The financial burden of sickle cell disease on households in Ekiti, Southwest Nigeria

Abstract

BackgroundStudies on economic impact of sickle cell disease (SCD) are scanty despite its being common among children in developing countries who are mostly Africans.ObjectiveTo determine the financial burden of SCD on households in Ado Ekiti, Southwest Nigeria.MethodsA longitudinal and descriptive study of household expenditures on care of 111 children with SCD managed at the pediatric hematology unit of the Ekiti State University Teaching Hospital was conducted between January and December 2014.ResultsThere were 64 male and 47 female children involved, aged between 15 and 180 months. They were from 111 households, out of which only eight (7.2%) were enrolled under the National Health Insurance Scheme. The number of admissions and outpatients’ consultations ranged from 1 to 5 and 1 to 10 per child, respectively. Malaria, vaso-occlusive crisis, and severe anemia were the leading comorbidities. The monthly household income ranged between ₦12,500 and ₦330,000 (US$76 and US$2,000) with a median of ₦55,000 (US$333), and health expenditure ranged between ₦2,500 and ₦215,000 (US$15 and US$1,303) with a mean of ₦39,554±35,479 (US$240±215). Parents of 63 children lost between 1 and 48 working days due to their children’s ill health. Parents of 23 children took loans ranging between ₦6,500 and ₦150,000 (US$39 and US$909) to offset hospital bills. The percentage of family income spent as health expenditure on each child ranged from 0.38 to 34.4. Catastrophic health expenditure (when the health expenditure >10% of family income) occurred in 23 (20.7%) households. Parents who took loan to offset hospital bills, low social class, and patients who took ill during the study period significantly had higher odds for catastrophic health expenditure (95% confidence interval [CI] 5.399–87.176, P=0.000; 95% CI 2.322–47.310, P=0.002; and 95% CI 1.128–29.694, P=0.035, respectively).ConclusionSCD poses enormous financial burden on parents and households.

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

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“…Financial risk protection for health care should, therefore, be a priority for Nigeria. Varying incidence of CHE from spending on specific health conditions in Nigeria has been documented including noncommunicable chronic diseases, sickle cell disease, tuberculosis, outpatient and inpatient services, drugs for human immunodeficiency virus (HIV), and malaria treatment . The objective of this review is to systematically review scientific data from studies conducted in Nigeria that provide information on incidence and factors associated with CHE.…”

“…Varying incidence of CHE from spending on specific health conditions in Nigeria has been documented including noncommunicable chronic diseases, sickle cell disease, tuberculosis, outpatient and inpatient services, drugs for human immunodeficiency virus (HIV), and malaria treatment. 14,[20][21][22][23][24] The objective of this review is to systematically review scientific data from studies conducted in Nigeria that provide information on incidence and factors associated with CHE. The implications of these findings for the achievement of UHC with financial risk protection will also be discussed.…”

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