ArticleBMJ global health2019
The catastrophic and impoverishing effects of out-of-pocket healthcare payments in Kenya, 2018.
Article in BMJ global health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
52 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Prevalence of genital and anorectal chlamydia trachomatis in Kenya by risk groups: a systematic review and meta-analysis.BMC infectious diseases · 2025Pooled it
- Catastrophic health expenditure in sub-Saharan Africa: systematic review and meta-analysis.Bulletin of the World Health Organization · 2022Pooled it
- Factors associated with catastrophic health expenditure in sub-Saharan Africa: A systematic review.PloS one · 2022Pooled it
- Cost of Home-Based Couples Human Immunodeficiency Virus Counseling and Testing and Human Immunodeficiency Virus Self-Testing During Pregnancy and Postpartum in Southwestern Kenya.Value in health regional issues · 2023Trial
- Article
- Levels and Determinants of Health Insurance Coverage in Kenya: Cross-Sectional Evidence from KDHS 2022.Healthcare (Basel, Switzerland) · 2026Article
- Preferences and Trade-offs for Attributes of Long-Acting HIV Prevention Products Among Pregnant and Breastfeeding Women in Kenya: A Discrete Choice Experiment.AIDS and behavior · 2026Article
- Sustainability starts with spending: public financial management lessons from Kenya's universal health care pilot.BMC health services research · 2025Article
- Catastrophic health expenditure, social protection coverage, and financial coping strategies in adults with symptoms of chronic respiratory diseases in Kenya: a cross-sectional study.The Lancet. Global health · 2025Article
- What influences the impact of health financing reforms? Using qualitative comparative analysis to identify patterns in health financing systems and their effects on financial protection.SSM - health systems · 2025Review
- Socioeconomic inequality in financial hardship in accessing quality healthcare services in Ethiopia: a community-based cross-sectional study.Frontiers in public health · 2025Article
- Article
- Observational
- Access to Medicines for Parkinson's Disease in Kenya: A Qualitative Exploration.Movement disorders clinical practice · 2024Article
- Barriers of access to primary healthcare services by National Health Insurance Fund capitated members in Uasin Gishu county, Kenya.BMC health services research · 2024Article
- Assessing the relationship between coverage of essential health services and poverty levels in low- and middle-income countries.Health policy and planning · 2024Article
- Long-term care needs and the risk of household poverty across Europe: a comparative secondary data study.BMC geriatrics · 2024Article
- Socioeconomic Inequalities in Out-of-Pocket and Catastrophic Health Expenditures in Pakistan.International journal of public health · 2024Article
- Can "the expanded free maternity services" enable Kenya to achieve universal health coverage by 2030: qualitative study on experiences of mothers and healthcare providers.Frontiers in health services · 2024Article
- Voting with their feet: Primary care provider choice and its implications for public sector primary care services in India.Social science & medicine (1982) · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionProgress towards effective service coverage and financial protection-the two dimensions of Universal Health Coverage (UHC)-has been limited in Kenya in the last decade. The government of Kenya has embarked on a highly ambitious reform programme currently being piloted in four Kenyan counties and aiming at national rollout by 2022. This study provides an updated assessment of the performance of the Kenyan health system in terms of financial protection allowing to monitor trends over time. In light of the UHC initiative, the study provides a baseline to assess the impact of the UHC pilot programme and inform scale-up plans. It also investigates household characteristics associated with catastrophic payments.
methodsUsing data from the Kenya Household Health Expenditure and Utilization Survey (KHHEUS) 2018, we investigated the incidence and intensity of catastrophic and impoverishing health expenditure. We used a logistic regression analysis to assess households' characteristics associated with the probability of incurring catastrophic health expenditures.
resultsThe results show that the incidence of catastrophic payments is more severe for the poorest households and in the rural areas and mainly due to outpatient services. Results for the impoverishing effect suggest that after accounting for out-of-pocket(OOP) payments, the proportion of poor people increases by 2.2 percentage points in both rural and urban areas. Thus, between 1 and 1.1 million individuals are pushed into poverty due to OOP payments. Among the characteristics associated with the probability of incurring OOP expenditures, socioeconomic conditions, the presence of elderly and of people affected by chronic conditions showed significant results.
conclusionKenya is still lagging behind in terms of protecting its citizens against financial risks associated with ill health and healthcare seeking behaviour. More effort is needed to protect the most vulnerable population groups from the high costs of illness.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.