ArticleBMC health services research2025
Out of pocket and catastrophic health expenditure in Tanzania: recent evidence on the incidence, intensity and distribution.
Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Out-of-pocket health expenditures and financial protection in Türkiye: pre-pandemic (2019) and COVID-19 era (2022) microdata.BMC health services research · 2026Article
- The effect of community-based health insurance on out-of-pocket expenditure among diabetic patients at hawassa university comprehensive specialized hospital: facility-based comparative cross-sectional study.BMC health services research · 2026Article
- Patterns and determinants of formal healthcare utilisation among individuals with and without proxy-identified mental health need in Tanzania: A cross-sectional analysis of the National Panel Survey.PLOS mental health · 2026Article
- Institutional design features of health insurance subsidy programmes in Africa: a narrative review.International journal for equity in health · 2025Review
- Access to emergency care in primary healthcare system in Tanzania: a mixed-method community-based study in a resource-limited setting.BMJ public health · 2025Article
- Comparative study: mapping treatment costs, best practices, and challenges across Africa.Frontiers in public health · 2025Article
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2 authors.
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Abstract
backgroundIn most low-income countries (LICs), health is mainly financed by out-of-pocket (OOP) expenditures. However, it is claimed that this form of payment causes a massive burden on poor households. This study investigates the catastrophic impact of out-of-pocket health expenditure by estimating the levels, intensities and distribution of catastrophic health expenditure among households in Tanzania.
methodsThe study applied the Wagstaff & va-Doorslaer methodology to measure the incidence and intensity of catastrophic expenditure and the concentration index to measure the distribution of catastrophic expenditure using panel data 2020/2021. Then descriptive-analytical methods such as frequencies, means, and proportions were used to report the results.
resultsThe study found that 21.9% (19.1% from rural and 24.6% from urban) of the respondents reported visiting a healthcare facility within four weeks before the survey. Over 50% (53.5% from rural and 57.4% from urban) reported an incidence of illness or injury within the same period. The study also found that among those who utilised health care, about 7.1% (8.4% from rural and 5.7% from urban areas) experienced catastrophic health expenditures. The concentration index (-0.0175 and -0.0638) show that poor households are more likely to experience catastrophic health costs than rich households given the negative values of the indices. This phenomenon is particularly visible in Tanzania, where health insurance is still in its early stages of development.
conclusionWe conclude that out-of-pocket health expenditures tend to lead to financial catastrophe for poor households, thereby exposing them to more poverty and forcing them to resort to coping mechanisms that compromise their welfare. This necessitates the development of new and reinforced existing systems to protect impoverished households against out-of-pocket and catastrophic healthcare costs.
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