IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0205745.html

The economic impact of non-communicable diseases among households in South Asia and their coping strategy: A systematic review

Author

Listed:
  • Anupa Rijal
  • Tara Ballav Adhikari
  • Jahangir A M Khan
  • Gabriele Berg-Beckhoff

Abstract

Background: Out of pocket payment (OOPP), is the major health financing mechanism in South Asia region. With the rising burden of non-communicable diseases (NCDs), the region is facing a high financial burden. However, the extent and nature of economic impact caused by treatment and management of NCDs at the household level is yet unknown. Method: We conducted a systematic review using Medline and Embase databases. Only peer-reviewed quantitative studies published between January 2000 to December 2016 assessing OOPP or catastrophic health expenditure or impoverishment or financial coping strategy due to at least one of the four major NCDs—cardiovascular diseases(CVDs), diabetes, cancer, chronic respiratory disease in South Asia region was included in the review. The review is registered in PROSPERO no: CRD42017059345. Results: A total of 21 studies (of 2693 records identified) met the inclusion criteria. The economic impact was most frequently studied in CVDs and in terms of OOPP. The studies collectively indicated high OOPP, higher likelihood of catastrophic expenditure and impoverishment for inpatient care for these major NCDs which was visible in all income levels. Borrowing and selling off assets were the most common forms of coping strategies adopted and varied inconsistently between urban and rural households. The true extent of the economic impact, however, remains difficult to determine due to methodological heterogeneity regarding outcomes reported and measures employed for calculation of OOPP, catastrophic expenditure, and impoverishment across these four major NCDs and between nations. Conclusion: The economic impact due to treatment and management of CVDs, diabetes, cancer and chronic respiratory diseases among households in South Asia seems dire. Given the lack of sufficient evidence the review stresses the need for further research in the region to develop evidence-informed nationally tailored prepayment mechanisms covering NCDs to reduce economic vulnerability and standardization of tools measuring the economic impact for generating comparable estimates.

Suggested Citation

  • Anupa Rijal & Tara Ballav Adhikari & Jahangir A M Khan & Gabriele Berg-Beckhoff, 2018. "The economic impact of non-communicable diseases among households in South Asia and their coping strategy: A systematic review," PLOS ONE, Public Library of Science, vol. 13(11), pages 1-23, November.
    • Handle: RePEc:plo:pone00:0205745
    DOI: 10.1371/journal.pone.0205745
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0205745
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0205745&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0205745?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Kankeu Tchewonpi, Hyacinthe & Saksena, Priyanka & Xu, Ke & Evans, David B, 2013. "The financial burden from non-communicable diseases in low- and middle-income countries: a literature review," MPRA Paper 54534, University Library of Munich, Germany.
    2. Syed Hamid & Syed Ahsan & Afroza Begum, 2014. "Disease-Specific Impoverishment Impact of Out-of-Pocket Payments for Health Care: Evidence from Rural Bangladesh," Applied Health Economics and Health Policy, Springer, vol. 12(4), pages 421-433, August.
    3. Manu Raj & Mary Paul & Abish Sudhakar & Anu Alphonse Varghese & Aareesh Chittulliparamb Haridas & Conrad Kabali & Raman Krishna Kumar, 2015. "Micro-Economic Impact of Congenital Heart Surgery: Results of a Prospective Study from a Limited-Resource Setting," PLOS ONE, Public Library of Science, vol. 10(6), pages 1-13, June.
    4. Ties Boerma & Patrick Eozenou & David Evans & Tim Evans & Marie-Paule Kieny & Adam Wagstaff, 2014. "Monitoring Progress towards Universal Health Coverage at Country and Global Levels," PLOS Medicine, Public Library of Science, vol. 11(9), pages 1-8, September.
    5. Alan M. Taylor & Mark P. Taylor, 2004. "The Purchasing Power Parity Debate," Journal of Economic Perspectives, American Economic Association, vol. 18(4), pages 135-158, Fall.
    6. John Tayu Lee & Fozia Hamid & Sanghamitra Pati & Rifat Atun & Christopher Millett, 2015. "Impact of Noncommunicable Disease Multimorbidity on Healthcare Utilisation and Out-Of-Pocket Expenditures in Middle-Income Countries: Cross Sectional Analysis," PLOS ONE, Public Library of Science, vol. 10(7), pages 1-18, July.
    7. Alan M. Taylor & Mark P. Taylor, 2004. "The Purchasing Power Parity Debate," Journal of Economic Perspectives, American Economic Association, vol. 18(4), pages 135-158, Fall.
    8. Priyanka Saksena & Justine Hsu & David B Evans, 2014. "Financial Risk Protection and Universal Health Coverage: Evidence and Measurement Challenges," PLOS Medicine, Public Library of Science, vol. 11(9), pages 1-11, September.
    9. Ajay Mahal & Anup Karan & Victoria Y Fan & Michael Engelgau, 2013. "The Economic Burden of Cancers on Indian Households," PLOS ONE, Public Library of Science, vol. 8(8), pages 1-10, August.
    10. Indrani Gupta & Arjun Roy, 2018. "Economic Studies on Non-Communicable Diseases and Injuries in India: A Systematic Review," Applied Health Economics and Health Policy, Springer, vol. 16(3), pages 303-315, June.
    11. O'Donnell, Owen & van Doorslaer, Eddy & Rannan-Eliya, Ravi P. & Somanathan, Aparnaa & Adhikari, Shiva Raj & Akkazieva, Baktygul & Harbianto, Deni & Garg, Charu C. & Hanvoravongchai, Piya & Herrin, Ale, 2008. "Who pays for health care in Asia?," Journal of Health Economics, Elsevier, vol. 27(2), pages 460-475, March.
    12. Sauerborn, R. & Adams, A. & Hien, M., 1996. "Household strategies to cope with the economic costs of illness," Social Science & Medicine, Elsevier, vol. 43(3), pages 291-301, August.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Nazmul Islam, Muhammed & Rabbani, Atonu & De Allegri, Manuela & Sarker, Malabika, 2024. "Medical treatment loans and their effects on health care utilization and out-of-pocket expenditure: Evidence from an experiment in northern Bangladesh," World Development, Elsevier, vol. 184(C).
    2. Tien Thanh, Pham & Bao Duong, Pham, 2022. "The economic burden of non-communicable diseases on households and their coping mechanisms: Evidence from rural Vietnam," World Development, Elsevier, vol. 151(C).
    3. Afroze, Farhana, 2024. "The Invisible Burden Gender Disparities and Their Cascading Impact on NCD Risks in Bangladeshi Women," MPRA Paper 123520, University Library of Munich, Germany, revised 29 Jan 2025.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Asankha Pallegedara, 2018. "Impacts of chronic non-communicable diseases on households’ out-of-pocket healthcare expenditures in Sri Lanka," International Journal of Health Economics and Management, Springer, vol. 18(3), pages 301-319, September.
    2. Levent, Korap, 2007. "Modeling purchasing power parity using co-integration: evidence from Turkey," MPRA Paper 19584, University Library of Munich, Germany.
    3. Gürkaynak, Refet S. & Kısacıkoğlu, Burçin & Lee, Sang Seok, 2022. "Exchange rate and inflation under weak monetary policy: Turkey verifies theory," CFS Working Paper Series 679, Center for Financial Studies (CFS).
    4. Mohsen Bahmani-Oskooee & Tsangyao Chang & Kuei-Chiu Lee, 2016. "Panel asymmetric nonlinear unit root test and PPP in Africa," Applied Economics Letters, Taylor & Francis Journals, vol. 23(8), pages 554-558, May.
    5. Zanin, Luca & Marra, Giampiero, 2012. "Assessing the functional relationship between CO2 emissions and economic development using an additive mixed model approach," Economic Modelling, Elsevier, vol. 29(4), pages 1328-1337.
    6. N/A, 2007. "Real Convergence, Price Level Convergence and Inflation in Europe," Bruegel Working Papers 267, Bruegel.
    7. Simões, Oscar R. & Marçal, Emerson Fernandes, 2012. "Agregação temporal e não-linearidade afetam os testes da paridade do poder de compra: Evidência a partir de dados brasileiros," Revista Brasileira de Economia - RBE, EPGE Brazilian School of Economics and Finance - FGV EPGE (Brazil), vol. 66(3), October.
    8. Deng, Kent & O'Brien, Patrick, 2021. "The Kuznetsian paradigm for the study of modern economic history and the Great Divergence with appendices of literature review and statistical data," LSE Research Online Documents on Economics 108563, London School of Economics and Political Science, LSE Library.
    9. Liew, Venus Khim-Sen & Baharumshah, Ahmad Zubaidi & Habibullah, Muzafar Shah & Midi, Habshah, 2008. "Monetary exchange rate model: supportive evidence from nonlinear testing procedures," MPRA Paper 7293, University Library of Munich, Germany.
    10. Georgios Chortareas & George Kapetanios, 2013. "How Puzzling Is The Ppp Puzzle? An Alternative Half‐Life Measure Of Convergence To Ppp," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 28(3), pages 435-457, April.
    11. Grossmann, Axel & Kim, Jintae, 2022. "The impact of U.S. dollar movements and U.S. dollar states on non-perishable commodity prices," Research in International Business and Finance, Elsevier, vol. 61(C).
    12. Lukas Menkhoff & Rafael Rebitzky & Michael Schroder, 2008. "Do dollar forecasters believe too much in PPP?," Applied Economics, Taylor & Francis Journals, vol. 40(3), pages 261-270.
    13. Robert A. Blecker, 2009. "Long-Run Growth in Open Economies: Export-Led Cumulative Causation or a Balance-of-Payments Constraint?," Working Papers 2009-23, American University, Department of Economics.
    14. Derek Bond & Michael J. Harrison & Edward J. O'Brien, 2006. "Purchasing Power Parity: The Irish Experience Re-visited," Trinity Economics Papers tep200615, Trinity College Dublin, Department of Economics.
    15. Pei-Long Shen & Chih-Wei Su & Hsu-Ling Chang, 2013. "Are real GDP levels nonstationary across Central and Eastern European countries?," Baltic Journal of Economics, Baltic International Centre for Economic Policy Studies, vol. 13(1), pages 99-108, July.
    16. Michael Frömmel & Darko B. Vukovic & Jinyuan Wu, 2022. "The Dollar Exchange Rate, Adjustment to the Purchasing Power Parity, and the Interest Rate Differential," Mathematics, MDPI, vol. 10(23), pages 1-17, November.
    17. BAHMANI-OSKOOEE, Mohsen & Wu, Tsung-Pao, 2017. "Purchasing Power Parity in the 34 OECD Countries: Evidence from Quantile-Based Unit Root Tests with both Smooth and Sharp Breaks," MPRA Paper 81820, University Library of Munich, Germany, revised 07 Feb 2017.
    18. Ahmed, Shamim & Liu, Xiaoquan & Valente, Giorgio, 2016. "Can currency-based risk factors help forecast exchange rates?," International Journal of Forecasting, Elsevier, vol. 32(1), pages 75-97.
    19. Philip Hans Franses & Dick van Dijk, 2006. "A simple test for PPP among traded goods," Applied Financial Economics, Taylor & Francis Journals, vol. 16(1-2), pages 19-27.
    20. Michael Takudzwa Pasara & Vincent Mugwira, 2023. "Exchange Rate (MIS-) Alignment: An Application of the Behavioural Equilibrium Exchange Rate (beer) Approach to Zimbabwe (1990-2018)," International Journal of Economics and Financial Issues, Econjournals, vol. 13(5), pages 128-141, September.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0205745. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.