The Financial Burden of Out of Pocket Payment for Medicines among Households in Ethiopia
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Date
2021-09
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Addis Abeba University
Abstract
Background: In Ethiopia, more than half of all out-of-pocket (OOP) health expenses
are for medicine. However, there is a scarcity of information on the cost impact of
medicine on households.
Objective: This study aims to investigate the financial implications of OOP payment
for medicines for Ethiopian households.
Methods: A sequential mixed methods explanatory design was employed in this study.
The quantitative part involved a secondary analysis of the national household
consumption and expenditure surveys of 2010/11 and 2015/16. Catastrophic OOP
expenditures for medicines were measured using the “capacity to pay” method. Logistic
regression models were used to determine the factors of catastrophic medicine payment.
In-depth interviews were used to collect qualitative data from key informants working
in relevant government agencies. The framework analysis approach was used also to
analyze qualitative data.
Results: From 2010 to 2016 the total percentage of households facing catastrophic
medicine payments decreased from 1% to 0.73%. This means payment for medicines
pushed 11,132 households into poverty in 2015/16. The majority of disparities were
explained by economic status, place of residence, and type of health services. The
qualitative analysis identified four major themes in the areas of the current context of
medicine OOP payment, aggravating factors for medicine OOP, failures to implement
planned interventions, and plans.
Conclusion: The findings show that, despite improvements over the years, OOP
payment for medicines pushed thousands of Ethiopian households to poverty. Hence,
introducing and strengthening the implementation of pro-poor policies are
recommended.
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Keywords
Catastrophic medicine expenditure, Ethiopia, financial risk protection, out- of-pocket payments, poverty, universal health coverage.