ArticleInternational journal for equity in health2017
Impoverishing effects of catastrophic health expenditures in Malawi.
Article in International journal for equity in health, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 2 of them syntheses that pooled it.
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Who cites it
46 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Catastrophic health expenditure and associated factors in low-, lower-middle and upper-middle-income countries: systematic review and meta-analysis.Global health action · 2026Pooled it
- Understanding variation in catastrophic health expenditure from socio-ecological aspect: a systematic review.BMC public health · 2024Pooled it
- Economic burden of COVID-19 on hospitalized patients: a cross-sectional study from Semnan, Iran.BMC health services research · 2026Article
- Catastrophic health expenditure and commercial health insurance purchase: evidence from China.BMC health services research · 2026Article
- A study on the impact of catastrophic health expenditure on social stability.Frontiers in public health · 2026Article
- Analysing the determinants of healthcare insurance uptake in Nigeria.BMC health services research · 2025Article
- Out of pocket and catastrophic health expenditure in Tanzania: recent evidence on the incidence, intensity and distribution.BMC health services research · 2025Article
- Developing comprehensive woman hand-held case notes to improve quality of antenatal care in low-income settings: participatory approach with maternal health stakeholders in Malawi.BMC health services research · 2024Article
- Do hospitalizations push households into poverty in India: evidence from national data.F1000Research · 2024Article
- Health, wealth, and medical expenditures among the elderly in rural Tanzania: experiences from Nzega and Igunga districts.BMC health services research · 2023Article
- Incidence of catastrophic health spending in Indonesia: insights from a Household Panel Study 2018-2019.International journal for equity in health · 2023Article
- Article
- The financial burden of out of pocket payments on medicines among households in Ethiopia: analysis of trends and contributing factors.BMC public health · 2023Article
- Assessing the efficiency of health systems in achieving the universal health coverage goal: evidence from Sub-Saharan Africa.Health economics review · 2023Article
- Do national health insurance schemes guarantee financial risk protection in the drive towards Universal Health Coverage in West Africa? A systematic review of observational studies.PLOS global public health · 2023Article
- What are the factors associated with catastrophic health expenditure in Colombia? A multi-level analysis.PloS one · 2023Article
- Effects of multimorbidity patterns and socioeconomic status on catastrophic health expenditure of widowed older adults in China.Frontiers in public health · 2023Article
- Catastrophic health expenditures in hospitalized patients with delta variant of COVID-19: A cross-sectional study.Health promotion perspectives · 2023Article
- Spatial disparities in impoverishing effects of out-of-pocket health payments in Malawi.Global health action · 2022Article
- Impoverishing effects of out-of-pocket healthcare expenditures in India.Journal of family medicine and primary care · 2022Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOut of pocket (OOP) health spending can potentially expose households to risk of incurring large medical bills, and this may impact on their welfare. This work investigates the effect of catastrophic OOP on the incidence and depth of poverty in Malawi.
methodsThe paper is based on data that was collected from 12,271 households that were interviewed during the third Malawi integrated household survey (IHS-3). The paper considered a household to have incurred a catastrophic health expenditure if the share of health expenditure in the household's non-food expenditure was greater than a given threshold ranging between 10 and 40%.
resultsAs we increase the threshold from 10 to 40%, we found that OOP drives between 9.37 and 0.73% of households into catastrophic health expenditure. The extent by which households exceed a given threshold (mean overshoot) drops from 1.01% of expenditure to 0.08%, as the threshold increased. When OOP is accounted for in poverty estimation, additional 0.93% of the population is considered poor and the poverty gap rises by almost 2.54%. Our analysis suggests that people in rural areas and middle income households are at higher risk of facing catastrophic health expenditure.
conclusionWe conclude that catastrophic health expenditure increases the incidence and depth of poverty in Malawi. This calls for the introduction of social insurance system to minimize the incidence of catastrophic health expenditure especially to the rural and middle income population.
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