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Leaving no one behind in health: Financial hardship to access health care in Ethiopia

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  • Yawkal Tsega
  • Gebeyehu Tsega
  • Getasew Taddesse
  • Gebremariam Getaneh

Abstract

Background: Financial hardship (of health care) is a global and a national priority area. All people should be protected from financial hardship to ensure inclusive better health outcome. However, financial hardship of healthcare has not been well studied in Ethiopia in general and in Debre Tabor town in particular. Therefore, this study aimed to assess the incidence of financial hardship of healthcare and associated factors among households in Debre Tabor town. Methods: Community based cross sectional study was conducted, from May 24/2022 to June 17/2022, on 423 (selected through simple random sampling) households. Financial hardship was measured through catastrophic (using 10% threshold level) and impoverishing (using $1.90 poverty line) health expenditures. Patient perspective bottom up and prevalence based costing approach were used. Indirect cost was estimated through human capital approach. Bi-variable and multiple logistic regressions were used. Results: The response rate was 95%. The mean household annual healthcare expenditure was Ethiopian birr 12050.64 ($227.37). About 37.1% (95%CI: 32, 42%) of the households spend catastrophic health expenditure with a 10% threshold level and 10.4% of households were impoverished with $1.90 per day poverty line. Being old, with age above 60, (AOR: 4.21, CI: 1.23, 14.45), being non-insured (AOR: 2.19, CI: 1.04, 4.62), chronically ill (AOR: 7.20, CI: 3.64, 14.26), seeking traditional healthcare (AOR: 2.63, CI: 1.37. 5.05) and being socially unsupported (AOR: 2.77, CI: 1.25, 6.17) were statistically significant factors for catastrophic health expenditure. Conclusion: The study showed that significant number of households was not yet protected from financial hardship of healthcare. The financial hardship of health care is stronger among the less privileged populations: non-insured, the chronically diseased, the elder and socially unsupported. Therefore, financial risk protection strategies should be strengthened by the concerned bodies.

Suggested Citation

  • Yawkal Tsega & Gebeyehu Tsega & Getasew Taddesse & Gebremariam Getaneh, 2023. "Leaving no one behind in health: Financial hardship to access health care in Ethiopia," PLOS ONE, Public Library of Science, vol. 18(3), pages 1-17, March.
    • Handle: RePEc:plo:pone00:0282561
    DOI: 10.1371/journal.pone.0282561
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    References listed on IDEAS

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    1. Gebeyehu Tsega & Gebremariam Getaneh & Getasew Taddesse, 2021. "Are Ethiopian diabetic patients protected from financial hardship?," PLOS ONE, Public Library of Science, vol. 16(1), pages 1-14, January.
    2. Adam Wagstaff & Eddy van Doorslaer, 2003. "Catastrophe and impoverishment in paying for health care: with applications to Vietnam 1993–1998," Health Economics, John Wiley & Sons, Ltd., vol. 12(11), pages 921-933, November.
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