Catastrophic health expenditure in sub-Saharan Africa: systematic review and meta-analysis
Bull. W.H.O. (Online)
; 105(5): 337-351, 2022. figures, tables
Article
in English
| AIM
| ID: biblio-1372829
Responsible library:
CG1.1
ABSTRACT
Objective To estimate the incidence of, and trends in, catastrophic health expenditure in sub-Saharan Africa. Methods:
We systematically reviewed the scientific and grey literature to identify population-based studies on catastrophic health expenditure in sub-Saharan Africa published between 2000 and 2021. We performed a meta-analysis using two definitions of catastrophic health expenditure 10% of total household expenditure and 40% of household non-food expenditure. The results of individual studies were pooled by pairwise meta-analysis using the random-effects model.Findings:
We identified 111 publications covering a total of 1 040 620 households across 31 sub-Saharan African countries. Overall, the pooled annual incidence of catastrophic health expenditure was 16.5% (95% confidence interval, CI 12.920.4; 50 datapoints; 462 151 households; I2 = 99.9%) for a threshold of 10% of total household expenditure and 8.7% (95% CI 7.210.3; 84 datapoints; 795 355 households; I2 = 99.8%) for a threshold of 40% of household non-food expenditure. Countries in central and southern sub-Saharan Africa had the highest and lowest incidence, respectively. A trend analysis found that, after initially declining in the 2000s, the incidence of catastrophic health expenditure in sub-Saharan Africa increased between 2010 and 2020. The incidence among people affected by specific diseases, such as noncommunicable diseases, HIV/AIDS and tuberculosis, was generally higher.Conclusion:
Although data on catastrophic health expenditure for some countries were sparse, the data available suggest that a non-negligible share of households in sub-Saharan Africa experienced catastrophic expenditure when accessing health-care services. Stronger financial protection measures are needed.
Full text:
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Index:
AIM (Africa)
Main subject:
Family Characteristics
/
Catastrophic Illness
/
Incidence
/
Health Expenditures
/
Africa South of the Sahara
Type of study:
Health economic evaluation
/
Incidence study
/
Prognostic study
/
Systematic reviews
Limits:
Female
/
Humans
/
Male
Country/Region as subject:
Africa
Language:
English
Journal:
Bull. W.H.O. (Online)
Year:
2022
Type:
Article
Institution/Affiliation country:
Department of Community Medicine, Enugu State University Teaching Hospital/NG
/
Institute of Health Policy, Management & Evaluation, University of Toronto/CA
/
Paul Eze aDepartment of Health Policy and Administration, 504A Donald H. Ford Building, Pennsylvania State University, University Park/US
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