The Prevalence of Household Catastrophic Health Expenditure in Nigeria: A Rural-Urban Comparison

Background: Catastrophic health expenditure occurs when the burden of Out-of-pocket health expenditure has reached a certain level that a household must forego the expenditure on other basic needs of life to meet the health expenses of its member(s) of the household. Worldwide, over 44 million households suffer annually from financial catastrophe. This study intends to determine the prevalence of household catastrophic health expenditure amongst rural and urban communities in Ekiti, Nigeria. Methodology: This is a comparative cross-sectional study of households within selected rural and urban communities in Ekiti State, Nigeria. A pre-tested interviewer-administered semi-structured questionnaire was used to collect data over a period of 4 months from a sample of 1,000 household heads, using a multistage sampling technique. Data obtained were then entered using the SPSS version 20 and analysed with STATA 12. Two different methodologies were used to calculate household catastrophic health expenditure, with sensitivity analysis done. Univariate analysis were used to describe the population in relation to relevant variables. Result: The prevalence of household catastrophic health expenditure is high using the two methodological calculations. It was significantly higher in the rural areas, 18.5% than the urban areas, 12.8% (p=0.015) for first method; it was also higher in the rural areas, 8.3% compared to the urban areas, 2.5% (p<0.001) for the second method. Conclusion: Prevalence of household catastrophic health expenditure is high in Nigeria, but worse in the rural areas. It’s therefore vital to establish financial and social intervention mechanisms that can protect households from incurring catastrophic health expenditure.

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The Prevalence of Household Catastrophic Health Expenditure in Nigeria: A Rural-Urban Comparison

10.31219/osf.io/k6x4f ◽

2021 ◽

Author(s):

Paul Oladapo Ajayi ◽

Demilade Olusola Ibirongbe ◽

Tope Michael Ipinnimo ◽

Oluremi Olayinka Solomon ◽

Austin Idowu Ibikunle ◽

...

Keyword(s):

Urban Communities ◽

Rural Areas ◽

Urban Areas ◽

Health Expenditure ◽

Univariate Analysis ◽

Sampling Technique ◽

Catastrophic Health Expenditure ◽

Cross Sectional ◽

Rural And Urban ◽

Household Heads

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Decomposing inequality in catastrophic health expenditure for self-reported hypertension household in Urban Shaanxi, China from 2008 to 2013: two waves’ cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2018-023033 ◽

2019 ◽

Vol 9 (5) ◽

pp. e023033 ◽

Cited By ~ 4

Author(s):

Yafei Si ◽

Zhongliang Zhou ◽

Min Su ◽

Xiao Wang ◽

Xin Lan ◽

...

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Health Expenditure ◽

Economic Status ◽

Cross Sectional Study ◽

Catastrophic Health Expenditure ◽

Urban China ◽

Shaanxi Province ◽

Vulnerable Groups ◽

Cross Sectional

ObjectiveDespite the latest wave of China’s healthcare reform initiated in 2009 has achieved unprecedented progress in rural areas, little is known for specific vulnerable groups’ catastrophic health expenditure (CHE) in urban China. This study aims to estimate the trend of incidence, intensity and inequality of CHE in hypertension households (households with one or more than one hypertension patient) in urban Shaanxi, China from 2008 to 2013.MethodsBased on the fourth and the fifth National Health Service Surveys of Shaanxi, we identified 460 and 1289 households with hypertension in 2008 and 2013, respectively for our analysis. We classified hypertension households into two groups: simplex households (with hypertension only) and mixed households (with hypertension plus other non-communicable diseases). CHE would be identified if out-of-pocket healthcare expenditure was equal to or higher than 40% of a household’s capacity to pay. Concentration index and its decomposition based on Probit regressions were employed to measure the income-related inequality of CHE.ResultsWe find that CHE occurred in 11.2% of the simplex households and 22.1% of the mixed households in 2008, and the 21.5% of the simplex households and the 46.9% of mixed households incurred CHE in 2013. Furthermore, there were strong pro-poor inequalities in CHE in the simplex households (−0.279 and −0.283) and mixed households (−0.362 and −0.262) both in 2008 and 2013. The majority of observed inequalities in CHE could be associated with household economic status, household head’s health status and having elderly members.ConclusionWe find a sharp increase of CHE occurrence and the sustained strong pro-poor inequalities for simplex and mixed households in urban Shaanxi Province of China from 2008 to 2013. Our study suggests that more concerns are needed for the vulnerable groups such as hypertension households in urban areas of China.

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Prevalence and socio-demographic factors associated with hypertension among rural and urban population of Kisii County, Kenya

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20213211 ◽

2021 ◽

Author(s):

Alex O. Ondieki ◽

Harun M. Kimani ◽

Titus M. Kahiga

Keyword(s):

Rural Areas ◽

Rural Population ◽

Urban Areas ◽

Demographic Factors ◽

Sampling Technique ◽

Cross Sectional Study ◽

Epidemiologic Transition ◽

Cross Sectional ◽

Rural And Urban ◽

Socio Demographic Factors

Background: Hypertension (HTN) is a major cause of morbidity and mortality worldwide. 9.4 out of the 20 million cardiovascular deaths are due to HTN. HTN has often been described to be more prevalent in urban areas. However, there has been an epidemiologic transition from urban to rural areas which often go unreported or underreported. This gap therefore called for a study to compare the prevalence of HTN burden and assess how socio-demographic factors contribute to HTN development among the rural and urban population.Methods: This study methodology focused on HTN among residents aged 30-69 years, from urban and rural population of Nyaribari Chache sub county, Kisii County, Kenya using a descriptive cross sectional study in which 490 respondents were interviewed. Sampling involved a random sampling technique which entailed household selection. Data was analysed using statistical package for social scientists (SPSS) version 21.Results: The prevalence of HTN for the sampled population was 44.668%. The prevalence of HTN was 44.134% in rural and 43.598% in urban areas. Rural population were more at risk of developing HTN than urban (OR=1.135 and RR=1.072). On general health, those who had ever been told that they had hypertension (p<0.000), ever been told that they had hypertension for the past 12 months (p=0.000) and those who were currently taking hypertension medication (p=0.026) were statistically significant variables.Conclusions: The study concludes that residents in rural population have higher prevalence of hypertension. Further, female respondents, those who are currently married, completed primary school education and were self-employed reported to have a higher prevalence of hypertension.

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Associations of the Initial COVID-19 Lockdown on Self-Reported Happiness and Worry about Developing Loneliness: A Cross-Sectional Analysis of Rural, Regional, and Urban Australian Communities

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18189501 ◽

2021 ◽

Vol 18 (18) ◽

pp. 9501

Author(s):

Vivian Isaac ◽

Teresa Cheng ◽

Louise Townsin ◽

Hassan Assareh ◽

Amy Li ◽

...

Keyword(s):

Urban Communities ◽

Rural Areas ◽

Urban Areas ◽

Negative Impact ◽

Postgraduate Education ◽

Well Being ◽

Cross Sectional ◽

Rural And Urban Areas ◽

Rural And Urban ◽

Sectional Analysis

Australia adopted hard lockdown measures to eliminate community transmission of COVID-19. Lockdown imposes periods of social isolation that contributes to increased levels of stress, anxiety, depression, loneliness, and worry. We examined whether lockdowns have similar psychosocial associations across rural and urban areas and whether associations existed between happiness and worry of loneliness in the initial wave of the COVID-19 pandemic in Australia. Data were collected using the “COVID-19 Living Survey” between 13 and 20 May 2020 by BehaviourWorks Australia at the Monash Sustainable Development Institute. The mean self-reported feeling of happiness and anxiousness (N = 1593), on a 10-point Likert scale with 0 being least happy or highly anxious, was 6.5 (SD = 2.4) and 3.9 (2.9), respectively. Factors associated with happiness were older age and having a postgraduate education. Participants worried about becoming lonely also exhibited reduced happiness (estimate = −1.58, 95%CI = −1.84–−1.32) and higher anxiousness (2.22, 1.93–2.51) scores, and these conditions remained associated after adjusting for demographics. Interestingly, worry about loneliness was greater in rural areas than in urban communities. The negative impact of the COVID-19 lockdown on rural youth and those less-educated was evident. Participants in rural Australia who were worried about becoming lonely were reportedly less happy than participants in major cities. This dataset provides a better understanding of factors that influence psychological well-being and quality of life in the Australian population and helps to determine whether happiness may be an associative factor that could mitigate self-feelings of anxiety and worry about loneliness.

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Urban-rural differences in catastrophic health expenditure among households with chronic non-communicable disease patients : evidence from China Family Panel Studies

10.21203/rs.3.rs-37742/v1 ◽

2020 ◽

Author(s):

Xianzhi Fu ◽

Qi-wei Sun ◽

Chang-qing Sun ◽

Fei Xu ◽

Jun-jian He

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Health Expenditure ◽

Communicable Disease ◽

Rural Households ◽

Catastrophic Health Expenditure ◽

System Reform ◽

Cross Sectional ◽

Urban Rural ◽

Panel Studies

Abstract Background: The prevalence of chronic non-communicable diseases (NCDs) challenges the Chinese health system reform. Little is known for the differences in catastrophic health expenditure (CHE) between urban and rural households with NCD patients. This study aims to measure the differences above and quantify the contribution of each variable in explaining the urban-rural differences.Methods: The second and the fourth waves of the China Family Panel Studies (CFPS) data, conducted in 2012 and 2016, were employed in this cross-sectional study. The techniques of Fairlie nonlinear decomposition and Blinder-Oaxaca decomposition were employed to measure the contribution of each independent variable to the urban-rural differences.Results: The CHE incidence and intensity of households with NCD patients were significantly higher in rural areas than in urban areas. The explained disparity of CHE incidence increased from 3.15% in 2012 to 27.04% in 2016, and the corresponding values of CHE intensity rose from 21.30% in 2012 to 53.37% in 2016. The major contribution to the urban-rural differences in CHE was associated with household economic status, education level, health status and supplementary medical insurance (SMI).Conclusions: Compared with urban households with NCD patients, rural households with NCD patients have higher risk of incurring CHE and heavier economic burden of diseases. Policy interventions should give priority to decreasing the urban-rural disparity in observable characteristics.

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A Comparative Study of Knowledge, Attitude, and Determinants of Tuberculosis-Associated Stigma in Rural and Urban Communities of Lagos State, Nigeria

Tuberculosis Research and Treatment ◽

10.1155/2020/1964759 ◽

2020 ◽

Vol 2020 ◽

pp. 1-14

Author(s):

David A. Oladele ◽

Mobolanle R. Balogun ◽

Kofoworola Odeyemi ◽

Babatunde L. Salako

Keyword(s):

Rural Communities ◽

Rural Areas ◽

Urban Areas ◽

Delayed Diagnosis ◽

Sampling Technique ◽

Health Concern ◽

Cross Sectional ◽

Rural And Urban Areas ◽

Rural And Urban ◽

Lagos State

Background. Tuberculosis (TB) is an important public health concern in Nigeria. TB-associated stigma could lead to delayed diagnosis and care, treatment default, and multidrug resistance. Understanding of TB-associated stigma is therefore important for TB control. The study is aimed at determining and comparing the knowledge, attitude, and determinants of TB-associated stigma. Methodology. This was a comparative cross-sectional study among adults in urban and rural areas of Lagos State, Nigeria. Respondents were selected through a multistage sampling technique and interviewed using a semistructured questionnaire, which contained the Explanatory Model Interviewed Catalogue (EMIC) stigma scale. IBM SPSS Statistics Software package version 20 was used for analysis. Results. A total of 790 respondents were interviewed. High proportions of respondents in rural and urban areas were aware of TB (97.5% and 99.2%, respectively). Respondents in the urban areas had overall better knowledge of TB compared to the rural areas (59.4% vs. 23%; p < 0.001 ), while respondents in the rural areas had a better attitude to TB (60.5% vs. 49.9%; p = 0.002 ). The majority of respondents in rural and urban areas had TB-associated stigma (93% and 95.7%, respectively). The mean stigma score was higher in the urban compared to rural areas ( 17.43 ± 6.012 and 16.54 ± 6.324 , respectively, p = 0.046 ). Marital status and ethnicity were the predictors of TB-associated stigma in the rural communities (AOR-0.257; CI-0.086-0.761; p = 0.014 and AOR–3.09; CI-1.087-8.812; p = 0.034 , respectively), while average monthly income and age of respondents were the predictors of TB-associated stigma in urban areas (AOR–0.274; CI–0.009-0.807; p = 0.019 and AOR-0.212; CI–0.057-0.788; p = 0.021 , respectively). Conclusion. TB-associated stigma is prevalent in both rural and urban areas in this study. There is therefore a need to disseminate health appropriate information through the involvement of the community. Also, innovative stigma reduction activities are urgently needed.

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Urban-rural differences in catastrophic health expenditure among households with chronic non-communicable disease patients: evidence from China Family Panel Studies

10.21203/rs.3.rs-82474/v1 ◽

2020 ◽

Author(s):

Xian-zhi Fu ◽

Qi-wei Sun ◽

Chang-qing Sun ◽

Fei Xu ◽

Jun-jian He

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Health Expenditure ◽

Communicable Disease ◽

Rural Households ◽

Catastrophic Health Expenditure ◽

System Reform ◽

Cross Sectional ◽

Urban Rural ◽

Panel Studies

Abstract BackgroundThe prevalence of chronic non-communicable diseases (NCDs) challenges the Chinese health system reform. Little is known for the differences in catastrophic health expenditure (CHE) between urban and rural households with NCD patients. This study aims to measure the differences above and quantify the contribution of each variable in explaining the urban-rural differences.MethodsThe second and the fourth waves of the China Family Panel Studies (CFPS) data, conducted in 2012 and 2016, were employed in this cross-sectional study. The techniques of Fairlie nonlinear decomposition and Blinder-Oaxaca decomposition were employed to measure the contribution of each independent variable to the urban-rural differences.ResultsThe CHE incidence and intensity of households with NCD patients were significantly higher in rural areas than in urban areas. The explained disparity of CHE incidence increased from 3.15% in 2012 to 27.04% in 2016, and the corresponding values of CHE intensity rose from 21.30% in 2012 to 53.37% in 2016. The major contribution to the urban-rural differences in CHE was associated with household economic status, education level, health status and supplementary medical insurance (SMI).ConclusionsCompared with urban households with NCD patients, rural households with NCD patients have higher risk of incurring CHE and heavier economic burden of diseases. Policy interventions should give priority to decreasing the urban-rural disparity in observable characteristics mentioned above.

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Urban–rural disparity in cancer incidence in China, 2008–2012: a cross-sectional analysis of data from 36 cancer registers

BMJ Open ◽

10.1136/bmjopen-2020-042762 ◽

2021 ◽

Vol 11 (4) ◽

pp. e042762

Author(s):

Shuai Yuan ◽

Shao-Hua Xie

Keyword(s):

Cancer Incidence ◽

Rural Areas ◽

Urban Areas ◽

Incidence Rates ◽

Cancer Type ◽

Anatomic Site ◽

Cross Sectional ◽

Rural And Urban Areas ◽

Rural And Urban ◽

Urban Rural

ObjectiveThe substantial differences in socioeconomic and lifestyle exposures between urban and rural areas in China may lead to urban–rural disparity in cancer risk. This study aimed to assess the urban–rural disparity in cancer incidence in China.MethodsUsing data from 36 regional cancer registries in China in 2008–2012, we compared the age-standardised incidence rates of cancer by sex and anatomic site between rural and urban areas. We calculated the rate difference and rate ratio comparing rates in rural versus urban areas by sex and cancer type.ResultsThe incidence rate of all cancers in women was slightly lower in rural areas than in urban areas, but the total cancer rate in men was higher in rural areas than in urban areas. The incidence rates in women were higher in rural areas than in urban areas for cancers of the oesophagus, stomach, and liver and biliary passages, but lower for cancers of thyroid and breast. Men residing in rural areas had higher incidence rates for cancers of the oesophagus, stomach, and liver and biliary passages, but lower rates for prostate cancer, lip, oral cavity and pharynx cancer, and colorectal cancer.ConclusionsOur findings suggest substantial urban–rural disparity in cancer incidence in China, which varies across cancer types and the sexes. Cancer prevention strategies should be tailored for common cancers in rural and urban areas.

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The Quality of Life of Coronavirus Disease Survivors Living in Rural and Urban Area of Riau Province, Indonesia

Infectious Disease Reports ◽

10.3390/idr14010005 ◽

2022 ◽

Vol 14 (1) ◽

pp. 33-42

Author(s):

Suyanto Suyanto ◽

Shashi Kandel ◽

Rahmat Azhari Kemal ◽

Arfianti Arfianti

Keyword(s):

Quality Of Life ◽

Rural Areas ◽

Urban Areas ◽

Cross Sectional Study ◽

Cross Sectional ◽

Rural And Urban Areas ◽

Rural And Urban ◽

The Status ◽

Rural And Urban Area

This study assesses the status of health-related quality of life (HRQOL) among coronavirus survivors living in rural and urban districts in Riau province, Indonesia. The cross-sectional study was conducted among 468 and 285 Coronavirus disease (COVID-19) survivors living in rural and urban areas, respectively in August 2021. The St. George Respiratory Questionnaire (SGRQ) was used to measure the HRQOL of COVID-19 survivors. A higher total score domain corresponds to worse quality of life status. Quantile regression with the respect to 50th percentile found a significant association for the factors living in rural areas, being female, having comorbidities, and being hospitalized during treatment, with total score of 4.77, 2.43, 7.22, and 21.27 higher than in their contra parts, respectively. Moreover, having received full vaccination had the score 3.96 in total score. The HRQOL of COVID-19 survivors living in rural areas was significantly lower than in urban areas. Factors such as living in rural areas, female sex, having comorbidities, and history of symptomatic COVID-19 infection were identified as significant predictors for lower quality of life. Meanwhile, having full vaccination is a significant predictor for a better quality of life. The results of this study can provide the targeted recommendations for improvement of HRQOL of COVID-19 survivors.

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Needs and rights awareness of stroke survivors and caregivers in urban and rural China: a cross-sectional, multiple-centre questionnaire survey

BMJ Open ◽

10.1136/bmjopen-2018-021820 ◽

2019 ◽

Vol 9 (4) ◽

pp. e021820

Author(s):

Xiaoshuang Xia ◽

Xiaolin Tian ◽

Tianli Zhang ◽

Peilu Wang ◽

Yanfen Du ◽

...

Keyword(s):

Social Support ◽

Rural Areas ◽

Urban Areas ◽

Rural China ◽

Potential Effect ◽

Psychological Support ◽

Stroke Survivors ◽

Cross Sectional ◽

Urban Settings ◽

Rural And Urban

ObjectivesStroke survivors require assistance and support in their daily lives. This survey aims to investigate the needs and rights awareness in Chinese stroke survivors and caregivers in rural and urban settings.SettingThis survey was adapted from the one created by the World Stroke Organization. The questionnaire included demands for psychological support, treatment and care, social support and information. From January 2015 to January 2016, the survey was pilot tested with urban and rural-dwelling stroke survivors and caregivers from 12 hospitals. Stroke survivors were invited to participate if they were over 18 years old and had experienced a stroke. Exclusion criteria were patients who had disorders of consciousness, significant cognitive impairment, aphasia, communication difficulties or psychiatric disorders. Only caregivers who were family members of the patients were chosen. Paid caregivers were excluded.ParticipantsOne thousand, one hundred and sixty-seven stroke survivors and 1119 caregivers were enrolled.Primary outcome measuresThe needs of stroke survivors and caregivers in rural and urban areas were compared. The correlations between needs of rural and urban stroke survivors and caregivers and potential effect factors were analysed, respectively.ResultsAmong the cohort, 93.5% reported the need for psychological support, 88.6% for treatment and care, 84.8% for information and 62.7% for social support. The total needs and each aspect of needs of stroke survivors in urban settings were greater than of those in rural settings (p<0.01). In rural areas, total needs and each aspect of needs were positively correlated with education level (p<0.01).ConclusionsNeeds and rights awareness of stroke survivors should also be recognised in both urban and rural China. According to the different needs of patients and their caregivers, regional and individualised services were needed by stroke survivors and their caregivers.

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