Of the five countries analyzed in the study whose results were released on Tuesday, only Nigeria has out of pocket hospital payments below 25 per cent of the total household non-food expenditure. Other countries including Uganda, Malawi, Ethiopia and Tanzania had expenditure on health above the 25 per cent threshold.
The burden of catastrophic health expenditures remains large
in many countries in Africa. A new paper by the Makerere University-based
Economic Policy Research Centre (EPRC) shows that most of the health
expenditure in Uganda is met privately and by the rich.
Due to this, a substantial proportion of
individuals who fall sick may fail to access health services even as countries
like Uganda have abolished user fees.
Of the five countries analyzed in the study whose results
were released on Tuesday, only Nigeria has out of pocket hospital
payments below 25 per cent of the total household non-food expenditure. Other
countries including Uganda, Malawi, Ethiopia and Tanzania had expenditure on health
above the 25 per cent threshold.
“For Nigeria, regardless of the threshold, it is the poor that
make catastrophic expenditures. For Ethiopia, at both the 15 per cent and 25 per cent
thresholds, it is the poor making the expenditures. Similarly, in Tanzania, the
poor make most payments. On the other hand, Uganda’s measures showed the burden
of catastrophic expenditures is borne by the rich,” he reports reads in part.
The researchers Dr Sarah Sewanyana and Dr Ibrahim Kasirye
examined how the burden of Out of Pocket health expenditures varies with
different thresholds for financial catastrophe through analyzing surveys done
in the five countries and found that households with low non-food expenditures
are more likely to incur catastrophic payments with the exception of Uganda
where catastrophic payments increase with the increase of non-food household expenditures.
When they looked at consulting a health practitioner, the
researchers found Ethiopia and Nigeria had the largest proportion of
individuals who had not consulted a provider for an illness in the past month
at 22 per cent and 21 per cent respectively. In order to reduce this burden, Dr Sewanyana says public
health expenditures need to be expanded as an alternative since poorer people cannot
afford healthcare at all.
However, this research comes out at the time when Uganda is
planning an introduction of the national health insurance which is being mooted
as the magic that will make the country attain its healthcare gains and solve
the immense out of pocket expenditure on health that has thrown many families
into poverty.
But, this research suggests that even with relatively high health insurance coverage in countries
like Tanzania, there’s still a high share of out of pocket payments meaning
that some people in those countries remain unprotected from catastrophic expenses.
To the policymakers, the researcher say their findings call
for renewed attention to expanding public revenues as the most sustainable methods
of financing health expenditure considering the high level of deprivation.
