants of catastrophic household health expenditure in Nigeria, with particular focus on Out-of-Pocket (OOP) health expenditure. Payments for healthcare through OOP are the major means of channeling funds to healthcare providers in many developing countries including Nigeria. It has great consequence on household well-being, especially when it is difficult for household to meet up with spending on other necessity goods.Design/methodology/approachThe demand for health theory provided the theoretical framework. The study used data from 2018/2019 Nigeria Living Standard Survey (NLSS) with catastrophic thresholds of 10 and 25%. A logistic regression model was used, while Pearson chi-squared test was used for models' goodness of fit.FindingsBased on the obtained result using Pearson chi-squared, at 10% threshold of total non-food expenditure, the likelihood of experiencing catastrophic health expenditure increased with secondary education, for those without health insurance and for severely ill or injured by 1.48, 2.57 and 8.70, respectively. It fell for those who consulted patent medicine vendors/chemists for illness or injury by 0.63 compared to orthodox practitioners. Enhancement of post-secondary education and widening the coverage of the available social health insurance would minimise the financial burden on many households.Originality/valueThis paper fulfills the need to examine the determinants of catastrophic household health expenditure on two catastrophic thresholds and two forms of household expenditure.

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Section: Review Of Theoretical Methodological and Empirical Issuesmentioning

confidence: 99%

Determinants of catastrophic household health expenditure in Nigeria

Opeloyeru

Lawanson

2023

IJSE

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Individual and household level factors associated with presence of multiple non-communicable disease risk factors in Kenyan adults

et al. 2018

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BackgroundNon-communicable diseases (NCDs), are increasing globally, causing about 60% of disability-adjusted life years and 39.8 million deaths in 2015. Risk factors often cluster and interact multiplicatively in an individual and this is strongly associated with the development and severity of NCDs. We assessed the sociodemographic factors associated with the presence of multiple NCD risk factors among individuals aged 18 years and older in the Kenyan population.MethodsWe used national representative data from 4066 individuals out of 4500 who participated in the WHO STEPs study in 2015. NCD risk factor counts were derived by summing the risk factors present in an individual and categorising into 1–3, 4–6 and 7+ risk factors in any combination of the 12 assessed NCD risk factors (hypertension, diabetes mellitus, cholesterol, insufficient physical activity, excessive alcohol use, tobacco use and obesity, excess sugar intake, insufficient fruit and vegetables intake, high salt consumption, and use of unhealthy cooking fats and oils). Ordered logistic regression was used to investigate the sociodemographic factors associated with an individual possesing multiple NCD risk factors.ResultsMajority (75.8%) of the individuals in the study possesed 4–6 and 10% had ≥7 NCDs risk factors. Nearly everyone (99.8%) had insufficient fruits and vegetable intakes, 89.5% consumed high salt in their diet and 80.3% did not engage in sufficient physical activity. Apart from NCD risk count which increased with age among both men and women, associations with other socio-demographic factors differed between men and women. A woman of Akamba ethinicity had lower odds (0.43) while Meru women had higher odds (3.58) of higher NCD risk factor count, compared to the Kalenjin women. Among men, being a Kisii or Luo was associated with lower odds (0.48 and 0.25 respectively) of higher NCD risk factor count. Women in a marital union had higher odds (1.58) of a higher NCD risk factor count.ConclusionMajority of Kenyan adults possess more than four NCD risk factors; a clear indication of an emerging epidemic of NCDs in this population. Effective and multi-sectoral interventions targeting multiple risk factors in individuals are required to mitigate especially the behavioural and modifiable NCD risk factors in Kenya.

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Understanding variation in catastrophic health expenditure from socio-ecological aspect: a systematic review

Mohsin,

Ahsan,

Haider

2024

BMC Public Health

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Background Out-of-pocket (OOP) payment is one of many countries’ main financing options for health care. High OOP payments push them into financial catastrophe and the resultant impoverishment. The infrastructure, society, culture, economic condition, political structure, and every element of the physical and social environment influence the intensity of financial catastrophes in health expenditure. Hence, the incidence of Catastrophic Health Expenditure (CHE) must be studied more intensively, specifically from regional aspects. This systematic review aims to make a socio-ecological synthesis of the predictors of CHE. Method We retrieved data from Scopus and Web of Science. This review followed PRISMA guidelines. The interest outcomes of the included literature were the incidence and the determinants of CHE. This review analyzed the predictors in light of the socio-ecological model. Results Out of 1436 screened documents, fifty-one met the inclusion criteria. The selected studies were quantitative. The studies analyzed the socioeconomic determinants from the demand side, primarily focused on general health care, while few were disease-specific and focused on utilized care. The included studies analyzed the interpersonal, relational, and institutional predictors more intensively. In contrast, the community and policy-level predictors are scarce. Moreover, neither of the studies analyzed the supply-side predictors. Each CHE incidence has different reasons and different outcomes. We must go with those case-specific studies. Without the supply-side response, it is difficult to find any effective solution to combat CHE. Conclusion Financial protection against CHE is one of the targets of sustainable development goal 3 and a tool to achieve universal health coverage. Each country has to formulate its policy and enact laws that consider its requirements to preserve health rights. That is why the community and policy-level predictors must be studied more intensively. Proper screening of the cause of CHE, especially from the perspective of the health care provider’s perspective is required to identify the individual, organizational, community, and policy-level barriers in healthcare delivery.

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Catastrophic Health Expenditure and Household Impoverishment: a case of NCDs prevalence in Kenya

Cited by 5 publications

References 20 publications

Determinants of catastrophic household health expenditure in Nigeria

Determinants of catastrophic household health expenditure in Nigeria

Individual and household level factors associated with presence of multiple non-communicable disease risk factors in Kenyan adults

Understanding variation in catastrophic health expenditure from socio-ecological aspect: a systematic review

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