Determinants and Impact of Households’s Out-of-Pocket Health Care Expenditure in Sudan: Evidence From Urban and Rural Population

This study examines the determinants of out of pocket (OOP) health expenditures and the factors that associated with the risk of catastrophic health expenditure in Sudan. It also investigates the effect of OOP health expenditure on poverty incidence in the country. The study uses the National Baseline Household Survey (NBHS) data, 2009, for national, urban and rural levels of population. To strengthen the insight of findings, the analysis of OOP expenditure is also executed for different income groups. The results show that factors such as household’s income, incidence of disease, education, household size, number of household’s members over 65 years and below 5 years old are the most important factors affecting health expenditures. The results also indicate that the number of elderly member and children and household belonging to the lowest income quintiles are the most significant variables that increase the risk of incurring catastrophic health expenditures. In addition, the results reveal that a household with catastrophic health expenditure tends to reduce its budget share allocated to education, food and other items. Moreover, the empirical results indicate that health expenditure pushes a considerable portion of Sudanese households into poverty, thus, increases poverty rates in the country. Finally, the paper ends with some recommendations that aim at assisting policymakers in designing an appropriate health system strategy to protect households against the risk of OOP health expenditures and to reduce impoverishment effect when become catastrophic.