Catastrophic and impoverishing out-of-pocket health expenditure in Ethiopia: Evidence from the Ethiopia Socioeconomic Survey
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Date
2023-06
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Addis Ababa University
Abstract
Background: Out of pocket payment remains one of the ways to finance health care in Ethiopia
accounting for 31%. These out of pocket health expense leads citizens’ face catastrophic and
impoverishing expenditure. The most recent survey-based study of catastrophic and impoverishing
health expenditure was done from the 2015/16 consumption and expenditure survey with finding
of 2.1% and 1% respectively.
Objective: To assess catastrophic and impoverishing out of pocket health expenditure and the
determinant factors of catastrophic health expenditure in Ethiopia, 2023 from the 2018/19
socioeconomic survey.
Methodology: A secondary data from Ethiopian socioeconomic survey 2018/19 conducted by
Ethiopia’s Central Statistical Agency and World Bank was used to assess the catastrophic and
impoverishing health expenditure at the national and subnational level by the Wagstaff and van
Doorslaer and Xu. Et.al Methodology. Then binary logistic regression was computed by the
STATA (ver.12) software to assess the determinant factors of catastrophic health expenditure.
Result: From 6770 households 1.49% and 0.89% of them in Ethiopia faced catastrophic and
impoverishing health expenditure respectively at 10% threshold level and households having a
member with more facility visit had increased likelihood of facing catastrophic health expenditure
(AOR=2.45, 95%CI; 1.6- 3.8) and also having member being hospitalized in the household had
increased odds of facing catastrophic health expenditure (AOR=1.9, 95%CI; 1.19- 3.16). On the
contrary, there is a decreased likelihood of facing catastrophic health expenditure among those
who were insured for health (AOR= 0.58, 95%CI; 0.35- 0.97) and was in the richest consumption
quintile group (AOR=0.6, 95%CI; 0.47- 0.65).
Conclusion and recommendation; The finding indicate that there are still notable households
facing catastrophic and impoverishing out of pocket health expenditure in Ethiopia especially in
the lower consumption quintiles indicating inequity. In addition it is found that those with health
insurance coverage, lower hospitalization and health service utilization had lower chance of facing
catastrophic health payment. So it is suggested that activities that reduce hospitalization rate,
increase insurance coverage and addressing the poor must be in place so that the catastrophic health
cost incurred can be lowered at national level.
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Keywords
Health expenditure, Ethiopia