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Who Can Afford Health Care? Evaluating the Socio-Economic Conditions and the Ability to Contribute to Health Care in a Post-Conflict Area in DR Congo

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  • Sibylle Gerstl
  • Justin Sauter
  • Joseph Kasanda
  • Alfred Kinzelbach

Abstract

Introduction: The Democratic Republic of the Congo is today one of the poorest countries in the world; the health status of the population ranks among the worst in Sub-Saharan Africa. Public health services charge user fees and drug prices. Since 2008, north-eastern Congo is facing a guerrilla war. Malteser International is assisting with free health care for internally displaced persons as well as the general population. Before the incursion the health system was based on user fees. The aim of this study was to determine the socio-economic conditions of the population and to assess their ability to contribute to health care. Methodology: Heads of 552 randomly selected households in 23 clusters in two health zones were interviewed using a standardised questionnaire. Findings: The demographic description and socio-economic conditions of the study population were homogenous. Major source of income was agriculture (57%); 47% of the households earned less than US$ 5.5/week. Ninety-two percent of the interviewed households estimated that they would be able to contribute to consultation fees (maximum amount of US$ 0.27) and 79% to the drug prices (maximum amount of US$ 1.10). Six percent opted for free consultations and 19% for free drugs. Conclusions: Living conditions were very basic; the estimated income of the study population was low. Almost half of the population perceived their current living situation as fairly good/good. More than 90% of the study population estimated to be able to contribute to consultation fees and 80% to drug prices. As a result Malteser International suggested introducing flat-rates for health care services. Once the project ends, the population will have to pay again for their health service. One solution would be the introduction of a health care financing system with the goal to reach universal coverage to health care.

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  • Sibylle Gerstl & Justin Sauter & Joseph Kasanda & Alfred Kinzelbach, 2013. "Who Can Afford Health Care? Evaluating the Socio-Economic Conditions and the Ability to Contribute to Health Care in a Post-Conflict Area in DR Congo," PLOS ONE, Public Library of Science, vol. 8(10), pages 1-1, October.
    • Handle: RePEc:plo:pone00:0077382
    DOI: 10.1371/journal.pone.0077382
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    References listed on IDEAS

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    1. Ravallion, Martin, 1996. "How Well Can Method Substitute for Data? Five Experiments in Poverty Analysis," The World Bank Research Observer, World Bank, vol. 11(2), pages 199-221, August.
    2. Hermann Donfouet & Ephias Makaudze & Pierre-Alexandre Mahieu & Eric Malin, 2011. "The determinants of the willingness-to-pay for community-based prepayment scheme in rural Cameroon," International Journal of Health Economics and Management, Springer, vol. 11(3), pages 209-220, September.
    3. Sabina Alkire, Maria Emma Santos, 2010. "Acute Multidimensional Poverty: A New Index for Developing Countries," OPHI Working Papers 38, Queen Elizabeth House, University of Oxford.
    4. Dong, Hengjin & Kouyate, Bocar & Snow, Rachel & Mugisha, Frederick & Sauerborn, Rainer, 2003. "Gender's effect on willingness-to-pay for community-based insurance in Burkina Faso," Health Policy, Elsevier, vol. 64(2), pages 153-162, May.
    5. Dasgupta, Partha, 2000. "Valuation and evaluation: measuring the quality of life and evaluating policy," LSE Research Online Documents on Economics 6657, London School of Economics and Political Science, LSE Library.
    6. Dasgupta, Partha, 2000. "Valuation and Evaluation: Measuring the Quality of Life and Evaluating Policy," Discussion Papers 10560, Resources for the Future.
    7. Pradhan, Menno & Ravallion, Martin, 1998. "Measuring poverty using qualitative perceptions of welfare," Policy Research Working Paper Series 2011, The World Bank.
    8. Dasgupta, Partha & Weale, Martin, 1992. "On measuring the quality of life," World Development, Elsevier, vol. 20(1), pages 119-131, January.
    9. Shaohua Chen & Martin Ravallion, 2010. "The Developing World is Poorer than We Thought, But No Less Successful in the Fight Against Poverty," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 125(4), pages 1577-1625.
    10. Hengjin Dong & Bocar Kouyate & John Cairns & Frederick Mugisha & Rainer Sauerborn, 2003. "Willingness‐to‐pay for community‐based insurance in Burkina Faso," Health Economics, John Wiley & Sons, Ltd., vol. 12(10), pages 849-862, October.
    11. Baiphethi, Mompati N. & Jacobs, Peter T., 2009. "The contribution of subsistence farming to food security in South Africa," Agrekon, Agricultural Economics Association of South Africa (AEASA), vol. 48(4), pages 1-24, December.
    12. World Bank, 2005. "Democratic Republic of Congo : Health, Nutrition and Population, Country Status Report," World Bank Publications - Reports 8771, The World Bank Group.
    13. Falkingham, Jane, 2004. "Poverty, out-of-pocket payments and access to health care: evidence from Tajikistan," Social Science & Medicine, Elsevier, vol. 58(2), pages 247-258, January.
    14. World Bank, 2009. "Abolishing School Fees in Africa : Lessons from Ethiopia, Ghana, Kenya, Malawi, and Mozambique," World Bank Publications - Books, The World Bank Group, number 2617.
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    1. Bertone, Maria Paola & Jowett, Matthew & Dale, Elina & Witter, Sophie, 2019. "Health financing in fragile and conflict-affected settings: What do we know, seven years on?," Social Science & Medicine, Elsevier, vol. 232(C), pages 209-219.

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