Out-of-pocket health expenditure for under-five illnesses in a semi-urban community in Northern Nigeria

Abstract

Background: Household expenditure on health is increasingly becoming a major source of health care financing in Nigeria. Recognizing the limitations of this pattern of financing health care, the government has introduced a social health insurance scheme policy that has provided for government meeting the health care costs of children. However, there is a dearth of information on the pattern and costs of under-five illnesses at community level. This study therefore sought to determine the magnitude and causes of illnesses among under-fives, sources of healthcare and out of pocket expenditure among children under-five in Layin Zomo, a semi-urban area of Northern Nigeria

Effects of poverty on child health and paediatric practice in Nigeria: An overview

“…Currently, (and this has been prevailing for almost 25 years) 1,57 health financing in most developing countries -including Nigeria, relies predominantly on out of pocket payments (OPP) by individuals at the time of treatment . 58 Although a National Health Insurance Scheme (NHIS) has recently been introduced in Nigeria, 57,58 the scheme is still in its initial stages of implementation, and has not yet covered all Nigerians including the poor, unemployed and the rural populace.…”

“…58 Although a National Health Insurance Scheme (NHIS) has recently been introduced in Nigeria, 57,58 the scheme is still in its initial stages of implementation, and has not yet covered all Nigerians including the poor, unemployed and the rural populace. 57 The OPP system often denies basic care to the poorest members of society.…”

“…58 Although a National Health Insurance Scheme (NHIS) has recently been introduced in Nigeria, 57,58 the scheme is still in its initial stages of implementation, and has not yet covered all Nigerians including the poor, unemployed and the rural populace. 57 The OPP system often denies basic care to the poorest members of society. 57 With OPP, even the middle income families are vulnerable to impoverishment if one of their members has to pay for expensive health care, or a family breadwinner can no longer work as a result of sickness or disability.…”

“…57 The OPP system often denies basic care to the poorest members of society. 57 With OPP, even the middle income families are vulnerable to impoverishment if one of their members has to pay for expensive health care, or a family breadwinner can no longer work as a result of sickness or disability. 60 A further problem with health care systems that rely heavily on OPP is that they leave public responsibilities such as disease surveillance, preventive programmes and control of epidemics severely under funded.…”

“…6,61 A recent study in poor semi urban community in northern Nigeria demonstrates that OPP is the main source of health care financing for the under five illnesses and most of the patients have low capacity to pay because of extreme poverty. 57 Another consequence of OPP is what is currently termed catastrophic health costs (CHC) or catastrophic household health expenditure (CHHE). Xu et al 61 defined CHHE as spending 40% or more of household income on health problem after meeting subsistence needs.…”