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Assessing out-of-pocket expenditures for primary health care: how responsive is the Democratic Republic of Congo health system to providing financial risk protection?

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  • Samia Laokri
  • Rieza Soelaeman
  • David R Hotchkiss

Abstract

The goal of universal health coverage is challenging for chronically under-resourced health systems. Although household out-of-pocket payments are the most important source of health financing in low-income countries, relatively little is known about the drivers of primary health care expenditure and the predictability of the burden associated with high fee-for-service payments. This study describes out-of-pocket health expenditure and investigates demand- and supply-side drivers of excessive costs in the Democratic Republic of Congo (DRC), a central African country in the midst of a process of reforming its health financing system towards universal health coverage.

Suggested Citation

  • Samia Laokri & Rieza Soelaeman & David R Hotchkiss, 2018. "Assessing out-of-pocket expenditures for primary health care: how responsive is the Democratic Republic of Congo health system to providing financial risk protection?," ULB Institutional Repository 2013/273019, ULB -- Universite Libre de Bruxelles.
    • Handle: RePEc:ulb:ulbeco:2013/273019
    Note: SCOPUS: ar.j
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    References listed on IDEAS

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    1. Samia Laokri & Olivier Weil & Koiné Maxime Drabo & Sary Mathurin Dembelé & Benoît Kafando & Bruno Dujardin, 2013. "Removal of user fees no guarantee of universal health coverage: observations from Burkina Faso," ULB Institutional Repository 2013/153197, ULB -- Universite Libre de Bruxelles.
    2. Kankeu, Hyacinthe Tchewonpi & Ventelou, Bruno, 2016. "Socioeconomic inequalities in informal payments for health care: An assessment of the ‘Robin Hood’ hypothesis in 33 African countries," Social Science & Medicine, Elsevier, vol. 151(C), pages 173-186.
    3. Hélène Barroy & Françoise André & Serge Mayaka & Hadia Samaha, 2014. "Investing in Universal Health Coverage," World Bank Publications - Reports 23880, The World Bank Group.
    4. Samia Laokri & Arnaud Amoussouhui & Edgard Marius Ouendo & Athanase Hounnankan & Séverin Anagonou & Martin Gninafon & Ferdinand Kassa & Léon Tawo & Bruno Dujardin, 2014. "A care pathway analysis of tuberculosis patients in benin: highlights on direct costs and critical stages for an evidence-based decision-making," ULB Institutional Repository 2013/173830, ULB -- Universite Libre de Bruxelles.
    5. Theodore Trefon, 2009. "Public Service Provision in a Failed State: Looking Beyond Predation in the Democratic Republic of Congo," Review of African Political Economy, Taylor & Francis Journals, vol. 36(119), pages 9-21, March.
    6. Samia Laokri & Arnaud Amoussouhui & Edgard M Ouendo & Athanase Cossi Hounnankan & Séverin Anagonou & Martin Gninafon & Ferdinand Kassa & Léon Tawo & Bruno Dujardin, 2014. "A Care Pathway Analysis of Tuberculosis Patients in Benin: Highlights on Direct Costs and Critical Stages for an Evidence-Based Decision-Making," PLOS ONE, Public Library of Science, vol. 9(5), pages 1-8, May.
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    Cited by:

    1. Bart Criel & Maria-Pia Waelkens & Fulbert Kwilu Nappa & Yves Coppieters & Samia Laokri, 2020. "Can mutual health organisations influence the quality and the affordability of healthcare provision? The case of the Democratic Republic of Congo," PLOS ONE, Public Library of Science, vol. 15(4), pages 1-21, April.
    2. Anelisa Jaca & Thobile Malinga & Chinwe Juliana Iwu-Jaja & Chukwudi Arnest Nnaji & Joseph Chukwudi Okeibunor & Dorcas Kamuya & Charles Shey Wiysonge, 2022. "Strengthening the Health System as a Strategy to Achieving a Universal Health Coverage in Underprivileged Communities in Africa: A Scoping Review," IJERPH, MDPI, vol. 19(1), pages 1-21, January.
    3. 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.
    4. Samuel Lordemus, 2022. "Does Aid for Malaria Increase with Exposure to Malaria Risk? Evidence from Mining Sites in the D.R.Congo," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 84(4), pages 719-748, August.
    5. Meike Irene Nakovics & Stephan Brenner & Paul Jacob Robyn & Ludovic Deo Gracias Tapsoba & Manuela De Allegri, 2019. "Determinants of individual healthcare expenditure: A cross‐sectional analysis in rural Burkina Faso," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(4), pages 1478-1494, October.
    6. Simon Schäfermann & Richard Neci & Edward Ngah Ndze & Fidelis Nyaah & Valentin Basolanduma Pondo & Lutz Heide, 2020. "Availability, prices and affordability of selected antibiotics and medicines against non-communicable diseases in western Cameroon and northeast DR Congo," PLOS ONE, Public Library of Science, vol. 15(1), pages 1-16, January.
    7. Pavitra Paul & Ulrich Nguemdjo & Armel Ngami & Natalia Kovtun & Bruno Ventelou, 2022. "Do efficiency and equity move together? Cross-dynamics of Health System performance and Universal Health Coverage," Palgrave Communications, Palgrave Macmillan, vol. 9(1), pages 1-8, December.

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