The Determinants of Catastrophic Health Expenditure and Coping Strategies for Households with People Living With HIV/AIDS in the Nkambe District Hospital, Cameroon

Authors

  • Bereynuy Jude Cholong
  • Kinga Bertila Mayin
  • Njong Mom Aloysius

DOI:

https://doi.org/10.47672/ejhs.945
Abstract views: 221
PDF downloads: 175

Keywords:

Determinants, Catastrophic Health Expenditure, Coping Strategies, HIV/AIDS and Cameroon

Abstract

Purpose: Despite free distribution of HIV/AIDs medication to patients, the expenditures on HIV/AIDS care and treatment can still be catastrophic to patients and their households due to the costs of other components (indirect cost) of care. This work was aimed at investigating the determinants of catastrophic health expenditure and the coping strategies for households with people living with HIV/AIDS in the Nkambe District Hospital, Cameroon.

Methodology: Data were collected using an administered questionnaire and secondary data from patients’ files, analyzed using frequencies and logistic regression. A convenient and purposive sample of 346 participants were enrolled (281 outpatients and 65 inpatients).

Results: Results show that the incidence of CHE was 20.3% for outpatient and 66.7% for inpatient visits, considering a 40% threshold. Factors that determine CHE identified were: use of motorbike as mode of transport (OR = 2.058, p-value = 0.05), divorced (OR 4.354, p-value = 0.033), borrowing (OR = 2.229, p-value = 0.027) and support from family members (OR = 2.367, p-value = 0.001).  The most common coping strategies adopted by participants were increasing working hours and support from friends and relatives with half of the participants seeing these strategies as sustainable.

Conclusion: It was concluded that the subsidization of ART services is not sufficient to eliminate the economic burden of treatment on HIV patients as many households still experienced CHE.

Recommendations: The study recommends implementing effective community dispensation of ARVs, Multimonth dispensation as measures to curb transportation cost. Also, implementation of the elimination of user fee policy for other HIV services. Finally, accelerating the process of universal health coverage in Cameroon will go a long way to help HIV patients and their households.

Downloads

Download data is not yet available.

Author Biographies

Bereynuy Jude Cholong

HIV/AIDS Prevention and Control Program, Cameroon Baptist Convention Health System, Bamenda, Cameroon.

Department of Health Economics, Policy and Management, Faculty of Business and Management Sciences, Catholic University of Cameroon (CATUC) Bamenda, Cameroon

Kinga Bertila Mayin

Department of Health Economics, Policy and Management, Faculty of Business and Management Sciences, Catholic University of Cameroon (CATUC) Bamenda, Cameroon

Njong Mom Aloysius

Department of Health Economics, Policy and Management, Faculty of Business and Management Sciences, Catholic University of Cameroon (CATUC) Bamenda, Cameroon

Faculty of Economics and Management Sciences, University of Bameda. Bambili, Cameroon

References

Adhkari, S., Maskay N., Sharma B. (2009). Paying for Hopsital-based care of Kalazar in Nepal: assessing catastrophic, improverishment and economic consequences. Health Policy Plan, 24(2), 129-39.

Amaya Lara J., Ruis GF. (2011). Determining factors of Catastrophic health expenditure in Bogota,Colombia. Int J Health care Finance Econ, 11:83-100.

Aregbeshola B.S, Khan S.M. (2018). Determinants of Catastrophic health expenditure in Nigeria. Eur J Health Econ, 19:521-532.

Barennes H., Frichittavong A., Gripenberg M., Koffi P. (2015). Evidence of high out of pocket spending for HIV care leading to catastrophic expenditure for affected patients in Lao Peoples democratic Republic. PLoS ONE, 10:8.

Batteh, S., Forsythe S., Martin G., Chettra T. (2008). Confirming the impact of HIV/AIDS epidermics in households vulnerability in Asia: The case of Cambodia. AIDS, 22(1), 103-11

Bell, C., Dvarajan S., Gersbach H. (2003). The long-run economic cost of Costs. Theory application tO South Africa. Heidelberg, Germany: University of Heidelberg.

Buigut S., Ettarch R., Amendah D. (2015). Catastrophic health expenditure and its determinants in Jenyan Slum communitiies. Int J for Equity in health, 14;46.

CAMPHIA. (2018). Cameroon Population-based HIV impact assessment preliminary findings. Yaounde: MINSANTE.

Chuma, J.,Gilson, L., Molyneux, C. (2007). Treatment seeking behaviou, Cost Burden and Coping strategies among rulal and urban Households in Coastal Kenya: an equity analysis. Tropical Medicine and internal Health, 12:673-686.

COP. (2016). Cameroon Country operational plan: strategic directory summary. PEPFAR.

Dhaliwal, M., Ellman T. (2003). Improving access to antiretroviral treatment in Cambodia. Cambodia: Eldis.

DHS. (2011). Cameroon demographic health survey report . Yaounde: Natitonal institute of statistics.

Etiaba, E., Onwujekwe O., Torpey K., Uzuchukwu B., Chiegil R. (2016). whta is the ecconomic burden of HIV/AIDS on patients in Nigeria and is this burden catastrophic to the households? PLoS ONE, 12(11).

Galarraga O., Sosa-Rubi SG, Salinas-Rodriguez A., sesma-Vaquez S. (2010). Health insurrance for the poor: impact on catastrophic and out-of-pocket payment in Mexico. Eur J Health Econ, 1:437-47.

Garg, C., Karan, A. (2005). Reducung out-of-pocket expenditure to reduce income poverty- evidence from india. World Health Organisation.

Gotsadze, G., Zoidze, A., Rukhadze N.,. (2009). Household catastrophic heath expenditure: Evidence from Georgia and its policy implication. BMC Health Service Research, 9:69.

Hecht, R., Alban A., Taylor K., Post S., Anderson N., Schwarz R. (2006). Putting it together: AIDS and the millenium development goals. PLoS Med, 3(11), 455.

Kerjcie, R. V., Morgan, D. W. (1970). Determining sample for research activities. Educational and Psychological Measurement, 30, 607-610.

Kipp, W., Tindyebwa D., Karamagi E., Rubaale T. (2006). Family caregiving to AIDS patients: the role of gender in caregiver burden in Uganda. Journal of international women's study, 7(4), 1-12.

Kumarasamy, N., Ventatesh K., Mayer K., Freedberg K. (2007). Financial burden of Health services for people with HIV/AIDS in India. Indian Med Res, 509-17.

Leive A., Xu k. (2008). coping with out-of-pocket health payments: empirical evidence from 15 countries. bulletin of World Health Organisation, 86:849-856.

Li Y., Wu Q., Xu L., Legge D.,Hao Y., Gao L.,. (2012). Factors affecting catastrophic health expenditure and improverishment from medical expenses : policy implication of u Limwanttananon S., Tangcharoensathien V., Prakongsai P. (2007). catastrophic and poverty impacts of health payments: results from national household survey in Thailand. Bull World Health Organ, 85:600-6.

Marlink, R., FOrsythe S., Bertozzi S., Muirhead D., Holmes M.,Sturchio J. (2008). the economic impact of HIV/AIDS on households and economes. AIDS, 22:87-8.

MINSANTE. (2018). Population cible de sante. Yaounde: Ministry of Public Health.

Moon S., Van Leemput L., Durier N., Jambert E., Dahamane A., Jie Y., Wu G., Phillips N.,Hu Y., Sanranchu P.,. (2008, Sep). Out-of-pocket cost of AIDS in China. are freeAnitretroviral drugs enough? AIDS Care, 984-94.

Murray C., Knual F., Musgrove P.,Xu K.,. (2000). Defining and measuring fairnes in financial contribution to health system. World Health Organisation .

NACC. (2017). Annual Report of 2016 activities for the fight against HIV/AIDS and STIs in Cameroon. Yaounde: National AIDS control committee.

Pal, R. (2012). Measuring incidence of catastrophic out-of-pocket health expenditure: with application to India. Int J Healthcae finance Econs, 12:63-85.

Poudel, A., Newland D.,Simkhada P. (2015). Economic Burden of HIV/AIDS upon households in Nepal: A critical review. Nepal journal of Epidemiology, 5(3), 502-10.

Riyarto, S., Hidayat B., Johns B., Probandari A., mahendradhata Y., Utarini A., Trisnantoro l., flessenkaemper S. (2010). The Financial Burden of HIV care, including Antiretroviral therapy, on patients in 3 sites in indonesia. Health Policy and Planning, 25(4), 272-282.

Russell, S. (2004, August). The Economic Burden of Illness for Households in Developing:A Review of studies Focusing on M alaria, Tuberculosis, and Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome,. American Journal of Tropical Medicine and Hygiene, 71(2).

Su, T., Kouyate B., Flessa S. (2006). Catastrophic household expenditure for health care in a low income society : A study from Nouna District, Burkina Fasso. Bull World Health Organ, 84:21-7.

Tin T.S., Kouyate B., Flessa S.,. (2006). Catastrophic Household Expenditure for health care in a low income society:A study from Nouna District, Burkina Faso. Bulletin of the World Health Organisation, 84:21-27.

UNDP. (2007). Poverty programmes to benefit from new data. Kuala Lumpur.

Wagner, G., Ryan G.,Huynh A., Kityo C., Muyengyi T. (2009). A quality analysis of the economic impact of HIV and antiretroviral therapy on individuals and households in Uganda. AIDS Patient Care, 23(9), 793-8.

Wagstaff A., van Doorslaer E. (2003). catastrophe and impverishment in paying for healthcare; with application to Vietnam 1993-1998. Health Econs, 12:921-34.

WHO. (2015). World health organisation , test and treat recommendations. Geneva: World Health Organisation.

Xu,K., Evans, D.B., Kwabata K., Zeramdini, R.,K. (2003). Household Catastrophic Health Expenditure: A multicounty Analysis. The Lancet, 362: 111-117.

Downloads

Published

2022-02-26

How to Cite

Cholong, B. J. ., Mayin, K. B. ., & Aloysius, N. M. . (2022). The Determinants of Catastrophic Health Expenditure and Coping Strategies for Households with People Living With HIV/AIDS in the Nkambe District Hospital, Cameroon. European Journal of Health Sciences, 7(1), 36 - 48. https://doi.org/10.47672/ejhs.945

Issue

Section

Articles