Leaving no one behind in health: Financial hardship to access health care in Ethiopia

Tsega, Yawkal; Tsega, Gebeyehu; Taddesse, Getasew; Getaneh, Gebremariam

doi:10.1371/journal.pone.0282561

Cited by 8 publications

(8 citation statements)

References 21 publications

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“…The outcome showed a significant difference between users' and non-users' marital status. The results agree with those of Ayoade and Adeola (2012) and Tsega et al (2023). The off-farm income generated by users and nonusers of healthcare facilities differs significantly, indicating that users of healthcare facilities experienced higher income than their peers.…”

Section: Socioeconomic Characteristics Of the Users And Non-users Of ...supporting

confidence: 89%

“…Living a socially and economically productive life depends fundamentally on good health (Occupational Safety and Health, 2022). Poor health inflicts great hardships on households, vis-à-vis debilitation, substantial monetary expenditures, labour loss, and seldom loss of life (Tsega et al, 2023). Poor health affects agricultural production.…”

Section: Original Research Articlementioning

confidence: 99%

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Impact of the decision to use healthcare facilities among farming households on labour productivity in Ogun State, Nigeria

Aboaba,

Akamo,

Obalola

et al. 2023

Agricultura Tropica Et Subtropica

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Productivity of agricultural labour is central to the improvement of livelihoods of rural population. This study used an instrumental variable approach to examine the impact of healthcare facilities use on household labour productivity using distance to healthcare facilities as an instrument. A multistage sampling procedure was used in selecting 200 households comprising 96 users and 104 non-users of healthcare facilities. The result revealed that the agricultural productivity of users of healthcare facilities was ₦652.34 (USD 1.65) per man-day higher than non-users. The result further showed that age (p < 0.1), sex (p < 0.05), contact with health extension worker (p < 0.01), incapacitation due to illness (p < 0.05) and distance to healthcare facilities (p < 0.01) significantly influenced the decision to use healthcare facilities while membership of cooperative society (p < 0.05), area cultivated and use of health care facilities (p < 0.1) significantly influenced labour productivity. The study concluded that increased distance to healthcare facilities reduces its utilisation while being member of cooperative society and utilisation of healthcare facilities increases labour productivity. This study recommended that health extension workers need to intensify their efforts in educating the households on the need to use healthcare facilities when they are sick; this is expected to improve the healthy time of the households which will invariably increase their productivity.

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Section: Socioeconomic Characteristics Of the Users And Non-users Of ...supporting

confidence: 89%

Section: Original Research Articlementioning

confidence: 99%

Impact of the decision to use healthcare facilities among farming households on labour productivity in Ogun State, Nigeria

Aboaba,

Akamo,

Obalola

et al. 2023

Agricultura Tropica Et Subtropica

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“…For instance, the prevalence of depression in adults with HF was 17.3% in the USA [ 17 ], 28.6% in the UK [ 41 ], 29.7% in Spain [ 42 ], 41% in the Netherlands [ 43 ]. The higher prevalence rate in our study could be due limited access to healthcare, including mental health services [ 44 , 45 ], which might hinder the early identification and treatment of depression. Developed countries generally have more stable economies, which contributes to reduced stress and anxiety, thereby lowering the risk of depression [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

Comorbid depression among adults with heart failure in Ethiopia: a hospital-based cross-sectional study

Mulugeta,

Sinclair,

Wilson

2024

BMC Psychiatry

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Background Depression is a common comorbidity in adults with heart failure. It is associated with poor clinical outcomes, including decreased health-related quality of life and increased morbidity and mortality. There is a lack of data concerning the extent of this issue in Ethiopia. Consequently, this study aimed to assess the prevalence of comorbid depression and associated factors among adults living with heart failure in Ethiopia. Methods A hospital-based cross-sectional study was conducted at the cardiac outpatient clinics of two selected specialist public hospitals in Addis Ababa, Ethiopia: St. Paul’s Hospital Millennium Medical College and St. Peter Specialized Hospital. An interviewer-administered questionnaire was used to collect data from 383 adults with heart failure who attended the clinics and met the inclusion criteria. Depression was measured using the Patient Health Questionnaire (PHQ-9). A binary logistic regression model was fitted to identify factors associated with depression. All statistical analyses were conducted using STATA version 17 software. Results The mean age of the participants was 55 years. On average, participants had moderate depression, as indicated by the mean PHQ-9 score of 11.02 ± 6.14, and 217 (56.6%, 95%CI 51.53–61.68) had comorbid depression. Significant associations with depression were observed among participants who were female (AOR: 2.31, 95%CI:1.30–4.08), had comorbid diabetes mellitus (AOR: 3.16, 95%CI: 1.47–6.82), were classified as New York Heart Association (NYHA) class IV (AOR: 3.59, 95%CI: 1.05–12.30), reported poor levels of social support (AOR: 6.04, 95%CI: 2.97–12.32), and took more than five medications per day (AOR: 5.26, 95%CI: 2.72–10.18). Conclusions This study indicates that over half of all adults with heart failure in Ethiopia have comorbid depression, influenced by several factors. The findings have significant implications in terms of treatment outcomes and quality of life. More research in the area, including interventional and qualitative studies, and consideration of multifaceted approaches, such as psychosocial interventions, are needed to reduce the burden of comorbid depression in this population.

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“…Households obligated to pay, direct medical, direct non-medical, indirect medical, and intangible medical costs in order to access essential health care. Direct out of pocket (OOP) healthcare expenditure is the major financial risk and cause of disparity and inequity in the provision of health care services in low-income countries such as Ethiopia [ 1 , 2 , 7 – 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…CHE contributes to disparities in the provision of essential quality healthcare services. The disparities are attributed to various factors like insurance status of the household, having chronic health conditions and being socially unsupported [ 7 , 8 ]. This burden is directly proportional to the severity of the underlying health condition (ill individuals spend more).…”

Section: Introductionmentioning

confidence: 99%

Insured-non-insured disparity of catastrophic health expenditure in Northwest Ethiopia: a multivariate decomposition analysis

Tsega,

Mekonen

et al. 2024

Health Econ Rev

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Background Financial risk protection is one indicator of universal health coverage (UHC). All people should be protected from financial risks such as catastrophic health expenditures (CHE) to ensure equitable health services. Ethiopia has launched community-based health insurance (CBHI) since 2011 to protect people from financial risk. However, out-of-pocket health expenditure is a financial barriers to achieve UHC. The insured-non-insured disparity of CHE has not been well studied in Ethiopia in general and in Debre Tabor town in particular. Therefore, this study aimed to assess the disparity of CHE between insured and non-insured households and its contributing factors in Debre Tabor town. Methods This study used the primary household survey data collected from May to June 2022 in Debre Tabor town. Data were collected from 825 household heads and analyzed using STATA version 17.0 statistical software. Logit-based multivariate decomposition analysis was conducted to determine insured-non-insured disparity of CHE. Statistical significance for all analysis was declared at a p < 0.05. Results The incidence of CHE was 17.94% and 5.58% among non-insured and insured households, respectively. About 53% and 153.20% of the insured-non-insured disparities in the magnitude of CHE were due to the difference in characteristics (endowments) and the effect of characteristics (coefficients), respectively. Age of the household head between 46 and 60 years and above 60 years, divorced and widowed marital status of household head, and chronic health conditions were the explanatory variables widening the gap in the incidence of CHE. However, do not seeking traditional medicine, family size above 4, and age of household head between 31 and 45 years were the variables contribute in reducing the gap (i.e. due to endowments) in the incidence of CHE between insured and non-insured households. Moreover, the variables that contributed to the gap in the incidence of CHE due to covariate effects were age (31–45) and marital status of household head, wealth status, family size, ownership of the household, and seeking traditional medicines. Conclusion This study revealed there is a significant disparity in the incidence of CHE between insured and non-insured households. Age, marital status and occupation of the household head, family size of household, presence of a chronically ill household member and seeking traditional medicine were significantly contributing factors for the disparity of CHE between insured and non-insured households due to endowments. The variables that contributed to the disparity in the incidence of CHE due to covariate effects were age and marital status of household head, wealth status, family size, ownership of the household, and seeking traditional medicines. Therefore, the policy makers need to emphasize in increasing the insurance coverage among households, and providing affordable health services in Ethiopia in general and Debre Tabor town in particular.

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Leaving no one behind in health: Financial hardship to access health care in Ethiopia

Cited by 8 publications

References 21 publications

Impact of the decision to use healthcare facilities among farming households on labour productivity in Ogun State, Nigeria

Impact of the decision to use healthcare facilities among farming households on labour productivity in Ogun State, Nigeria

Comorbid depression among adults with heart failure in Ethiopia: a hospital-based cross-sectional study

Insured-non-insured disparity of catastrophic health expenditure in Northwest Ethiopia: a multivariate decomposition analysis

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