Catastrophic health expenditure in sub-Saharan Africa: systematic review and meta-analysis
Bull. W.H.O. (Online)
; 105(5): 337-351, 2022. figures, tables
Artigo
em Inglês
| AIM
| ID: biblio-1372829
Biblioteca responsável:
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.
Texto completo:
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Índice:
AIM (África)
Assunto principal:
Características da Família
/
Doença Catastrófica
/
Incidência
/
Gastos em Saúde
/
África Subsaariana
Tipo de estudo:
Avaliação Econômica em Saúde
/
Estudo de incidência
/
Estudo prognóstico
/
Revisões Sistemáticas Avaliadas
Limite:
Feminino
/
Humanos
/
Masculino
País/Região como assunto:
África
Idioma:
Inglês
Revista:
Bull. W.H.O. (Online)
Ano de publicação:
2022
Tipo de documento:
Artigo
Instituição/País de afiliação:
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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