Financial burden of health care for Buruli ulcer patients in Nigeria: the patients’ perspective

Chukwu, Joseph N.; Meka, Anthony O.; Nwafor, Charles C.; Oshi, Daniel C.; Madichie, Nelson O.; Ekeke, Ngozi; Anyim, Moses C.; Alphonsus, Chukwuka; Obinna, Mbah; Adegbesan, Julie; Njoku, Martin; Soyinka, Festus Olukayode; Adelokiki, Adebola O.; Enemuoh, Isreal O.; Okolie, Patrick I.; Edochie, Joseph E.; Offor, Jonah B; Ushaka, Joseph; Ukwaja, Kingsley Nnanna

doi:10.1093/inthealth/ihw056

Cited by 25 publications

(41 citation statements)

References 15 publications

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“…All the studies fulfilled most of the quality criteria except for five studies that did not provide a sample size justification and power description . Also, 13 of the studies did not measure key potential confounding variables measured nor adjust for them statistically …”

Section: Methodsmentioning

confidence: 99%

“…20,21,[29][30][31] Also, 13 of the studies did not measure key potential confounding variables measured nor adjust for them statistically. 6,20,23,24,[30][31][32][33][34][35][36][37][38]…”

Section: Quality Appraisalmentioning

confidence: 99%

“…Two studies assessed the incidence of CHE using 10% of total household income and found that 20.7% to 50% of the study population faced CHE. 21,32 Three of the studies utilized 10% of consumption expenditure and 5% and 30% of nonfood expenditure to define CHE. At 10% of consumption expenditure, 9.6% of households experienced CHE.…”

Section: Incidence Of Catastrophic Health Expenditurementioning

confidence: 99%

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A review of the incidence and determinants of catastrophic health expenditure in Nigeria: Implications for universal health coverage

Okedo‐Alex

Akamike

Ezeanosike

et al. 2019

Health Planning & Management

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Summary Background In the Nigerian context, preconditions for financial catastrophe are operational as there is high out‐of‐pocket spending (OOPS) on health with low capacity to pay, presence of user fees, and poor prepayment insurance coverage. We reviewed the incidence and determinants of catastrophic health expenditure (CHE) in Nigeria. Methods Databases including PubMed, OVID, EMBASE, CINAHL, and Web of Science were searched for primary research studies on the incidence and determinants of CHE in Nigeria published between 2003 and 2018. Search terms used include household, out‐of‐pocket expenditure, catastrophic health expenditure, and Nigeria. Results Twenty studies that met the inclusion criteria were included in the review. At 10% of total household and nonfood expenditure, the incidence of CHE was 8.2% to 50%, while 3.2% to 100% households incurred CHE at 40% of nonfood expenditure. The incidence of CHE was higher among inpatients and studies with lower threshold definitions. Outpatient CHE was highest for type 2 diabetes and tuberculosis while human immunodeficiency virus (HIV) care incurred the most CHE among inpatients. Determinants of CHE include wealth status, age, gender, place of residence/geographical location, household size/composition, educational status, health insurance status, illness, and health provider types. Conclusion There is a high incidence of CHE across various common health conditions in Nigeria. CHE was more among the poor, elderly, rural dwellers, private facility utilization, female gender, and noninsured among others. We recommend expansion of the National Health Insurance Scheme via informal social and financing networks platforms. Increased budgetary allocation to health and intersectoral collaboration will also play a significant role in CHE reduction.

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Section: Methodsmentioning

confidence: 99%

“…20,21,[29][30][31] Also, 13 of the studies did not measure key potential confounding variables measured nor adjust for them statistically. 6,20,23,24,[30][31][32][33][34][35][36][37][38]…”

Section: Quality Appraisalmentioning

confidence: 99%

Section: Incidence Of Catastrophic Health Expenditurementioning

confidence: 99%

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A review of the incidence and determinants of catastrophic health expenditure in Nigeria: Implications for universal health coverage

Okedo‐Alex

Akamike

Ezeanosike

et al. 2019

Health Planning & Management

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“…In Ghana, the cost of care per patient with Buruli ulcer in a household in the poorest earning quartile can be as high as 315% of annual earnings [15]. Similarly, in Nigeria the cost of Buruli Ulcer care and diagnosis can be on average 162% of patient’s median monthly household income, leading to catastrophic financial loss [16]. The cost of NTDs is not limited to human infections.…”

Section: Main Textmentioning

confidence: 99%

The cross-cutting contribution of the end of neglected tropical diseases to the sustainable development goals

et al. 2017

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The Sustainable Development Goals (SDGs) call for an integrated response, the kind that has defined Neglected Tropical Diseases (NTDs) efforts in the past decade.NTD interventions have the greatest relevance for SDG3, the health goal, where the focus on equity, and its commitment to reaching people in need of health services, wherever they may live and whatever their circumstances, is fundamentally aligned with the target of Universal Health Coverage. NTD interventions, however, also affect and are affected by many of the other development areas covered under the 2030 Agenda. Strategies such as mass drug administration or the programmatic integration of NTD and WASH activities (SDG6) are driven by effective global partnerships (SDG17). Intervention against the NTDs can also have an impact on poverty (SDG1) and hunger (SDG2), can improve education (SDG4), work and economic growth (SDG8), thereby reducing inequalities (SDG10). The community-led distribution of donated medicines to more than 1 billion people reinforces women’s empowerment (SDG5), logistics infrastructure (SDG9) and non-discrimination against disability (SDG16). Interventions to curb mosquito-borne NTDs contribute to the goals of urban sustainability (SDG11) and resilience to climate change (SDG13), while the safe use of insecticides supports the goal of sustainable ecosystems (SDG15). Although indirectly, interventions to control water- and animal-related NTDs can facilitate the goals of small-scale fishing (SDG14) and sustainable hydroelectricity and biofuels (SDG7).NTDs proliferate in less developed areas in countries across the income spectrum, areas where large numbers of people have little or no access to adequate health care, clean water, sanitation, housing, education, transport and information. This scoping review assesses how in this context, ending the epidemic of the NTDs can impact and improve our prospects of attaining the SDGs.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-017-0288-0) contains supplementary material, which is available to authorized users.

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“…Other direct and indirect treatment costs, such as for transport and stay at health facilities, wound management, and loss of labor of patients and caretakers have to be covered by patients and their families. The main source of funding for these costs is direct household spending, mostly through out-of-pocket payments, which may prevent patients from seeking care or may have catastrophic consequences for the household economies [25,26]. The situation is further aggravated by the fact that many patients report with advanced stages of the disease, for which treatment is both much more demanding and more expensive.…”

Section: Diagnosis and Treatment Of Bumentioning

confidence: 99%

Buruli Ulcer in Africa

Tabah

Johnson²,

Degnonvi

et al. 2019

Buruli Ulcer

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Financial burden of health care for Buruli ulcer patients in Nigeria: the patients’ perspective

Abstract: Direct costs of Buruli ulcer diagnosis and treatment are catastrophic to a substantial proportion of patients and their families.

Cited by 25 publications

References 15 publications

A review of the incidence and determinants of catastrophic health expenditure in Nigeria: Implications for universal health coverage

A review of the incidence and determinants of catastrophic health expenditure in Nigeria: Implications for universal health coverage

The cross-cutting contribution of the end of neglected tropical diseases to the sustainable development goals

Buruli Ulcer in Africa

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