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Catastrophic health expenditure and its determinants among Nigerian households

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  • Ryoko Sato

    (Harvard T.H. Chan School of Public Health)

Abstract

Health expenditure can be substantial, especially in countries without national health insurance schemes, and it can negatively affect people’s welfare. This study uses recent data to evaluate the extent to which Nigerian households suffer from catastrophic health expenditure (CHE) and evaluates its determinants. We used the Living Standards Survey 2018–2019 to estimate the headcount of Nigerian households that experience CHE—the proportion of health expenditures exceeding a certain ratio of such expenditures to non-food expenditures. To evaluate the determinants of CHE, we used ordinary least square regression with state fixed effects. The total sample was 22,110 nationally representative households. Many households, especially poorer ones, do not have any health care expenses; only 60.6% of the poorest households had some health-related expenditure. Even with the limited health-seeking behaviors in this demographic, the percentage of households that suffered from CHE was very high: with a 15% cutoff for CHE thresholds, 34.9 to 44.2% of households experienced CHE. Lower education, higher non-food consumption, and rural residence were correlated with higher amounts of health expenditure and higher odds of CHE. Health-seeking behaviors such as clinic visits for sickness treatment and prevention are limited, especially among the poorer households. Even so, the headcount of households experiencing CHE is very high in Nigeria. Advancing the implementation of national health insurance scheme is important to reduce the burden of health expenditure, especially among the poor, as well as to remove financial barriers to their seeking adequate health services.

Suggested Citation

  • Ryoko Sato, 2022. "Catastrophic health expenditure and its determinants among Nigerian households," International Journal of Health Economics and Management, Springer, vol. 22(4), pages 459-470, December.
  • Handle: RePEc:kap:ijhcfe:v:22:y:2022:i:4:d:10.1007_s10754-022-09323-y
    DOI: 10.1007/s10754-022-09323-y
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    References listed on IDEAS

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    1. Sarah Ssewanyana & Ibrahim Kasirye, 2020. "Estimating Catastrophic Health Expenditures from Household Surveys: Evidence from Living Standard Measurement Surveys (LSMS)-Integrated Surveys on Agriculture (ISA) from Sub-Saharan Africa," Applied Health Economics and Health Policy, Springer, vol. 18(6), pages 781-788, December.
    2. God’stime Osariyekemwen Igiebor, 2019. "Political Corruption in Nigeria: Implications for Economic Development in the Fourth Republic," Journal of Developing Societies, , vol. 35(4), pages 493-513, December.
    3. Adam Wagstaff & Eddy van Doorslaer, 2003. "Catastrophe and impoverishment in paying for health care: with applications to Vietnam 1993–1998," Health Economics, John Wiley & Sons, Ltd., vol. 12(11), pages 921-933, November.
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    More about this item

    Keywords

    Catastrophic health expenditure; Determinants; Nigeria;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development

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