Economic consequences for households of illness and of paying health care in Zimbabwe: A case study

This study investigates the economic consequences of illness and of paying for health care in Zimbabwe. It explores the incidence of out-of-pocket (OOP) payments, catastrophic health expenditure (CHE), impoverishment and the factors, (particularly socio-economic factors) associated with them. In addition, this study determines the strategies that households employ to cope with the financial burden of OOP payments in Zimbabwe. Data was collected from 499 households in Harare urban and Seke rural districts of Zimbabwe. Total monthly household OOP health expenditure was defined as 'catastrophic' if it exceeded the threshold level of 40% of a household's monthly capacity to pay. Logistic regression analysis was used to identify the factors that influence the incidence of CHEs. A non-poor household was impoverished by OOP health expenditure if its total household expenditure after deducting OOP payments was lower than the subsistence expenditure. The results of this study indicated that, the incidence of CHEs was very high amongst the study population. Households at all levels of wealth incurred catastrophic health expenditures, and the proportion of households incurring CHEs was similar across the asset quintiles. Out-of-pocket payments precipitated impoverishment of non-poor households. Poor households, households with members above 65 years, female headed households, households with member(s) suffering from chronic illness and households with greater use of health services were at higher risk of incurring CHEs. On the contrary, households with a disabled member were less likely to incur CHEs. Besides 'avoiding seeking care', selling of assets and borrowing were the 2 most popular strategies used to cope with OOP health care payments. An analysis of these results suggests that, targeted exemption of vulnerable households, as well as provision of subsidised health services could reduce the economic impact of illness on households. The results of this study also point out to the need for strengthening risk pooling mechanisms through the implementation of community based health insurance schemes and enhancing tax collection. In addition, other strategies that extend beyond the health sector such as economic empowerment of women could be effective in mitigating the economic impact of illness amongst female headed households in Zimbabwe.

Grantor dc:publisher.institution

Health Economics Unit

Year dc:date.issued

2009

Author dc:creator

• Maredza, Mandy

Advisor dc:contributor.advisor

• Okorafor, Okore

Language dc:language.iso

eng

Handle dc:identifier.uri

http://hdl.handle.net/11427/9397

OAI identifier oai:identifier

oai:open.uct.ac.za:11427/9397