Investigating determinants of out-of-pocket spending and strategies for coping with payments for healthcare in southeast Nigeria.
Obinna Onwujekwe,Benjamin Uzochukwu,Eric Obikeze,Ijeoma L. Okoronkwo,Ogbonnia Ochonma,Chima Onoka,Grace Madubuko,Chijioke Okoli +7 more
Reads0
Chats0
TLDR
There is the need to reduce OOPS and channel and improve equity in healthcare financing by designing and implementing payment strategies that will assure financial risk protection of the poor such pre-payment mechanisms with government paying for the poor.Abstract:
Out-of-pocket spending (OOPS) is the major payment strategy for healthcare in Nigeria. Hence, the paper assessed the determinants socio-economic status (SES) of OOPS and strategies for coping with payments for healthcare in urban, semi-urban and rural areas of southeast Nigeria. This paper provides information that would be required to improve financial accessibility and equity in financing within the public health care system. The study areas were three rural and three urban areas from Ebonyi and Enugu states in South-east Nigeria. Cross-sectional survey using interviewer-administered questionnaires to randomly selected householders was the study tool. A socio-economic status (SES) index that was developed using principal components analysis was used to examine levels of inequity in OOPS and regression analysis was used to examine the determinants of use of OOPS. All the SES groups equally sought healthcare when they needed to. However, the poorest households were most likely to use low level and informal providers such as traditional healers, whilst the least poor households were more likely to use the services of higher level and formal providers such as health centres and hospitals. The better-off SES more than worse-off SES groups used OOPS to pay for healthcare. The use of own money was the commonest payment-coping mechanism in the three communities. The sales of movable household assets or land were not commonly used as payment-coping mechanisms. Decreasing SES was associated with increased sale of household assets to cope with payment for healthcare in one of the communities. Fee exemptions and subsidies were almost non-existent as coping mechanisms in this study There is the need to reduce OOPS and channel and improve equity in healthcare financing by designing and implementing payment strategies that will assure financial risk protection of the poor such pre-payment mechanisms with government paying for the poor.read more
Citations
More filters
Journal ArticleDOI
Health care financing in Nigeria: Implications for achieving universal health coverage
TL;DR: To achieve universal coverage using health financing as the strategy, there is a dire need to review the system of financing health and ensure that resources are used more efficiently while at the same time removing financial barriers to access by shifting focus from OOPs to other hidden resources.
Journal ArticleDOI
Public health care financing in Nigeria: Which way forward?
TL;DR: The need for Nigeria to explore and strengthen other mechanisms of health system and shift focus from out-of-pocket payments, address the issues that have undermined public health care financing in Nigeria, improve on evidence-based planning, and prompt implementation of the National Health Bill when signed into law is recommended.
Journal ArticleDOI
Time and Money: The True Costs of Health Care Utilization for Patients Receiving "Free" HIV/Tuberculosis Care and Treatment in Rural KwaZulu-Natal
Natsayi Chimbindi,Jacob Bor,Marie-Louise Newell,Frank Tanser,Rob Baltussen,Jan A. C. Hontelez,Sake J. de Vlas,Mark N. Lurie,Deenan Pillay,Till Bärnighausen +9 more
TL;DR: Large expenditure on alternative care among pre-ART patients suggests that transitioning patients to ART earlier, as under HIV treatment-as-prevention policies, may not substantially increase patients' financial burden.
Journal ArticleDOI
The prescribing of generic medicines in Nigeria: knowledge, perceptions and attitudes of physicians
Joseph O Fadare,Adekunle Olatayo Adeoti,Olufemi Olumuyiwa Desalu,Okezie O. Enwere,AM Makusidi,Olayinka O Ogunleye,Taofiki A. Sunmonu,Ilse Truter,Onyinye O. Akunne,Brian Godman +9 more
TL;DR: Knowledge gaps were identified especially with the perception of generics, which need to be addressed, and the majority of respondents did not believe that generic medicines are of lower quality than branded medicines.
Journal ArticleDOI
Distribution of health facilities in Nigeria: Implications and options for Universal Health Coverage.
Olusesan Ayodeji Makinde,Olusesan Ayodeji Makinde,Abayomi Sule,Olayinka O. Ayankogbe,David Boone +4 more
TL;DR: The geographic and sectoral distribution of health facilities in Nigeria is nonuniform and a UHC strategy must be responsive to the variation in health facility distribution across the country.
References
More filters
Posted Content
Estimating Wealth Effects without Expenditure Data or Tears: With an Application to Educational Enrollments in States of India
TL;DR: This work estimates the relationship between household wealth and children’s school enrollment in India by constructing a linear index from asset ownership indicators, using principal-components analysis to derive weights, and shows that this index is robust to the assets included, and produces internally coherent results.
Journal ArticleDOI
Estimating Wealth Effects Without Expenditure Data—Or Tears: An Application to Educational Enrollments in States of India
Deon Filmer,Lant Pritchett +1 more
TL;DR: In this paper, a method for estimating the effect of household economic status on educational outcomes without direct survey information on income or expenditures is proposed and defended, which uses an index based on household asset ownership indicators.
World development report 1993 : investing in health
Seth Berkley,Jose Luis Bobadilla,Robert Hecht,Kenneth Hill,Dean T. Jamison,Christopher J L Murray,Philip Musgrove,Helen Saxenian,Jee-Peng Tan +8 more
TL;DR: This report examines the controversial questions surrounding health care and health policy and advocates a threefold approach to health policy for governments in developing countries and in the formerly socialist countries, based in large part on innovative research.
Journal ArticleDOI
On the measurement of inequalities in health
TL;DR: It is suggested that only two methods--the slope index of inequality and the concentration index--are likely to present an accurate picture of socioeconomic inequalities in health.
Book
Investing in development : a practical plan to achieve the Millennium Development Goals
TL;DR: Investing in Development as mentioned in this paper is the capstone volume of the Millennium Project, which brings together the core recommendations of the UN Millennium Project and provides practical investment strategies and approaches to finance them and an operational framework that will allow even the poorest countries to achieve the MDGs within ten years.
Related Papers (5)
Coping with out-of-pocket health payments: empirical evidence from 15 African countries
Adam Leive,Ke Xu +1 more