Exploring the effects catastrophic health expenditure due to non-communicable diseases and coping strategies: A case study among households in Bangladesh.

Objectives: Non-communicable diseases (NCDs), due to their chronic nature, lead to long-term and significant health burdens that result in catastrophic expenses for individuals and communities. This study explores the socioeconomic effects of catastrophic health costs on households with family members experiencing NCDs and their coping mechanisms in rural areas of Bangladesh. Study design: Qualitative study. Methods: Case studies were conducted with ten NCD patients who had experienced catastrophic events and their close contacts. Purposive sampling strategies were used to recruit participants from two sub-districts in areas with a high prevalence of NCDs. In-depth interviews and observations were conducted, and documents (e.g. hospital and diagnosis bills, medicine purchase receipts) were reviewed. Data were analysed using thematic analysis. Results: Data revealed that the treatment costs of NCDs are multifaceted and long-term. This catastrophic health expenditure has many economic effects, such as compromising food, housing, living standards and quality of life. It also has non-economic effects, including social stigmatisation, adjusting wishes and dreams, hampering children's education, disrupting family relationships and undermining social dignity. Households' adaptive strategies include loaning and borrowing, selling assets, using savings, seeking assistance from friends and relatives, reconciling living standards and even adopting alternative medicines. Conclusions: Thisstudy highlights the socioeconomic impact of catastrophic health costs associated with NCDs and how households adapt and cope with these expenses. The results increase understanding of the impact of NCDs and the importance of managing the economic burden. Results highlight the necessity for a strategic plan to aid families affected by chronic NCDs.