Assessing catastrophic and impoverishing effects of health care payments in Uganda

Type Journal Article - BMC health services research
Title Assessing catastrophic and impoverishing effects of health care payments in Uganda
Author(s)
Volume 15
Issue 1
Publication (Day/Month/Year) 2015
URL https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-015-0682-x
Abstract
Background
Direct out-of-pocket payments for health care are recognised as limiting access to health care services and also endangering the welfare of households. In Uganda, such payments comprise a large portion of total health financing. This study assesses the catastrophic and impoverishing impact of paying for health care out-of-pocket in Uganda.

Methods
Using data from the Uganda National Household Surveys 2009/10, the catastrophic impact of out-of-pocket health care payments is defined using thresholds that vary with household income. The impoverishing effect of out-of-pocket health care payments is assessed using the Ugandan national poverty line and the World Bank poverty line ($1.25/day).

Results
A high level and intensity of both financial catastrophe and impoverishment due to out-of-pocket payments are recorded. Using an initial threshold of 10% of household income, about 23% of Ugandan households face financial ruin. Based on both the $1.25/day and the Ugandan poverty lines, about 4% of the population are further impoverished by such payments. This represents a relative increase in poverty head count of 17.1% and 18.1% respectively.

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