Determinants of catastrophic health spending among rural households in Nigeria

Abstract

Background: Globally, over “150 million individuals” suffer annually from catastrophic health spending mainly as a result of direct spending on  healthcare services. According to the World Health Organization, “household catastrophic health spending is health spending greater than or equal to  40% of the household’s non-subsistence income”. Little is known about the determinants of household catastrophic health spending in developing  countries.

Objectives: The study aims to find the determinants of household catastrophic health spending in rural Nigeria.

Methods: The study used a cross- sectional survey design to recruit 496 rural households within selected communities in Gbonyin Local government Area of Ekiti State, Nigeria. Data was  collected using a pretested, interviewer-administered, and semi-structured questionnaire from 496 household heads. A multistage sampling technique  was used over a period of 4months. Data analysis conducted includes univariate analysis, bivariate analysis (chi-square), and binary logistic regression analysis using STATA 12 software package and principal component analysis done to derive the wealth quartiles. Statistical significance level was set at  p≤0.05 and 95%CI calculated for the adjusted OR.

Results: The factors associated with household catastrophic spending include the presence of a  hospitalized household member (OR=50.38, 95%CI: 7.11 – 59.62; p=0.042) and the number of employed household members less than 3 which will give a  positive value (OR=0.001, 95%CI:0.00-0.15; p= 0.009).

Conclusion: The predictors of household catastrophic spending in the rural areas were the presence  of hospitalized household members and the presence of employed household member(s). Informed targeted intervention could help reduce  the burden of financial catastrophe among rural households.