Distribution of out of pocket health expenditures in a sub-Saharan Africa country: evidence from the national survey of household standard of living, Côte d’Ivoire

Attia-Konan, A.R.; Oga, A.S.S.; Amadou, Touré; Kouadio, Kouakou Luc

doi:10.1186/s13104-019-4048-z

Cited by 24 publications

(33 citation statements)

References 26 publications

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“…This is consistent with reports from a previous study regarding the proportion of the population actively enrolled in the national health insurance scheme [ 25 ]. Moreover, our findings on pro-rich out-of-pocket expenditure were consistent with the results from previous studies conducted in resource-poor settings that respondents from higher household wealth quintiles were more likely to have out-of-pocket health expenditures compared with their counterparts from poor household wealth quintiles [ 26 – 28 ]. Further studies are required to investigate the exact reasons why women from low neighborhood socioeconomic disadvantage level in Ghana have higher out-of-pocket health expenditures.…”

Section: Discussionsupporting

confidence: 91%

Inequalities in out-of-pocket health expenditure among women of reproductive age: after-effects of national health insurance scheme initiation in Ghana

Ekholuenetale

Barrow

2021

J. Egypt. Public. Health. Assoc.

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Background Improvement in maternal healthcare is a public health priority. Unfortunately, in spite of the efforts made over time regarding universal coverage, there remain issues with accessibility and use of healthcare services up to now. In this study, we examined inequalities in out-of-pocket health expenditure among women of reproductive age in Ghana. We analyzed secondary data collected in Ghana Demographic and Health Survey (GDHS) - 2014. A total of 9,002 women of reproductive age were included in this study. Lorenz curves and the concentration index were used to examine neighborhood socioeconomic disadvantage inequalities in out-of-pocket expenditure for maternal healthcare utilization Results About two thirds (66.0%) of women of reproductive age in Ghana were covered by health insurance. In sum, women of high neighborhood socioeconomic disadvantage status had the least out-of-pocket expenditure for total healthcare utilization, laboratory investigations, antenatal care visits, post-natal care visits, care for new born for up to 3 months, and other healthcare services. The converse was however true for family planning service utilization. Using Concentration Index, we quantified the degree of neighborhood socioeconomic disadvantage inequalities in healthcare service utilizations. Conclusion This study showed a gap in health insurance coverage among women of reproductive age. There were also inequalities in out-of-pocket expenditure for healthcare services utilization. It is expedient for stakeholders in the healthcare system to make policies targeted at bridging the neighborhood socioeconomic differences in maternal healthcare use and develop programs to improve women’s financial protection. Moreover, enlightenment on health insurance availability and coverage should focus on women at risk of out-of-pocket expenditure.

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Section: Discussionsupporting

confidence: 91%

Inequalities in out-of-pocket health expenditure among women of reproductive age: after-effects of national health insurance scheme initiation in Ghana

Ekholuenetale

Barrow

2021

J. Egypt. Public. Health. Assoc.

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“…In most cases, people use traditional medicine or self-medicate and only consult when the condition becomes life-threatening [31,32]. Also, most older adults in Africa do not have health insurance and they have to make out-of-pocket payments for healthcare services [33,34].…”

Section: Discussionmentioning

confidence: 99%

Predictors of three-month mortality among hospitalized older adults in Togo

et al. 2020

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Background Assessing hospital mortality and its predictors is important as some of these can be prevented through appropriate interventions. Few studies have reported hospital mortality data among older adults in sub-Saharan Africa. The objective of this study was to assess the mortality and associated factors among hospitalized older adults in Togo. Methods We conducted a prospective cohort study from February 2018 to September 2019 among patients ≥50 years admitted in medical and surgical services of six hospitals in Togo. Data were recorded during hospitalization and through telephone follow-up survey within 90 days after admission. The main outcome was all-cause mortality at 3 months. Survival curves were estimated using the Kaplan-Meier method and Cox regression analyses were performed to assess predictors of mortality. Results The median age of the 650 older adults included in the study period was 61 years, IQR: [55–70] and at least one comorbidity was identified in 59.7% of them. The all-cause mortality rate of 17.2% (95%CI: 14.4–20.4) and the majority of death (93.7%) occurred in hospital. Overall survival rate was 85.5 and 82.8% after 30 and 90 days of follow-up, respectively. Factors associated with 3-month mortality were the hospital level in the health pyramid, hospitalization service, length of stay, functional impairment, depression and malignant diseases. Conclusion Togolese health system needs to adjust its response to an aging population in order to provide the most effective care.

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“…In general, in Africa, the population does not consult a health professional when rst symptoms appear. In most cases, people use traditional medicine or self-medicate and only consult when the condition becomes life-threatening [32,33]. Also, most older adults in Africa do not have health insurance and they have to make out-of-pocket payments for healthcare services.…”

Section: Discussionmentioning

confidence: 99%

Predictors of three-month mortality among hospitalized older adults in Togo

Gbeasor-Komlanvi

Tchankoni

Bakoubayi

et al. 2020

Preprint

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Background: Assessing hospital mortality and its predictors is important as some of these can be prevented through appropriate interventions. Few studies have reported hospital mortality data among older adults in sub-Saharan Africa. The objective of this study was to assess the mortality and associated factors among hospitalized older adults in Togo.Methods: We conducted a prospective cohort study from February 2018 to September 2019 among patients ≥50 years admitted in medical and surgical services of six hospitals in Togo. Data were recorded during hospitalization and through telephone follow-up survey within 90 days after admission. The main outcome was all-cause mortality at 3 months. Survival curves were estimated using the Kaplan-Meier method and Cox regression analyses were performed to assess predictors of mortality.Results: The median age of the 650 older adults included in the study period was 61 years, IQR: [55-70] and at least one comorbidity was identified in 59.7% of them. The all-cause mortality rate of 17.2% (95%CI: 14.4-20.4) and the majority of death (93.7%) occurred in hospital. Overall survival rate was 85.5% and 82.8% after 30 and 90 days of follow-up, respectively. Factors associated with 3-month mortality were the hospital level in the health pyramid, hospitalization service, length of stay, functional impairment, depression and malignant diseases.Conclusion: Togolese health system needs to adjust its response to an aging population in order to provide the most effective care.

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Distribution of out of pocket health expenditures in a sub-Saharan Africa country: evidence from the national survey of household standard of living, Côte d’Ivoire

Cited by 24 publications

References 26 publications

Inequalities in out-of-pocket health expenditure among women of reproductive age: after-effects of national health insurance scheme initiation in Ghana

Inequalities in out-of-pocket health expenditure among women of reproductive age: after-effects of national health insurance scheme initiation in Ghana

Predictors of three-month mortality among hospitalized older adults in Togo

Predictors of three-month mortality among hospitalized older adults in Togo

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