The financial burden of noncommunicable diseases from out-of-pocket expenditure in sub-Saharan Africa: a scoping review

被引:1
作者
Odunyemi, Adelakun [1 ,2 ]
Islam, Md Tauhidul [1 ]
Alam, Khurshid [1 ]
机构
[1] Murdoch Univ, Murdoch Business Sch, Management & Mkt Dept, Murdoch, 90 South St, Perth, WA 6150, Australia
[2] Hosp Management Board, Clin Dept, Akure 340223, Ondo, Nigeria
关键词
noncommunicable diseases; out-of-pocket catastrophic health expenditures; impoverishment; coping strategies; crowding-out effect on consumption; unmet needs; scoping review; sub-Saharan Africa; CATASTROPHIC HEALTH EXPENDITURE; TYPE-2; DIABETES-MELLITUS; MEDICATION ADHERENCE; CATARACT-SURGERY; CARE SERVICES; ETHIOPIA; INCOME; CANCER; IMPACT; BARRIERS;
D O I
10.1093/heapro/daae114
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
The growing financial burden of noncommunicable diseases (NCDs) in sub-Saharan Africa (SSA) hinders the attainment of the sustainable development goals. However, there has been no updated synthesis of evidence in this regard. Therefore, our study summarizes the current evidence in the literature and identifies the gaps. We systematically search relevant databases (PubMed, Scopus, ProQuest) between 2015 and 2023, focusing on empirical studies on NCDs and their financial burden indicators, namely, catastrophic health expenditure (CHE), impoverishment, coping strategies, crowding-out effects and unmet needs for financial reasons (UNFRs) in SSA. We examined the distribution of the indicators, their magnitudes, methodological approaches and the depth of analysis. The 71 included studies mostly came from single-country (n = 64), facility-based (n = 52) research in low-income (n = 22), lower-middle-income (n = 47) and upper-middle-income (n = 10) countries in SSA. Approximately 50% of the countries lacked studies (n = 25), with 46% coming from West Africa. Cancer, cardiovascular disease (CVD) and diabetes were the most commonly studied NCDs, with cancer and CVD causing the most financial burden. The review revealed methodological deficiencies related to lack of depth, equity analysis and robustness. CHE was high (up to 95.2%) in lower-middle-income countries but low in low-income and upper-middle-income countries. UNFR was almost 100% in both low-income and lower-middle-income countries. The use of extreme coping strategies was most common in low-income countries. There are no studies on crowding-out effect and pandemic-related UNFR. This study underscores the importance of expanded research that refines the methodological estimation of the financial burden of NCDs in SSA for equity implications and policy recommendations.
引用
收藏
页数:25
相关论文
共 172 条
  • [1] Primary open angle glaucoma in northern Nigeria: stage at presentation and acceptance of treatment
    Abdull, Mohammed M.
    Gilbert, Clare C.
    Evans, Jennifer
    [J]. BMC OPHTHALMOLOGY, 2015, 15
  • [2] Abegaz TM, 2020, BMC PULM MED, V20, DOI 10.1186/s12890-020-1081-6
  • [3] Adanu KK, 2022, PLOS GLOB PUBL HLTH, V2, DOI 10.1371/journal.pgph.0000268
  • [4] Essential medicines and technology for hypertension in primary healthcare facilities in Ebonyi State, Nigeria
    Adeke, Azuka Stephen
    Umeokonkwo, Chukwuma David
    Balogun, Muhammad Shakir
    Odili, Augustine Nonso
    [J]. PLOS ONE, 2022, 17 (02):
  • [5] Adeniji F. I. P., 2023, Journal of Health Economics and Outcomes Research, V10
  • [6] The microeconomic impact of out-of-pocket medical expenditure on the households of cardiovascular disease patients in general and specialized heart hospitals in Ibadan, Nigeria
    Adeniji, Folashayo Ikenna Peter
    Lawanson, Akanni Olayinka
    Osungbade, Kayode Omoniyi
    [J]. PLOS ONE, 2022, 17 (07):
  • [7] Akpan Effiong E, 2020, Niger Med J, V61, P307, DOI 10.4103/nmj.NMJ_106_20
  • [8] Economic impacts of health shocks on households in low and middle income countries: a review of the literature
    Alam, Khurshid
    Mahal, Ajay
    [J]. GLOBALIZATION AND HEALTH, 2014, 10
  • [9] Non-communicable disease policy implementation from 2014 to 2021: a repeated cross-sectional analysis of global policy data for 194 countries
    Allen, Luke N.
    Wigley, Simon
    Holmer, Hampus
    Barlow, Pepita
    [J]. LANCET GLOBAL HEALTH, 2023, 11 (04): : E525 - E533
  • [10] Economic burden and catastrophic cost among people living with sickle cell disease, attending a tertiary health institution in south-east zone, Nigeria
    Amarachukwu, C. N.
    Okoronkwo, I. L.
    Nweke, M. C.
    Ukwuoma, M. K.
    [J]. PLOS ONE, 2022, 17 (08):