Inventaire d'enquêtes Demostaf

Information sur la citation

Type Revue - Bulletin of the World Health Organization
Titre Coping with out-of-pocket health payments: empirical evidence from 15 African countries
Volume 86
Numéro 11
Publication (Jour/Mois/Année) 2008
Numéros de page 849-856
Objective To explore factors associated with household coping behaviours in the face of health expenditures in 15 African countries and provide evidence for policy-makers in designing financial health protection mechanisms. Methods A series of logit regressions were performed to explore factors correlating with a greater likelihood of selling assets, borrowing or both to finance health care. The average partial effects for different levels of spending on inpatient care were derived by computing the partial effects for each observation and taking the average across the sample. Data used in the analysis were from the 2002–2003 World Health Survey, which asked how households had financed out-of-pocket payments over the previous year. Households selling assets or borrowing money were compared to those that financed health care from income or savings. Those that used insurance were excluded. For the analysis, a value of 1 was assigned to selling assets or borrowing money and a value of 0 to other coping mechanisms. Findings Coping through borrowing and selling assets ranged from 23\% of households in Zambia to 68\% in Burkina Faso. In general, the highest income groups were less likely to borrow and sell assets, but coping mechanisms did not differ strongly among lower income quintiles. Households with higher inpatient expenses were significantly more likely to borrow and deplete assets compared to those financing outpatient care or routine medical expenses, except in Burkina Faso, Namibia and Swaziland. In eight countries, the coefficient on the highest quintile of inpatient spending had a P-value below 0.01. Conclusion In most African countries, the health financing system is too weak to protect households from health shocks. Borrowing and selling assets to finance health care are common. Formal prepayment schemes could benefit many households, and an overall social protection network could help to mitigate the long-term effects of ill health on household well-being and support poverty reduction.

Études utilisées

Leive, and Xu. "Coping with out-of-pocket health payments: empirical evidence from 15 African countries." Bulletin of the World Health Organization 86, no. 11 (2008): 849-856.
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