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Title: Economic Burden of Health Care at Household Level: Examination of Out-Of-Pocket Expenditure on Sexual & Reproductive Health Care including HIV/AIDS in Butajira District
Authors: Tibebe, Akalu
Advisors: Damen H/Mariam, (MD, MPH, PhD)
Keywords: Economic Burden
Sexual & Reproductive
Copyright: Jun-2010
Date Added: 4-May-2012
Publisher: AAU
Abstract: In Ethiopia, as in other developing countries, although public health care is provided at nominally low prices and for free to those that do not afford to pay, the health care consumer population is still required to make considerable amount of out-of-pocket expenditures (OOPE) for various reasons. NHA have shown that 33.9% accounts for households as financing agents on reproductive health care and it is a substantial part of total financial resource flow. However, out-of-pocket expenditures remain poorly visible in resource tracing effort since it is in need of specialized surveys. This study examines economic burden of health care at household level in rural setting of Ethiopia and was conducted within the Butajira demographic surveillance site starting from October 2007 to May 2008. The study was done by collecting household level expenditures made for financing reproductive health and HIV/AIDS related health problems through cross sectional study with simple vi random sampling methods of 370 study households which were computed by single population mean formula. Then, the data collected were entered and analyzed into appropriate statistical software (SPSS v.11) that enables analysis within the framework of the study objectives. From the study participants 44.9% females were under reproductive age group where as among 44.2% males were belong age above 15 years. 73.9% of the eligible study population were married, and females take higher proportion (76.1%). 47.6% of study participants were in formal education with different level and 41.0% were illiterates. On the other hand, majority were Muslims (76%) followed by Orthodox Christian (18%). Total annual gross out-of-pocket expenditures for households on sexual and reproductive health including HIV/AIDS is ETB 85900.90 ($9357.40) with ETB 282.57 ($30.78) per household. Out of the total expenditure 72.4% spent on ANC, delivery, PNC, obstetric care including abortion, where as the rest 27.6% spent on FP and other sexual and reproductive health services. Conversely, 6.5% of the total out-of- pocket expenditure as percentage of the annual household expenditure in each service is for sexual and reproductive health services including HIV/AIDS. Further more, the net (direct) out-of-pocket expenditure on sexual and reproductive health services including HIV/AIDS has a gap of 64.08% from the gross out-of-pocket expenditure which shows much expense are related with non medical activities. vii To put it briefly, the study tries to assess the financial burden of sexual and reproductive health care services and identifies the different direct and indirect costs incurred on different intervention components that the National Health Account lacks. From this angle, existence of price elasticity among the poor that suggests out-of-pocket expenditure has a regressive distributional impact and poor and very poor people are expected to expend more. Into the bargain, all expenses are covered from regular income that leads to catastrophic household economic crises in most cases. Therefore, the general findings lead to a conclusion that the presence of an economic burden of health care at household level. At the end, based on pertinent results recommendations were set like introducing other alternative health care financing mechanisms [community based health insurance, social insurance], strong monitoring and evaluation mechanisms should be set on health programs, increasing the primary health service coverage both in kind and in human resource, parallel education and encouragement work on saving income for future use, periodic surveys.
URI: http://hdl.handle.net/123456789/2536
Appears in:Thesis - Public Health

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