ArticleApplied health economics and health policy2020
Estimating Catastrophic Health Expenditures from Household Surveys: Evidence from Living Standard Measurement Surveys (LSMS)-Integrated Surveys on Agriculture (ISA) from Sub-Saharan Africa.
Article in Applied health economics and health policy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- State capacity and health system financing: a cross-country analysis.BMJ global health · 2026Article
- Assessing the costs of antenatal care in Eastern Ethiopia: implications for improving the free maternity services policy.Health policy and planning · 2026Article
- A study on the impact of catastrophic health expenditure on social stability.Frontiers in public health · 2026Article
- Article
- Association between out-of-pocket health expenditures and low birth weight in Eastern Ethiopia: a generalized structural equation modeling (GSEM).BMC public health · 2025Article
- A Simple Measure of Catastrophic Health Expenditures.Health economics · 2025Article
- Catastrophic and impoverishing out-of-pocket health expenditure in Ethiopia: evidence from the Ethiopia socioeconomic survey.Health economics review · 2025Article
- Controversies in implementing the exemption policy for the elderly healthcare services in Tanzania: experiences from the priority setting process in two selected districts.Cost effectiveness and resource allocation : C/E · 2024Article
- Whether or not to enroll, and stay enrolled? A Tanzanian cross-sectional study on voluntary health insurance.Health policy OPEN · 2023Article
- Impacts of the COVID-19 Lockdown on Healthcare Inaccessibility and Unaffordability in Uganda.The American journal of tropical medicine and hygiene · 2023Article
- Association between women's household decision-making autonomy and health insurance enrollment in sub-saharan Africa.BMC public health · 2023Article
- A critical review of literature on health financing reforms in Uganda - progress, challenges and opportunities for achieving UHC.African health sciences · 2023Review
- A Comparative Cross-Sectional Study of the Prevalence and Determinants of Health Insurance Coverage in Nigeria and South Africa: A Multi-Country Analysis of Demographic Health Surveys.International journal of environmental research and public health · 2022Article
- The cost of illness for childhood clinical pneumonia and invasive pneumococcal disease in Nigeria.BMJ global health · 2022Article
- Health Financing in Sub-Saharan Africa: From Analytical Frameworks to Empirical Evaluation.Applied health economics and health policy · 2020Article
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2 authors.
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Abstract
backgroundOut of pocket (OOP) payments for healthcare remain a significant health financing challenge in sub-Saharan Africa (SSA). Understanding the drivers and impacts of this financial health burden is both an economic and a public health priority.
objectiveThis study examines how the burden of OOP health expenditures varies with different thresholds for financial catastrophe.
methodsThe analysis is based on Livings Standards Measurement Surveys (LSMS)-Integrated Surveys on Agriculture (ISA) for five SSA countries-Ethiopia, Malawi, Nigeria, Tanzania, and Uganda. We estimate the degree by which OOP payments as share of total household non-food expenditures exceed either the 15 or 25% threshold.
resultsFor the countries considered, the severity of OOP payments is substantial-the average positive overshoot (beyond the 25% threshold) is above 10%, except for Nigeria. This reflects a higher percentage of OOP in total household health expenditures-compared to taxes and contributions-especially among the poor in these specific countries. Regarding sensitivity of distribution of catastrophic health expenditures, we find that households with low non-food expenditures are more likely to incur catastrophic payments with the exception for Uganda where catastrophic payments increase with the increase of non-food household expenditures.
conclusionThe burden of catastrophic health expenditures remains large. In order to reduce this burden, public health expenditures need to be expanded as an alternative. This calls for renewed attention to expand public revenues as the most sustainable methods of financing health expenditures in Africa.
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