scholarly journals Equity in Health Care Expenditure in Nigeria

2013 ◽  
Vol 2 (3) ◽  
pp. 76-88
Author(s):  
Frances Susan Obafemi ◽  
Olanrewaju Olaniyan ◽  
Frances Ngozi Obafemi
Keyword(s):  
Health Care ◽  
Health Care Expenditure ◽  
Health Financing ◽  
Living Standard ◽  
National Bureau ◽  
Financing Policy ◽  
Risk Pooling ◽  
Poor Households ◽  
Out Of Pocket Payments ◽  
Using Data

Equity is one of the basic principles of health systems and features explicitly in the Nigerian health financing policy. Despiteacclaimed commitment to the implementation of this policy through various pro-poor health programmes and interventions,the level of inequity in health status and access to basic health care interventions remain high. This paper examines theequity of health care expenditure by individuals in Nigeria. The paper evaluated equity in out-of-pocket spending (OOP) forthe country and separately for the six geopolitical zones of the country. The methodological framework rests on KakwaniProgressivity Indices (KPIs), Reynold-Smolensky indices and concentration indices (CIs) using data from the 2004 Nigerian National Living Standard Survey (NLSS) collected by the National Bureau of Statistic. The results reveal that health financing is regressive with the incidence disproportionately resting on poor households with about 70% of the total expenditure on health being financed through out-of-pocket payments by households. Poor households are prone to bear most of the expenses in the event of any health shock. The catastrophic consequences thus push some into poverty, and aggravate the poverty of others. The paper therefore suggests that the country’s health financing systems must be such that allows people to access services when they are needed, but must also protect household, from financial catastrophe, by reducing OOP spending through risk pooling and prepayment schemes within the health system.

scholarly journals The Impact of Education on Household Income in Rural Vietnam

2020 ◽  
Vol 8 (1) ◽  
pp. 11 ◽  
Author(s):  
Hung Van Vu
Keyword(s):  
Quantile Regression ◽  
Household Income ◽  
Living Standard ◽  
Regression Analyses ◽  
Poor Households ◽  
Quantile Regression Analysis ◽  
Research Findings ◽  
Using Data ◽  
The Impact ◽  
Positive Effect

Using data from the 2018 Vietnam Household Living Standard Survey, our study investigates the impact of education on household income in rural Vietnam. Both mean and quantile regression analyses were employed to analyze the impact of education. We found that education has a positive effect on the household income after controlling for various factors in the models. However, quantile regression analysis reveals that the effect of schooling years increases with quantiles, suggesting that education bring higher returns for richer households. We also found that households with the heads having higher qualifications or vocational education tend to earn higher income levels. Combined together, these findings imply that while education was found to increase household income, it increases income inequality in rural Vietnam. Our research findings suggest that improving the access of poor households to better education is expected to increase their income and reduce inequality in rural Vietnam.

scholarly journals Catastrophic Health Expenditures And Impoverishment In Kenya

2016 ◽  
Vol 12 (15) ◽  
pp. 434 ◽  
Author(s):  
Diana N. Kimani ◽  
Mercy G. Mugo ◽  
Urbanus M. Kioko
Keyword(s):  
Health Care ◽  
Health Care Expenditure ◽  
Health Expenditures ◽  
Chronically Ill ◽  
Health Care Expenditures ◽  
The Poor ◽  
Out Of Pocket Payments ◽  
Catastrophic Health Expenditures ◽  
The Government ◽  
Catastrophic Expenditures

Background: Out-of-pocket health expenditures leave households exposed to the risk of financial catastrophe and poverty whenever they entail significant dissaving or the sale of key household assets. Even relatively small expenditures on health can be financially disastrous for poor households and similarly, large health care expenditures can lead to financial catastrophe and bankruptcy for rich households. Objective: There is increasing evidence that out-of-pocket expenditures act as a financial barrier to accessing health care, and are a source of catastrophic expenditures and impoverishment. This paper estimates the burden of out-of-pocket payments in Kenya; the incidence and intensity of catastrophic health care expenditure and impoverishment in Kenya. Methods: Using Kenya Household Health Expenditures and Utilization Survey data of 2007, the study uses both descriptive and econometric analysis to investigate the incidence and intensity of catastrophic health expenditures and impoverishment as well as the determinants of catastrophic health expenditures. To estimate the incidence and intensity of catastrophic expenditures and impoverishment, the study used both Wagstaff and van Doorslaer, (2002) and Xu et al. (2005) and applied various thresholds to demonstrate the sensitivity of catastrophic measures. For determinants of catastrophic health expenditures, a logit model was employed. Findings: Among those who utilized health care, 11.7 percent experienced catastrophic expenditures and 4 percent were impoverished by health care payments. In addition, approximately 2.5 million individuals were pushed into poverty as a result of paying for health care. The poor experienced the highest incidence of catastrophic expenditures. Conclusion: The paper recommends that the government should establish avenues for reducing the burden of out-of-pocket expenditures borne by households. This could be through a legal requirement for everyone to belong to a health insurance and targeting the poor, the elderly and chronically ill through the devolved system of the government and devolved funds.

Extent of Household Catastrophic Health Expenditure among Urban Dwellers in Mandalay City

2019 ◽  
Vol 31 (3) ◽  
pp. 191-197
Keyword(s):  
Health Care ◽  
Social Protection ◽  
Large Fraction ◽  
Group Discussion ◽  
Health Care Expenditure ◽  
Catastrophic Health Expenditure ◽  
Household Resources ◽  
Out Of Pocket Payments ◽  
Protection Mechanisms ◽  
Care Costs

Self-payments (out-of-pocket payments OOP) are the principal means of financing health care throughout Myanmar. It leaves households exposed to the risk of unforeseen expenditures that absorb a large share of the household budget. The OOP expenditures may be considered as catastrophic in the sense that they absorb a large fraction of household resources. Catastrophic impact of health care costs among households in selected area of Mandalay City is measured by indices such as incidence, intensity and mean positive gap and explored the opinions of people paying for health care by conducting focus group discussion. As expected, households’ catastrophic impacts are considerably high in Mandalay. The incidence of catastrophic health care payment is 8%, 4% and 1.3% for the defined catastrophic thresholds of 10, 20 and 30 percent, respectively. The intensities are 1.62, 1.09 and 0.8 percents for the same thresholds. Mean Positive Gaps are 20.2, 27.3 and 61.5 percents for the three defined threshold levels. Because of heavy out-of-pocket health care expenditure, most of the households’ income absorbed with repeated borrowing and lending mechanisms can push these households into impoverishment. Although they pay heavily, Myanmar people do not blame anyone but their destiny because they know nothing about social protection mechanisms.

On Health Expenditure and Income Inequality

2020 ◽  
pp. 117-151
Author(s):  
Orhan Torul
Keyword(s):  
Health Care ◽  
Income Inequality ◽  
Negative Correlation ◽  
Health Expenditure ◽  
Fixed Effects ◽  
Health Care Expenditure ◽  
Health Care Expenditures ◽  
Significant Negative Correlation ◽  
Developed Economies ◽  
Using Data

This study investigates the relationship between health care expenditure and income inequality empirically. Using data from a large panel of countries covering a sizeable period of time, how level and composition of health care expenditures correlate with income inequality is studied via the panel data fixed effects estimation methodology. These estimations yield several robust findings. First, there is a significant positive correlation between income inequality and reliance on private resources for health care financing. Second, there exists a significant negative correlation between health care expenditure per capita and income inequality. Third, there is a significant negative correlation between income inequality and health care expenditure as a share of GDP. Next, this study analyzes a select group of well-established democracies with developed economies to detect if health expenditure and income inequality variables correlate with public beliefs and preferences. Empirical analyses reveal that indeed belief and preferences accord well with policy choices.

scholarly journals COMPOSITION AND DETERMINANTS OF RURAL NON-FARM INCOME DIVERSIFICATION IN NIGERIA

2020 ◽  
Vol 57 (3) ◽  
Author(s):  
Oluseyi Olutoyin Olugbire ◽  
Oluwatosin Esther Obafunsho ◽  
Titilope Omolara Olarewaju ◽  
Ruth Ibukun Kolade ◽  
Festus Abiodun Odediran ◽  
...  
Keyword(s):  
Poverty Reduction ◽  
Formal Education ◽  
Rural Households ◽  
Farm Size ◽  
Living Standard ◽  
Farm Income ◽  
National Bureau ◽  
Access To Credit ◽  
Poor Households ◽  
Reduction Strategies

Farming has been considered as main source of income for rural households in Nigeria, despite their involvement in other income generating activities. Focusing on income derivable from farming alone may be partially responsible for the ineffective poverty reduction strategies in Nigeria. Using the National Living Standard Survey data collected by the National Bureau of Statistics, this paper investigated the composition and determinants of non-farm incomes of rural households in Nigeria. The results show that the share of farm, non-farm wage (NFW)- and self-employment (NFS) incomes in total household incomes were 24.3%, 43.0% and 23.7% respectively. Households whose heads are male (0.647), had formal education (0.522), increased the likelihood of households’ participation in NFW activities, while access to credit (-0.307) and having larger farm size (-0.221) decreased it. Access to credit (0.379); community participation (0.103); larger family size (0.193) and possession of capital assets (0.069) increased the likelihood of participation in NFS-employment activities, while having larger farm size (-0.211) decreased it. The study concludes that policy targeting poverty reduction should focus on providing enabling environment for poor households’ access to non-farm activities in the study area.

scholarly journals Effect of Payments for Disease Specific Care on Poverty Estimates in Nepal

2018 ◽  
pp. 18-34
Author(s):  
Shiva Raj Adhikari
Keyword(s):  
Health Care ◽  
Health Care Cost ◽  
Estimation Method ◽  
Basic Needs ◽  
Poverty Line ◽  
Living Standard ◽  
Care Needs ◽  
Basic Health ◽  
Basic Health Care ◽  
Out Of Pocket Payments

The popular poverty estimation method follows the cost of basic needs approach through estimation of poverty line. Health care is a basic necessity of life, as important as food, shelter, and clothing; however, current practice of estimating poverty indicators in Nepal does not capture the basic health care cost. Not accounted of out of pocket payment for health care into the poverty estimation could give a misleading picture of trends in poverty over time. Ignoring health care costs altogether can result in misclassifying which households or individuals are in the greatest need. Therefore, the paper estimated the revised poverty statistics with explicitly accounting for basic health care needs along with other basic needs such as food, clothing, and shelter by utilizing the Nepal living standard surveys(2010/11) data. The paper used the Foster, Greer and Thorbecke (FGT) poverty estimation method to estimate hidden or underestimated poverty before and after accounting health care payment. The results show that official poverty statistics are significantly underestimated while incorporating basic health care cost in the estimation of poverty statistics in Nepal. Out of pocket payments for health care of different diseases have different impoverishment impacts in terms of incidence and intensity of poverty. Higher average costs of health care cause higher impoverishment impacts. This paper indicates that incidence of poverty is underestimated by almost 4 percentage point and intensity of poverty is underestimated by 0.29 percent based on official estimation of poverty. Economic Journal of Development Issues Vol. 23 & 24 No. 1-2 (2017) Combined Issue, Page : 18-34

scholarly journals Study on the Factors Influencing Total Health Cost Based on Multiple Regression Model

2021 ◽  
Vol 2 (6) ◽  
Author(s):  
Xiaoduo Zu ◽  
Jun Fang
Keyword(s):  
Regression Model ◽  
Structural Adjustment ◽  
Social Economy ◽  
Health Financing ◽  
Multiple Regression Model ◽  
Institutional Transformation ◽  
Medical Expenditure ◽  
Coordinated Development ◽  
Financing Policy ◽  
Using Data

In recent years, China's social economy and income level of residents have increased rapidly, the total cost of health has increased rapidly, and the level of medical expenditure of residents has been increasing. This paper establishes a multivariate linear regression model using data from 1996 to 2020, and analyzes several important influencing factors that affect overall health expenditure. The aim is to formulate a health financing policy suitable for the coordinated development of China's social economy, and to provide a basis for adapting to the needs of economic development, structural adjustment and institutional transformation.

scholarly journals Analysis of Health Sector Budget of Nepal

1970 ◽  
Vol 52 (194) ◽  
pp. 811-821 ◽  
Author(s):  
Ram Krishna Dulal ◽  
Angel Magar ◽  
Shreejana Dulal Karki ◽  
Dipendra Khatiwada ◽  
Pawan Kumar Hamal
Keyword(s):  
Public Health ◽  
Health Care ◽  
Fiscal Federalism ◽  
Health Care Services ◽  
Central Government ◽  
Health Sector ◽  
Health Financing ◽  
Political Commitment ◽  
Financing Policy ◽  
Health Budget

Introduction: Primarily, health sector connects two segments - medicine and public health, where medicine deals with individual patients and public health with the population health. Budget enables both the disciplines to function effectively. The Interim Constitution of Nepal, 2007 has adapted the inspiration of federalism and declared the provision of basic health care services free of cost as a fundamental right, which needs strengthening under foreseen federalism. Methods: An observational retrospective cohort study, aiming at examining the health sector budget allocation and outcome, was done. Authors gathered health budget figures (2001 to 2013) and facts published from authentic sources. Googling was done for further information. The keywords for search used were: fiscal federalism, health care, public health, health budget, health financing, external development partner, bilateral and multilateral partners and healthcare accessibility. The search was limited to English and Nepali-language report, articles and news published. Results: Budget required to meet the population's need is still limited in Nepal. The health sector budget could not achieve even gainful results due to mismatch in policy and policy implementation despite of political commitment. Conclusions: Since Nepal is transforming towards federalism, an increased complexity under federated system is foreseeable, particularly in the face of changed political scenario and its players. It should have clear goals, financing policy and strict implementation plans for budget execution, task performance and achieving results as per planning. Additionally, collection of revenue, risk pooling and purchasing of services should be better integrated between central government and federated states to horn effectiveness and efficiency.  Keywords: health care; budget; financing; unitary system; federalism.

Income and the use of health care: an empirical study of Egypt and Lebanon

2009 ◽  
Vol 4 (4) ◽  
pp. 445-478 ◽  
Author(s):  
HEBA ELGAZZAR
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Financing ◽  
Interesting Case ◽  
Arab Countries ◽  
World Health ◽  
Cross Sectional ◽  
Policy Objective ◽  
Income Groups ◽  
Out Of Pocket Payments

AbstractIn middle-income Arab countries such as Egypt and Lebanon, income-associated equity in health care remains an elusive policy objective in part due to a relatively high reliance on out-of-pocket payments in financing care. This article examines the effect of income on the use of outpatient and inpatient health care services in Egypt and Lebanon using econometric analysis of cross-sectional data from the World Health Organization. In light of noticeable differences in income and public financing arrangements, these two countries serve as interesting case studies. Multivariate regression results suggest that Egyptian respondents were more likely to use health services than their Lebanese counterparts, holding all else constant, and that this effect was particularly evident for outpatient care. A higher income and insurance increased the likelihood of outpatient use more so than inpatient use, with these effects more pronounced in Lebanon. Overall, lower-income groups tended to report having worse health levels and paying more out-of-pocket on health care as a share of income than did higher-income groups. At the same time, these socioeconomic disparities in health appeared to be greater in Lebanon than in Egypt. Economic barriers to the use of health services are discussed within the context of health financing policy reforms aimed at improving equity in access to care in countries such as Egypt and Lebanon.

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