Assessment of Catastrophic Health Expenditure and Coping strategies of Multi Drug ResistantTuberculosis (MDR-TB Patients in Addis Ababa, Ethiopia.
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Date
2023-06
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Addis Ababa University
Abstract
Introduction: The World Health Assembly (WHA) in 2014 adopted the World Health Organization’s (WHO) END TB strategy containing three pillars among which TB affected families’ catastrophic costs to be zero percent by 2030. Tuberculosis (TB), which mostly affects the poorest of the poor, is an example of a disease that can substantially contribute to the disease poverty trap. Even though most countries have aimed to provide the diagnosis and treatment of TB free of charge, a number of studies have found out that patients are still subject to direct and indirect cost due to TB illness and care-seeking, hampering access and putting people at risk of financial ruin or further impoverishment. A number of health care financing schemes have been designed and implemented in Ethiopia. However, the status of catastrophic cost for TB in general and MDR-
TB have not been established for the country.
Objective: The objective of this study is to assess catastrophic health expenditure and coping strategies of MDR-TB patients in Addis Ababa.
Methods: Facility based cross-sectional survey to assess catastrophic health expeditures and coping strategies of patients with MDR-TB was employed at two hospitals in Addis Ababa, the leading of which are known TB care and research. All MDR-TB patients being cared for the disease at the time of the survey were identified from the national TB registry for inclusion. For accurate estimation of costs and other associated factors such as coping strategies all MDR-TB patients being treated in two hospitals known for initiating treatment and follow-up for MDR-TB fulfilling the inclusion criteria were part of the survey.
Result: In this survey about 54.3 % of households experienced catastrophic health expenditure more than 20% of their annual household income. To cope with the costs associated with TB care, patients underwent variety of coping mechanisms including about 61 (33%) patients borrowing an estimated average of 5739 birr (108 USD); about 26 (14%) patients selling house properties (mainly household items, land and livestokcs) with the estimated mean market value of the property sold being 21375 birr (403 USD); and about 21 (11.4%) patients undergoing dissavings including withdrawal of money from banks the amoung standing at an average of 55000 ETB (1037 USD).
Conclusion: The catastrophic cost of MDR-TB service Addis Ababa cannot be overlooked, despite the free policy. This study has revealed the incidence of catastrophic health expenditure among households affected by MDR-TB is about 54.3%..
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Keywords
MDR-TB Patients, Drug Resistant, Tuberculosis