ArticlePloS one2015
Out-of-pocket expenditure on chronic non-communicable diseases in sub-Saharan Africa: the case of rural Malawi.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 2 of them syntheses that pooled it.
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Who cites it
37 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Financial Protection Indexes and the Iranian Health Transformation Plan: A Systematic Review.The Yale journal of biology and medicine · 2021Pooled it
- Pharmacotherapy for hypertension in Sub-Saharan Africa: a systematic review and network meta-analysis.BMC medicine · 2020Pooled it
- Health-seeking behavior and the related out-of-pocket expenditure for noncommunicable diseases in Erbil, Iraq: a quantile regression analysis.Journal of health, population, and nutrition · 2026Article
- Examining the potential of mobile money-based health insurance for people living with HIV and hypertension or diabetes in Uganda.Frontiers in health services · 2026Article
- Unveiling the global impact of hypertensive heart disease among individuals aged ≥ 65 years: metabolic risk factors and future projections for 2050.Frontiers in nutrition · 2025Article
- Challenges in implementing Indonesia's community-based chronic disease management program (Prolanis): A scoping review.AIMS public health · 2025Review
- Ten years of ear, nose and throat (ENT) services in Southern Africa: a scoping review.Global health action · 2024Article
- Provider and female client economic costs of integrated sexual and reproductive health and HIV services in Zimbabwe.PloS one · 2024Article
- Experiences and practices of traditional healers on snakebite treatment and prevention in rural Malawi.PLoS neglected tropical diseases · 2023Article
- War and Health Care Services Utilization for Chronic Diseases in Rural and Semiurban Areas of Tigray, Ethiopia.JAMA network open · 2023Article
- Non-communicable disease burden among inpatients at a rural district hospital in Malawi.Global health research and policy · 2023Article
- Out-of-pocket spending on hypertension and diabetes among patients reporting in a health -care teaching institute of the Western Rajasthan.Journal of family medicine and primary care · 2022Article
- Article
- Disparities in Physical Accessibility among Rural Thais Under Universal Health Coverage.The American journal of tropical medicine and hygiene · 2021Article
- Household Economic Consequences of Rheumatic Heart Disease in Uganda.Frontiers in cardiovascular medicine · 2021Article
- The Nexus Between Adherence to Recommended Lifestyle Behaviors and Blood Pressure Control in Hypertensive Patients at Mutare Provincial Hospital, Zimbabwe: A Cross-Sectional Study.Patient preference and adherence · 2021Article
- Financial and food security challenges of Egyptian women undergoing breast cancer treatment.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2020Article
- Out of pocket expenditures of patients with a chronic condition consulting a primary care provider in Tajikistan: a cross-sectional household survey.BMC health services research · 2020Article
- Determinants of healthcare seeking and out-of-pocket expenditures in a "free" healthcare system: evidence from rural Malawi.Health economics review · 2020Article
- Cost of Hypertension Illness and Associated Factors Among Patients Attending Hospitals in Southwest Shewa Zone, Oromia Regional State, Ethiopia.ClinicoEconomics and outcomes research : CEOR · 2020Article
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6 authors.
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Abstract
In Sub-Saharan Africa (SSA) the disease burden of chronic non-communicable diseases (CNCDs) is rising considerably. Given weaknesses in existing financial arrangements across SSA, expenditure on CNCDs is often borne directly by patients through out-of-pocket (OOP) payments. This study explored patterns and determinants of OOP expenditure on CNCDs in Malawi. We used data from the first round of a longitudinal household health survey conducted in 2012 on a sample of 1199 households in three rural districts in Malawi. We used a two-part model to analyze determinants of OOP expenditure on CNCDs. 475 respondents reported at least one CNCD. More than 60% of the 298 individuals who reported seeking care incurred OOP expenditure. The amount of OOP expenditure on CNCDs comprised 22% of their monthly per capita household expenditure. The poorer the household, the higher proportion of their monthly per capita household expenditure was spent on CNCDs. Higher severity of disease was significantly associated with an increased likelihood of incurring OOP expenditure. Use of formal care was negatively associated with the possibility of incurring OOP expenditure. The following factors were positively associated with the amount of OOP expenditure: being female, Alomwe and household head, longer duration of disease, CNCDs targeted through active screening programs, higher socio-economic status, household head being literate, using formal care, and fewer household members living with a CNCD within a household. Our study showed that, in spite of a context where care for CNCDs should in principle be available free of charge at point of use, OOP payments impose a considerable financial burden on rural households, especially among the poorest. This suggests the existence of important gaps in financial protection in the current coverage policy.
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