IDEAS home Printed from https://ideas.repec.org/a/wly/jintdv/v21y2009i2p185-199.html
   My bibliography  Save this article

Issues in equitable health financing in South Eastern Nigeria: Socio-economic and geographic differences in households' illness expenditures and policy makers' views on the financial protection of the poor

Author

Listed:
  • Obinna Onwujekwe
  • Chima Onoka
  • Benjamin Uzochukwu
  • Eric Obikeze

    (Health Policy Research Group, College of Medicine, University of Nigeria, Enugu, Nigeria)

  • Nkoli Ezumah

Abstract

This study examined the socio-economic and geographic differences in illness occurrence and levels of expenditures in South Eastern Nigeria, together with policymaker and healthcare provider views on how to alleviate the financial burdens placed on the poorest by existing payment mechanisms. We found no evidence of differences across socio-economic group in illness occurrence but there was inequity in expenditures, payment mechanisms used and sources of funds to cope with the burden of payments. Policymakers and facility managers were found to assume that households have the capacity to cope with healthcare payments and there is no functioning system of fee exemptions. Policies are needed to protect the poor and other vulnerable groups against the financial risk of ill-health. Copyright © 2009 John Wiley & Sons, Ltd.

Suggested Citation

  • Obinna Onwujekwe & Chima Onoka & Benjamin Uzochukwu & Eric Obikeze & Nkoli Ezumah, 2009. "Issues in equitable health financing in South Eastern Nigeria: Socio-economic and geographic differences in households' illness expenditures and policy makers' views on the financial protection of the," Journal of International Development, John Wiley & Sons, Ltd., vol. 21(2), pages 185-199.
    • Handle: RePEc:wly:jintdv:v:21:y:2009:i:2:p:185-199
    DOI: 10.1002/jid.1547
    as

    Download full text from publisher

    File URL: http://hdl.handle.net/10.1002/jid.1547
    File Function: Link to full text; subscription required
    Download Restriction: no
    File URL: https://libkey.io/10.1002/jid.1547?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Wagstaff, Adam & van Doorslaer, Eddy & Paci, Pierella, 1989. "Equity in the Finance and Delivery of Health Care: Some Tentative Cross-country Comparisons," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 5(1), pages 89-112, Spring.
    2. Deon Filmer & Lant Pritchett, 2001. "Estimating Wealth Effects Without Expenditure Data—Or Tears: An Application To Educational Enrollments In States Of India," Demography, Springer;Population Association of America (PAA), vol. 38(1), pages 115-132, February.
    3. Tibaijuka, Anna Kajumulo, 1997. "AIDS and economic welfare in peasant agriculture: Case studies from Kagabiro village, Kagera region, Tanzania," World Development, Elsevier, vol. 25(6), pages 963-975, June.
    4. Filmer, Deon & Pritchett, Lant, 1998. "Estimating wealth effects without expenditure data - or tears : with an application to educational enrollments in states of India," Policy Research Working Paper Series 1994, The World Bank.
    5. Haddad, Slim & Fournier, Pierre & Machouf, Nimâ & Yatara, Fassinet, 1998. "What does quality mean to lay people? Community perceptions of primary health care services in Guinea," Social Science & Medicine, Elsevier, vol. 47(3), pages 381-394, August.
    6. Onwujekwe, Obinna, 2005. "Inequities in healthcare seeking in the treatment of communicable endemic diseases in Southeast Nigeria," Social Science & Medicine, Elsevier, vol. 61(2), pages 455-463, July.
    7. Kent Ranson, M. & Sinha, Tara & Chatterjee, Mirai & Acharya, Akash & Bhavsar, Ami & Morris, Saul S. & Mills, Anne J., 2006. "Making health insurance work for the poor: Learning from the Self-Employed Women's Association's (SEWA) community-based health insurance scheme in India," Social Science & Medicine, Elsevier, vol. 62(3), pages 707-720, February.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Angus Deaton & Jean Dreze, 2008. "Nutrition in India: Facts and Interpretations," Working Papers 1071, Princeton University, Woodrow Wilson School of Public and International Affairs, Research Program in Development Studies..
    2. Sandra Viviana Polanía Reyes, 2005. "Capital Social E Ingreso De Los Hogares Del Sector Urbano En Colombia," Documentos CEDE 2099, Universidad de los Andes, Facultad de Economía, CEDE.
    3. David Bishaia & Michael Koenig & Mehrab Ali Khan, 2003. "Measles vaccination improves the equity of health outcomes: evidence from Bangladesh," Health Economics, John Wiley & Sons, Ltd., vol. 12(5), pages 415-419, May.
    4. Adam Wagstaff & Magnus Lindelow, 2014. "Are Health Shocks Different? Evidence From A Multishock Survey In Laos," Health Economics, John Wiley & Sons, Ltd., vol. 23(6), pages 706-718, June.
    5. Richard Mussa, 2013. "Spatial Comparisons of Poverty and Inequality in Living Standards in Malawi," South African Journal of Economics, Economic Society of South Africa, vol. 81(2), pages 192-210, June.
    6. Rashid, Dewan Arif & Smith, Lisa C. & Rahman, Tauhidur, 2011. "Determinants of Dietary Quality: Evidence from Bangladesh," World Development, Elsevier, vol. 39(12), pages 2221-2231.
    7. Lisa Chauvet & Flore Gubert & Sandrine Mesplé-Somps, 2009. "Are Remittances More Effective Than Aid To Reduce Child Mortality ? An Empirical Assessment using Inter and Intra-Country Data," Working Papers halshs-00966367, HAL.
    8. Anne Case & Angus Deaton, 2009. "Health and Well-Being in Udaipur and South Africa," NBER Chapters, in: Developments in the Economics of Aging, pages 317-349, National Bureau of Economic Research, Inc.
    9. Lopez-Feldman, Alejandro, 2005. "Panel Data Evidence on the Determinants of Non-Timber Forest Products Extraction: The Case of Xate in Mexico," 2005 Annual meeting, July 24-27, Providence, RI 19410, American Agricultural Economics Association (New Name 2008: Agricultural and Applied Economics Association).
    10. Tarozzi, Alessandro & Mahajan, Aprajit, 2005. "Child Nutrition in India in the Nineties: A Story of Increased Gender Inequality?," Working Papers 05-06, Duke University, Department of Economics.
    11. Rama Pal, 2010. "Analysing Catastrophic OOP Health Expenditure in India: Concepts, Determinants and Policy Implications," Working Papers id:2420, eSocialSciences.
    12. Grimm, Michael & Harttgen, Kenneth & Klasen, Stephan & Misselhorn, Mark, 2008. "A Human Development Index by Income Groups," World Development, Elsevier, vol. 36(12), pages 2527-2546, December.
    13. Nava Ashraf & James Berry & Jesse M. Shapiro, 2010. "Can Higher Prices Stimulate Product Use? Evidence from a Field Experiment in Zambia," American Economic Review, American Economic Association, vol. 100(5), pages 2383-2413, December.
    14. Patrick Ward, 2014. "Measuring the Level and Inequality of Wealth: An Application to China," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 60(4), pages 613-635, December.
    15. Behrman, Jere R. & Skoufias, Emmanuel, 2004. "Correlates and determinants of child anthropometrics in Latin America: background and overview of the symposium," Economics & Human Biology, Elsevier, vol. 2(3), pages 335-351, December.
    16. Schady, Norbert & Araujo, Maria Caridad, 2006. "Cash transfers, conditions, school enrollment, and child work : evidence from a randomized experiment in Ecuador," Policy Research Working Paper Series 3930, The World Bank.
    17. Locatelli, Andrea & Carneiro, Pedro & Gebremeskel, Tewolde & Keating, Joseph, 2011. "Behavioral Response to an Anti Malaria Spraying Campaign, with Evidence from Eritrea," Proceedings of the German Development Economics Conference, Berlin 2011 53, Verein für Socialpolitik, Research Committee Development Economics.
    18. Kanako Ishida, 2010. "The Role of Ethnicity in Father Absence and Children’s School Enrollment in Guatemala," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 29(4), pages 569-591, August.
    19. Ashish Singh, 2011. "Inequality of Opportunity in Indian Children: The Case of Immunization and Nutrition," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 30(6), pages 861-883, December.
    20. Kazianga, Harounan & Klonner, Stefan, 2009. "The Intra-household Economics of Polygyny: Fertility and Child Mortality in Rural Mali," MPRA Paper 12859, University Library of Munich, Germany.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:jintdv:v:21:y:2009:i:2:p:185-199. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/journal/5102/home .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.