Author:
- Introduction
- Materials and Methods
- Results
- Demographic characteristics of respondents.
- Types of illness that people had and where they sought treatment.
- Average monthly treatment and transportation costs for the respondents.
- Average treatment and transportation costs for the respondents by socio-economic status.
- Payment and payment coping mechanisms.
- Discussion
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Leive A, Xu K, 2008. Coping with out-of-pocket health payments: empirical evidence from 15 African countries. Bull World Health Organ 86: 817–908.
-
2.
Asenso-Okyere W, Anum A, Osei-Akoto I, Adukonu A, 1998. Cost recovery in Ghana: are there any changes in health care seeking behaviour? Health Policy Plan 13: 181–188.
-
3.
Chuma J, Gilson L, Molyneux K, 2007. Treatment seeking behavior, cost burdens and coping strategies among rural and urban households in coastal Kenya: an equity analysis. Trop Med Int Health 12: 673–686.
-
4.
Whitehead M, Dahlgren G, Evans T, 2001. Equity and health sector reforms: can low-income countries escape the medical poverty trap? Lancet 358: 833–836.
-
5.
World Health Organization, 2000. The World Health Report—Health Systems: Improving Performance. Geneva, Switzerland: World Health Organization.
-
6.
Leighton C, Foster R, 1993. Economic Impact of Malaria in Kenya and Nigeria. ABT Associates. Health Financing and Sustainability Project. Available at: www.phrplus.org. Accessed November 12, 2010.
-
7.
McIntyre D, Thiede M, Dahlgren G, Whitehead M, 2006. What are the economic consequences for households of illness and of paying for healthcare in low and middle income country contexts? Soc Sci Med 62: 858–865.
-
8.
Ranson M, 2002. Reduction of catastrophic health care expenditures by a community based health insurance scheme in Gujarat, India: current experiences and challenges. Bull World Health Organ 80: 613–621.
-
9.
Van Damme W, Van Leemput L, Por I, Hardeman W, Meesen B, 2004. Out of pocket health expenditure and debt in poor households: evidence from Cambodia. Trop Med Int Health 9: 273–280.
-
10.
Boutayeb A, 2006. The double burden of communicable and non-communicable diseases in developing countries. Trans R Soc Trop Med Hyg 100: 191–199.
-
11.
Onwujekwe O, 2005. Inequities in healthcare seeking in the treatment of communicable endemic diseases in southeast Nigeria. Soc Sci Med 61: 455–463.
-
12.
Federal Ministry of Health (FMOH), 2005. National Antimalarial Treatment Guidelines, National Malaria and Vector Control Division Abuja, Nigeria. Abuja, Nigeria: Federal Ministry of Health.
-
13.
Federal Ministry of Health (FMoH), Nigeria, and National Malaria Control Programme (NMCP), 2009. Strategic Plan 2009–2013. A Road Map for Malaria Control in Nigeria. Abuja, Nigeria: Yaliam Press Ltd.
-
14.
National Population Commission, 2008. Nigeria Demographic and Health Survey. Abuja, Nigeria: National Population Commission.
-
15.
Onwujekwe O, Hanson K, Uzochukwu B, Ichoku H, Ike E, Onwughalu B, 2010. Are malaria treatment expenditures catastrophic to different socio-economic and geographic groups and how do they cope with payment? A study in southeast Nigeria. Trop Med Int Health 15: 18–25.
-
16.
Ayé R, Wyss K, Abdualimova H, Saidaliev S, 2010. Household costs of illness during different phases of tuberculosis treatment in central Asia: a patient survey in Tajikistan. BMC Public Health 10: 18.
-
17.
Thuan N, Lofgren C, Chuc N, Janlert U, Lindholm L, 2006. Households out of pocket payments for illness: evidence from Vietnam. BMC Public Health 6: 283.
-
18.
Soyibo A, 2009. National Health Accounts (NHA) of Nigeria. Abuja, Nigeria: Federal Ministry of Health.
-
19.
McIntyre D, 2007. Learning from Experience: Health Care Financing in Low and Middle Income Countries. Geneva, Switzerland: Global Forum for Health Research.
-
20.
Russell S, 2004. The economic burden of illness for households in developing countries: a review of studies focusing on malaria, tuberculosis, and human acquired immunodeficiency syndrome. Am J Trop Med Hyg 71 (Suppl 2): 147–155.
-
21.
Kruk M, Goldmann E, Galea S, 2009. Borrowing and paying to pay for care in low and middle income countries. Health Aff 28: 1056–1066.
-
22.
Mock C, Gloyd S, Adjei S, Acheampong F, Gish O, 2001. Economic costs of injury and resulting family coping strategies in Ghana. Accid Anal Prev 819: 1–10.
-
23.
Bennet S, Gilson L, 2001. Health Financing: Designing and Implementing Pro Poor Policies. Available at: www.healthsystemsrc.org. Accessed August 6, 2010.
-
24.
Nigeria Population Commission (NPC), 2006. National Census Figures. Abuja, Nigeria: Population Commission.
-
25.
Background Information and Historical Development of Anambra State. Available at: http://www.onlinenigeria.com/links/anambraadv.asp?blurb=193. Accessed August 15, 2010.
-
26.
Federal Government of Nigeria, 2007. The 2005 National Census Report. Abuja, Nigeria: Federal Republic of Nigeria Official Gazette.
-
27.
Background Information and Historical Development of Enugu State. Available at: http://www.onlinenigeria.com/links/enuguadv.asp?blurb=254. Accessed August 15, 2010.
-
28.
Uzochukwu B, Onwujekwe O, Eriksson BO, 2004. Inequity in the Bamako initiative programme—implications for the treatment of malaria in south-east Nigeria. Int J Health Plann Manage 19: S107–S116.
-
29.
Filmer D, Pritchett LH, 2001. Estimating wealth effects without expenditure data-or tears: an application to educational enrolments in states of India. Demography 38: 115–132.
-
30.
Onwujekwe O, Uzochukwu B, 2005. Socio-economic and geographic differentials in costs and payment strategies for primary health care services in Southeast Nigeria. Health Policy 71: 383–397.
-
31.
Uzochukwu BS, Onwujekwe OE, 2004. Socio-economic differences and health seeking behaviour for the diagnosis and treatment of malaria: a case study of four local government areas operating the Bamako initiative programme in south-east Nigeria. Int J Equity Health 17: 6.
-
32.
Okeke T, Okafor H, 2008. Perception and treatment seeking behavior for malaria in rural Nigeria: implications for control. J Hum Ecol 24: 215–222.
-
33.
O'Donnell O, van Doorslaer E, Rannan-Eliya R, 2005. EQUITAP Project: Working Paper #5. Thessaloniki, Macedonia: University of Macedonia.
-
34.
Goudge J, Russel S, Gilson L, 2009. Illness-related impoverishment in rural South Africa: why does social protection work for some households but not for others? J Int Dev 21: 231–251.
-
35.
Sauerborne Nougtara A, Hien M, Diesfield J, 1996. Seasonal variations of household costs of illness in Burkina Faso. Soc Sci Med 43: 281–290.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 71 | 71 | 11 |
| Full Text Views | 629 | 291 | 0 |
| PDF Downloads | 166 | 42 | 0 |
Towards Universal Coverage: Examining Costs of Illness, Payment, and Coping Strategies to Different Population Groups in Southeast Nigeria
Ogochukwu P. Ezeoke
Ogochukwu P. Ezeoke
Health Policy Research Group, College of Medicine, University of Nigeria, Enugu Campus, Nigeria; Department of Health Administration and Management, College of Medicine, University of Nigeria, Enugu Campus, Nigeria; Department of Community Medicine, College of Medicine, University of Nigeria, Enugu Campus, Nigeria
Search for other papers by Ogochukwu P. Ezeoke in
Current site
Google Scholar
PubMed
Search for other papers by Ogochukwu P. Ezeoke in
Current site
Google Scholar
PubMed
Obinna E. Onwujekwe
Obinna E. Onwujekwe
Health Policy Research Group, College of Medicine, University of Nigeria, Enugu Campus, Nigeria; Department of Health Administration and Management, College of Medicine, University of Nigeria, Enugu Campus, Nigeria; Department of Community Medicine, College of Medicine, University of Nigeria, Enugu Campus, Nigeria
Search for other papers by Obinna E. Onwujekwe in
Current site
Google Scholar
PubMed
Search for other papers by Obinna E. Onwujekwe in
Current site
Google Scholar
PubMed
Benjamin S. Uzochukwu
Benjamin S. Uzochukwu
Health Policy Research Group, College of Medicine, University of Nigeria, Enugu Campus, Nigeria; Department of Health Administration and Management, College of Medicine, University of Nigeria, Enugu Campus, Nigeria; Department of Community Medicine, College of Medicine, University of Nigeria, Enugu Campus, Nigeria
Search for other papers by Benjamin S. Uzochukwu in
Current site
Google Scholar
PubMed
Search for other papers by Benjamin S. Uzochukwu in
Current site
Google Scholar
PubMed
This study investigated the costs of illness to households in different socio-economic status (SES) groups and geographic places of abode in addition to the mechanisms that the different population groups used to pay for health services and cope with payments. A cross-sectional descriptive study of 3,200 households selected from six communities in two states was conducted using interviewer-administered pre-tested questionnaires. An SES index was used to divide the households into quartiles, and χ2 analysis was used to determine the relationship of SES and geographic abode of households with cost of illness, payment mechanism, and coping strategies. The results show that malaria was the illness that most people had. The average cost of transportation for malaria was 86 Naira ($0.6 US), and the total cost of treatment was 2,819.9 Naira ($20 US); of this cost, drug costs alone contributed more than 90%. Out of pocket was the main method of payment. Treatment costs differed by geographic location and socio-economic status. Policy measures should establish targeted mechanisms to protect the general population, especially rural dwellers and poorer households, against the financial burden of direct healthcare payments.
Author Notes
Authors' addresses: Ogochukwu P. Ezeoke, Health Policy Research Group, College of Medicine, University of Nigeria, Enugu Campus, Nigeria, E-mail: ogoezeoke@yahoo.co.uk. Obinna E. Onwujekwe, Department of Health Administration and Management, College of Medicine, University of Nigeria, Enugu Campus, Nigeria, E-mail: onwujekwe@yahoo.co.uk. Benjamin S. Uzochukwu, Department of Community Medicine, College of Medicine, University of Nigeria, Enugu Campus, Nigeria, E-mail: bscuzochukwu@yahoo.com.
- Introduction
- Materials and Methods
- Results
- Demographic characteristics of respondents.
- Types of illness that people had and where they sought treatment.
- Average monthly treatment and transportation costs for the respondents.
- Average treatment and transportation costs for the respondents by socio-economic status.
- Payment and payment coping mechanisms.
- Discussion
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Leive A, Xu K, 2008. Coping with out-of-pocket health payments: empirical evidence from 15 African countries. Bull World Health Organ 86: 817–908.
-
2.
Asenso-Okyere W, Anum A, Osei-Akoto I, Adukonu A, 1998. Cost recovery in Ghana: are there any changes in health care seeking behaviour? Health Policy Plan 13: 181–188.
-
3.
Chuma J, Gilson L, Molyneux K, 2007. Treatment seeking behavior, cost burdens and coping strategies among rural and urban households in coastal Kenya: an equity analysis. Trop Med Int Health 12: 673–686.
-
4.
Whitehead M, Dahlgren G, Evans T, 2001. Equity and health sector reforms: can low-income countries escape the medical poverty trap? Lancet 358: 833–836.
-
5.
World Health Organization, 2000. The World Health Report—Health Systems: Improving Performance. Geneva, Switzerland: World Health Organization.
-
6.
Leighton C, Foster R, 1993. Economic Impact of Malaria in Kenya and Nigeria. ABT Associates. Health Financing and Sustainability Project. Available at: www.phrplus.org. Accessed November 12, 2010.
-
7.
McIntyre D, Thiede M, Dahlgren G, Whitehead M, 2006. What are the economic consequences for households of illness and of paying for healthcare in low and middle income country contexts? Soc Sci Med 62: 858–865.
-
8.
Ranson M, 2002. Reduction of catastrophic health care expenditures by a community based health insurance scheme in Gujarat, India: current experiences and challenges. Bull World Health Organ 80: 613–621.
-
9.
Van Damme W, Van Leemput L, Por I, Hardeman W, Meesen B, 2004. Out of pocket health expenditure and debt in poor households: evidence from Cambodia. Trop Med Int Health 9: 273–280.
-
10.
Boutayeb A, 2006. The double burden of communicable and non-communicable diseases in developing countries. Trans R Soc Trop Med Hyg 100: 191–199.
-
11.
Onwujekwe O, 2005. Inequities in healthcare seeking in the treatment of communicable endemic diseases in southeast Nigeria. Soc Sci Med 61: 455–463.
-
12.
Federal Ministry of Health (FMOH), 2005. National Antimalarial Treatment Guidelines, National Malaria and Vector Control Division Abuja, Nigeria. Abuja, Nigeria: Federal Ministry of Health.
-
13.
Federal Ministry of Health (FMoH), Nigeria, and National Malaria Control Programme (NMCP), 2009. Strategic Plan 2009–2013. A Road Map for Malaria Control in Nigeria. Abuja, Nigeria: Yaliam Press Ltd.
-
14.
National Population Commission, 2008. Nigeria Demographic and Health Survey. Abuja, Nigeria: National Population Commission.
-
15.
Onwujekwe O, Hanson K, Uzochukwu B, Ichoku H, Ike E, Onwughalu B, 2010. Are malaria treatment expenditures catastrophic to different socio-economic and geographic groups and how do they cope with payment? A study in southeast Nigeria. Trop Med Int Health 15: 18–25.
-
16.
Ayé R, Wyss K, Abdualimova H, Saidaliev S, 2010. Household costs of illness during different phases of tuberculosis treatment in central Asia: a patient survey in Tajikistan. BMC Public Health 10: 18.
-
17.
Thuan N, Lofgren C, Chuc N, Janlert U, Lindholm L, 2006. Households out of pocket payments for illness: evidence from Vietnam. BMC Public Health 6: 283.
-
18.
Soyibo A, 2009. National Health Accounts (NHA) of Nigeria. Abuja, Nigeria: Federal Ministry of Health.
-
19.
McIntyre D, 2007. Learning from Experience: Health Care Financing in Low and Middle Income Countries. Geneva, Switzerland: Global Forum for Health Research.
-
20.
Russell S, 2004. The economic burden of illness for households in developing countries: a review of studies focusing on malaria, tuberculosis, and human acquired immunodeficiency syndrome. Am J Trop Med Hyg 71 (Suppl 2): 147–155.
-
21.
Kruk M, Goldmann E, Galea S, 2009. Borrowing and paying to pay for care in low and middle income countries. Health Aff 28: 1056–1066.
-
22.
Mock C, Gloyd S, Adjei S, Acheampong F, Gish O, 2001. Economic costs of injury and resulting family coping strategies in Ghana. Accid Anal Prev 819: 1–10.
-
23.
Bennet S, Gilson L, 2001. Health Financing: Designing and Implementing Pro Poor Policies. Available at: www.healthsystemsrc.org. Accessed August 6, 2010.
-
24.
Nigeria Population Commission (NPC), 2006. National Census Figures. Abuja, Nigeria: Population Commission.
-
25.
Background Information and Historical Development of Anambra State. Available at: http://www.onlinenigeria.com/links/anambraadv.asp?blurb=193. Accessed August 15, 2010.
-
26.
Federal Government of Nigeria, 2007. The 2005 National Census Report. Abuja, Nigeria: Federal Republic of Nigeria Official Gazette.
-
27.
Background Information and Historical Development of Enugu State. Available at: http://www.onlinenigeria.com/links/enuguadv.asp?blurb=254. Accessed August 15, 2010.
-
28.
Uzochukwu B, Onwujekwe O, Eriksson BO, 2004. Inequity in the Bamako initiative programme—implications for the treatment of malaria in south-east Nigeria. Int J Health Plann Manage 19: S107–S116.
-
29.
Filmer D, Pritchett LH, 2001. Estimating wealth effects without expenditure data-or tears: an application to educational enrolments in states of India. Demography 38: 115–132.
-
30.
Onwujekwe O, Uzochukwu B, 2005. Socio-economic and geographic differentials in costs and payment strategies for primary health care services in Southeast Nigeria. Health Policy 71: 383–397.
-
31.
Uzochukwu BS, Onwujekwe OE, 2004. Socio-economic differences and health seeking behaviour for the diagnosis and treatment of malaria: a case study of four local government areas operating the Bamako initiative programme in south-east Nigeria. Int J Equity Health 17: 6.
-
32.
Okeke T, Okafor H, 2008. Perception and treatment seeking behavior for malaria in rural Nigeria: implications for control. J Hum Ecol 24: 215–222.
-
33.
O'Donnell O, van Doorslaer E, Rannan-Eliya R, 2005. EQUITAP Project: Working Paper #5. Thessaloniki, Macedonia: University of Macedonia.
-
34.
Goudge J, Russel S, Gilson L, 2009. Illness-related impoverishment in rural South Africa: why does social protection work for some households but not for others? J Int Dev 21: 231–251.
-
35.
Sauerborne Nougtara A, Hien M, Diesfield J, 1996. Seasonal variations of household costs of illness in Burkina Faso. Soc Sci Med 43: 281–290.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 71 | 71 | 11 |
| Full Text Views | 629 | 291 | 0 |
| PDF Downloads | 166 | 42 | 0 |