Volume 07 Issue 04 April 2024
Hans Ferry Wandji
Faculty of Economic and Management, University of Dschang, Dschang, Cameroon
DOI : https://doi.org/10.47191/ijsshr/v7-i04-09Google Scholar Download Pdf
ABSTRACT
The objective of this article is to study the exposure of Cameroonian households to the financial risk linked to catastrophic health expenditure. The study population is made up of households and the data used come from the fourth Cameroon Household Survey conducted in 2014. The statistical and econometric methods deployed are essentially descriptive statistics, hypothesis tests and logistic regression. Analyzes show that Cameroonian households spend an average of 5% of their total expenditure on health. Medication, used primarily by poor households, represents the first health service, followed by consultation and hospitalization, much more used by rich households. A significant proportion of Cameroonian households (10.33%) devote at least 10% of their income to direct payment for health care and services. The incidence of impoverishment due to these direct payments is 1.29%. The socioeconomic characteristics of Cameroonian households are the main determinants of their catastrophic health expenditures and their impoverishment due to direct payments for health care and services.
KEYWORDS:Financial risk in health; out-of-pocket payments for health care and services; catastrophic health expenditure; impoverishment.
REFERENCES1) Ezzrari, Abdeljaouad & Fellousse, Asma. (2018). Study of catastrophic individual expenditure and its impact on household impoverishment: the case of Morocco. 10.13140/RG.2.2.10753.35688.
2) Adam Wagstaff (2002), Poverty and inequality in the health sector. WHO Bulletin, 80(2), 97-105.
3) Amemiya T. (1981)"Qualitative Response Models: A Survey", Journal of Economic Litterature, 19(4), 481-536
4) Anyanwu, J. C., & Erhijakpor, A. E. (2007). Health Expenditures and Health Outcomes in Africa. Economic Research Working Paper 91 African Development Bank.
5) Barros A, Bastos J-L, Damaso, A. (2011). Catastrophic spending on health care in Brazil: private health insurance does not seem to be the solution. Cad. Saude Publica, Rio de Janeiro, 27 (2), S254-S262.
6) Beegle, K., Christiaensen, L., Dabalen, A., Gaddis, I (2016). Poverty in a rising Africa. The World Bank Africa poverty report.
7) Berthélemy, J.-C., & Seban, J. (2009). Health expenditure and equity in access to health services in developing countries. Journal of Development Economics, 33-71.
8) Boidin, B. (2015). Extension of health coverage and community based health insurance schemes in Africa: myths and realities. Bull. Soc. Pathol. Exot, 63-69.
9) Cameroon Household Survey Report (ECAM 2014), Cameroon.
10) Carrin, G., & James, C. (2005). Social Health Insurance: Key Factors Affecting the Transition towards Universal Coverage. International Social Security Review, 45-64.
11) Carrin, G., James, C. (2005). Key Performance Indicators for the Implementation of Social Health Insurance. Appl Health Econ Health Policy, 15-22.
12) Carrin, G., James, C., Evans, D. (2006). Achieving universal health coverage: The development of the financing system. World Bank report, 149-161.
13) Castro-Leal, F., Dayton, J., Demery, L., & Mehra, K. (2000). Public spending on health care in Africa: health care in Africa? Bulletin of the World Health Organization, 66-77.
14) Chokri, A. (2015). Does universal health coverage reduce social inequalities in health? Health & Medecine, 1-29.
15) D.W. Hosmer, S. Lemeshow (2000), Applied Logistic Regression. Wiley Series in Probability and Mathematical Statistics.
16) Denis Raynaud (2005), Individual determinants of health expenditure: the influence of social category and complementary health insurance,
17) Dukhan, Y. (2010). Improve the efficiency of health systems and financial protection against disease risk in developing countries. Humanities and Social Sciences University of Auvergne-Clermont-Ferrand I.
18) Dumoulin, J., & Miloud, K. (1993). The payment of care by users in sub-Saharan African countries: economic rationality and other subsequent questions: Social sciences and health, 81-119.
19) Edoka, I., McPake, B., Ensor, T., Amara, R., & Edem-Hotah, J. (2017). Changes in catastrophic health expenditure in post-conflict Sierra Leone: an Oaxaca-blinder decomposition analysis. International Journal for Equity in Health.
20) Eiko Saito & al (2014), Catastrophic household expenditure on health in Nepal: a cross-sectional survey, WHO Bulletin, 24(92), 760-767.
21) Eloko Eya Matangelo & al (2018), Study on the analysis of protection against financial risks in health. Case of the Democratic Republic of Congo. Journal d’Épidémiologie et de Santé Publique, 18(20), 197-211.
22) F. Duyme et al (2005), Quality of validation of binary logistic regression models. Journal of Applied Statistics, 53(3), 91-102.
23) Grossman, M. (1972). On the Concept of Health Capital and the Demand for Health. The Journal of Political Economy, 223-255.
24) Isabelle Joumard, André, C., & Nicq, C. (2010). Health care systems: Efficiency and institutions. Economics Department working papers.
25) Kawabata K, Xu K, & Carrin G (2002). Preventing impoverishment through protection against catastrophic health expenditure, Bulletin of the World Health Organization, Vol. 80 (8).
26) Klein, Spady & Spady (1993). An Efficient Semi Parametric Estimator for Binary Response Models, Econometrica, 61, 387-421
27) Lombrail, P., & Pascal, J. (2005). Social inequalities in health and access to care. Revue les tribunes de la santé, 3-31.
28) M. El Sanharawi & F. Naudet (2013), Understanding Logistic Regression. French Journal of Ophthalmology, 36(8), 710-715.
29) McIntyre D, Thiede M, Dahlgren G et al. (2006) “What are the economic consequences for households of illness and of paying for health care in low and middle-income country contexts?” Social Science & Medicine 62, 858-865.
30) Michael Grossman (1972), “On the concept of health capital and the demand for health”. Journal of political economy, 80(26), 223-225.
31) Nahar S, Costello A. (1998), “The hidden cost of free maternity care in Dhaka, Bangladesh”. Health Policy and Planning, 13(4), 417-422. Oxford University Press 1998.
32) OMS (2010), World Health Report: health financing, the path to Universal Health Coverage. Geneva: WHO.
33) Pascal, J., Abbey-Huguenin, H., & Lombrail, P. (2006). Social inequalities in health: what impact on access to preventive care? Social Link and Policies, 115-124.
34) Russel S (2005). Illuminating cases: Understanding the economic burden of illness through case study household research. Health Policy & Planning, 20(5), 277-289.
35) Russell S (2004). The economic burden of illness for household in developing countries: a review of studies focusing on malaria, tuberculosis and HIV/AIDS. The American Journal of Tropical Medicine and Hygiene 71(2), 147-155.
36) Séne, L. M., & Cissé, M. (2015). Catastrophic out-of-pocket payments for health and poverty nexus: evidence from Senegal. Int J Health Eco Manage, 307-328.
37) Sow, M., & D, M. (2013). Analysis report on catastrophic health expenditure and its impact on impoverishment and the use of services in Senegal, 2005 and 2011.
38) Tin Tin Su & al., (2006). Catastrophic household expenditure for health care in a low-income society: a study from Nouna District, Burkina Faso. Bulletin de l’OMS, 86, and 21-27.
39) Wagstaff A, van Doorslaer E (2003). Catastrophic and impoverishment in paying for health care: with applications to Vietnam 1993-1998. Health Econ, 12, 921-34.
40) Wagstaff, A. (2010). Benefit Incidence Analysis: Are Government Health Expenditures More Pro‐rich Than We Think? Policy Research Working Paper. The World Bank Development Research Group.
41) Wagstaff, A., Flores, G., Hsu, J., Smitz, M.-F., Chepynoga, K., Buisman, L. R., Eazenou, P. (2017). Progress on catastrophic health spending in 133 countries: a retrospective observational study. Lancet Glob Health 2017.
42) WHO (2005). Designing health financing systems to reduce catastrophic health expenditure. Technical briefs for policy makers. WHO/EIP/HSF/PB 05.02. Number 2.
43) WHO (2014), The impact of health expenditure on households and health care financing options. Geneva: WHO.
44) WHO (2015), Health and human rights. Geneva: WHO.
45) WHO (2019), Analysis of Financial Risk Protection in Health, World Health Organization.
46) Xu K, Evans DB, Kawabata K, et al., (2003). Household catastrophic health expenditure: a multicountry analysis. Lancet, 362 (9378), 111-17.
47) Xu K., Evans, D. B., Carrin, G., Aguilar-Rivera, A. M., Musgrove, P., & Evans, T. (2007). Protecting Households from Catastrophic Health Spending. Health Affairs, 972-983.