Household expenses in healthcare and its coping mechanism in rural Nepal

Authors

  • Aliza Shrestha Department of Public Health, Om Health Campus, Kathmandu, Nepal
  • Susmita Nepal Department of Public Health, Om Health Campus, Kathmandu, Nepal
  • Aassmi Poudyal Department of Public Health, Om Health Campus, Kathmandu, Nepal

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20213771

Keywords:

Household expenditure, Coping mechanism, Acute disease, Chronic illness

Abstract

Background: In Nepal, the most frequent mode of payment for health care is household expenditure. It accounts for more than half of all health-care expenditures. In addition, the study intends to investigate household expenditure on health care and its coping mechanisms in Nepal's rural districts.

Methods: This is a quantitative, cross-sectional study in which 410 households were chosen using a multiple sampling procedure. The research study region was chosen using a purposive sampling strategy. The two wards for the study were chosen by a lottery system. The estimated households were then chosen using a systematic random selection technique. A semi-structured questionnaire was utilized to gather data, and a face-to-face interview with the household head was undertaken to obtain the data. SPSS version 20 was used to analyze all of the data.

Results: The overall household health expenditure in Miklajung rural municipality was determined to be 31.7% in the previous six months, with the biggest expenditure in medicine/drugs or pharmacies, followed by in-patient care and health treatment abroad. Income/savings was discovered to be a major coping mechanism used to deal with household expenditure and was found to be significantly associated in a bivariate analysis with type of illness, age, and more with a confidence interval of 95% in a bivariate analysis.

Conclusions: At the conclusion of the investigation, we discovered that people spent the most money on medicines and drugs, followed by in-patient hospital care. According to the findings, a significant portion of the target group used their income and savings to cover unexpected healthcare costs.

References

Saito E, Gilmour S, Rahman MM, Gautam GS, Shrestha PK, Shibuya K. Catastrophic household expenditure on health in Nepal: a cross-sectional survey. Bull WHO. 2014;92(10):760-7.

World health Organization, Country Office for Nepal. Health System in Nepal: Challeneges and Strategic Options. Phulchowk, Lalitpur. 2007. Available at: https://apps.who.int/iris/bitstream/handle/10665/205258/B1361.pdf;sequence=1.

World Health Organization. out-of-pocket expenditure. 2014. Available at: https://apps.who.int/gho/data/view.main.GHEDOOPSCHESHA2011v.

His Majesty's Government of Nepal, National Planning Commission Secretariat, Central Bureau of Statistics. Nepal Living Standard Survey. Thapathali, Kathamndu, Nepal. 2006.

Daivadanam M, Thankappan KR, Sarma PS, Harikrishnan S. Catastrophic health expenditure and coping strategies associated with acute coronary syndrome in Kerala, India. Indian J Med Res. 2012;136(4):585-92.

Basumatary J, Srivastav N. Household's Coping Mechanism of Out-of-Pocket Expenditure pn Health Care: a Case Study of Assam, India. J Humanities Social Sci. 2018;23(1):70-84.

National Health Systems Resource Centre. Household Health Expenditures in India (2013-14). New Delhi: Ministry of Health and Family Welfare, Government of India. 2016.

Arenliu Qosaj F, Froeschl G, Berisha M, Bellaqa B, Holle R. Catastrophic expenditures and impoverishment due to out-of-pocket health payments in Kosovo. Cost Effectiveness and Resource Allocation. 2018;16(1):26.

Mahumud RA, Sarker AR, Sultana M, Islam Z, Khan J, Morton A. Distribution and Determinants of Out-of-pocket Healthcare Expenditures in Bangladesh. J Preventive Med Public Health. 2017;50(2):91-9.

Damme WV, Leemput L, Por I, Hardeman W, Meesen B. Out-of-pocket health expenditure and debt in poor households: evidence from Cambodia. Wiley Online Library. 2004;9(2):273-80.

Correa-Burrows P. Out-Of-Pocket Health Care Spending by the Chronically Ill in Chile. Procedia Economics and Finance. 2012;1:88-97.

Tahsina T, Ali NB, Hoque DME, Huda TM, Salam SS, Hasan MM et al. Out-of-pocket expenditure for seeking health care for sick children younger than 5 years of age in Bangladesh: findings from cross-sectional surveys, 2009 and 2012. J Health, Population, Nutri. 2017;36:33.

Brinda EM, Rajkumar AP, Enemark U, Prince M, Jacob KS. Nature and determinants of out-of-pocket health expenditure among older people in a rural Indian community. Int Psychogeriatrics Asso. 2012;24(10):1664-73.

Torres da Silva M, Barros JDA, Bertoldi A, Jacinto P, Matijasevich A, Santos I et al. Determinants of out-of-pocket health expenditure on children: An analysis of the 2004 Pelotas Birth Cohort. Int J Equity Health. 2015;14:53.

Adhikari C, Sharma BP, Subedi S. Out-of-Pocket and Catastrophic Expenditure of Neonatal Health Care in Kaski District, Nepal. Economic J Development Issues. 2018;21(22):2016.

Thapa AK, Pandey AR. National and Provincial Estimates of Catastrophic Health Expenditure and its Determinants in Nepal. J Nepal Health Res Council. 2021;18(4):741-6.

Leive A, Xu K. Coping with out-of-pocket health payments: empirical evidence from 15 African countries. SciELO Public Health. Bull World Health Organ. 2008;86(11):849-56.

Ruger JP, Kim H-J. Out-of-Pocket Healthcare Spending by the Poor and Chronically Ill in the Republic of Korea. Am j public health. 2007;97(5):804-11.

Thuan NTB, Lofgren C, Chuc NTK, Janlert U, Lindholm L. Household out-of-pocket payments for illness: Evidence from Vietnam. BMC public health. 2006;6(1):283.

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Published

2021-09-27

How to Cite

Shrestha, A., Nepal, S., & Poudyal, A. (2021). Household expenses in healthcare and its coping mechanism in rural Nepal. International Journal Of Community Medicine And Public Health, 8(10), 4750–4758. https://doi.org/10.18203/2394-6040.ijcmph20213771

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Original Research Articles