Assessing catastrophic and impoverishing effects of health care payments in Uganda

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dc.contributor.authorKwesiga, Brendan
dc.contributor.authorZikusooka, Charlotte M
dc.contributor.authorAtaguba, John E
dc.coverage.spatialUgandaen_ZA
dc.date.accessioned2015-02-05T04:01:02Z
dc.date.available2015-02-05T04:01:02Z
dc.date.issued2015-01-22
dc.date.updated2015-01-28T19:05:09Z
dc.description.abstractBackground: Direct out-of-pocket payments for health care are recognised as limiting access to health care services and also endangering the welfare of households. In Uganda, such payments comprise a large portion of total health financing. This study assesses the catastrophic and impoverishing impact of paying for health care out-of-pocket in Uganda. Methods: Using data from the Uganda National Household Surveys 2009/10, the catastrophic impact of out-of-pocket health care payments is defined using thresholds that vary with household income. The impoverishing effect of out-of-pocket health care payments is assessed using the Ugandan national poverty line and the World Bank poverty line ($1.25/day). Results: A high level and intensity of both financial catastrophe and impoverishment due to out-of-pocket payments are recorded. Using an initial threshold of 10% of household income, about 23% of Ugandan households face financial ruin. Based on both the $1.25/day and the Ugandan poverty lines, about 4% of the population are further impoverished by such payments. This represents a relative increase in poverty head count of 17.1% and 18.1% respectively. Conclusion: The absence of financial protection in Uganda’s health system calls for concerted action. Currently, out-of-pocket payments account for a large share of total health financing and there is no pooled prepayment system available. There is therefore a need to move towards mandatory prepayment. In this way, people could access the needed health services without any associated financial consequence.en_ZA
dc.identifier.apacitationKwesiga, B., Zikusooka, C. M., & Ataguba, J. E. (2015). Assessing catastrophic and impoverishing effects of health care payments in Uganda. <i>BMC Health Services Research</i>, http://hdl.handle.net/11427/12380en_ZA
dc.identifier.chicagocitationKwesiga, Brendan, Charlotte M Zikusooka, and John E Ataguba "Assessing catastrophic and impoverishing effects of health care payments in Uganda." <i>BMC Health Services Research</i> (2015) http://hdl.handle.net/11427/12380en_ZA
dc.identifier.citationKwesiga, B., Zikusooka, C. M., and Ataguba, J. E. (2015). Assessing catastrophic and impoverishing effects of health care payments in Uganda. BMC Health Services Research, 15(1), 30.en_ZA
dc.identifier.issn1472-6963
dc.identifier.ris TY - Journal Article AU - Kwesiga, Brendan AU - Zikusooka, Charlotte M AU - Ataguba, John E AB - Background: Direct out-of-pocket payments for health care are recognised as limiting access to health care services and also endangering the welfare of households. In Uganda, such payments comprise a large portion of total health financing. This study assesses the catastrophic and impoverishing impact of paying for health care out-of-pocket in Uganda. Methods: Using data from the Uganda National Household Surveys 2009/10, the catastrophic impact of out-of-pocket health care payments is defined using thresholds that vary with household income. The impoverishing effect of out-of-pocket health care payments is assessed using the Ugandan national poverty line and the World Bank poverty line ($1.25/day). Results: A high level and intensity of both financial catastrophe and impoverishment due to out-of-pocket payments are recorded. Using an initial threshold of 10% of household income, about 23% of Ugandan households face financial ruin. Based on both the $1.25/day and the Ugandan poverty lines, about 4% of the population are further impoverished by such payments. This represents a relative increase in poverty head count of 17.1% and 18.1% respectively. Conclusion: The absence of financial protection in Uganda’s health system calls for concerted action. Currently, out-of-pocket payments account for a large share of total health financing and there is no pooled prepayment system available. There is therefore a need to move towards mandatory prepayment. In this way, people could access the needed health services without any associated financial consequence. DA - 2015-01-22 DB - OpenUCT DO - 10.1186/s12913-015-0682-x DP - University of Cape Town J1 - BMC Health Services Research LK - https://open.uct.ac.za PB - University of Cape Town PY - 2015 SM - 1472-6963 T1 - Assessing catastrophic and impoverishing effects of health care payments in Uganda TI - Assessing catastrophic and impoverishing effects of health care payments in Uganda UR - http://hdl.handle.net/11427/12380 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/12380
dc.identifier.urihttp://dx.doi.org/10.1186/s12913-015-0682-x
dc.identifier.vancouvercitationKwesiga B, Zikusooka CM, Ataguba JE. Assessing catastrophic and impoverishing effects of health care payments in Uganda. BMC Health Services Research. 2015; http://hdl.handle.net/11427/12380.en_ZA
dc.languageengen_ZA
dc.language.rfc3066en
dc.publisherBioMed Centralen_ZA
dc.publisher.departmentHealth Economics Uniten_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsCreative Commons Attribution 4.0 International (CC BY 4.0)*
dc.rights.holderKwesiga et al.; licensee BioMed Central.
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_ZA
dc.sourceBMC Health Services Researchen_ZA
dc.source.urihttp://www.biomedcentral.com/1472-6963
dc.subject.otherFinancial health protectionen_ZA
dc.subject.otherOut-of-pocket paymentsen_ZA
dc.subject.otherCatastrophic paymentsen_ZA
dc.subject.otherImpoverishmenten_ZA
dc.titleAssessing catastrophic and impoverishing effects of health care payments in Ugandaen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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