Poor Ugandans not seeking healthcare

Kampala, Uganda | THE INDEPENDENT | The burden of catastrophic health expenditures remains large in many countries in Africa. A report by the Makerere University-based Economic Policy Research Centre (EPRC) shows that most of the health expenditure in Uganda is met privately and by the rich.

Due to this, a substantial proportion of individuals who fall sick may fail to access health services even as countries like Uganda have abolished user fees.

Of the five countries analyzed in the study whose results were released on Tuesday, only Nigeria has out of pocket hospital payments below 25 percent of the total household non-food expenditure. Other countries including Uganda, Malawi, Ethiopia and Tanzania had expenditure on health above the 25 percent threshold.

“For Nigeria, regardless of the threshold, it is the poor that make catastrophic expenditures. For Ethiopia, at both the 15 percent and 25 percent thresholds, it is the poor making the expenditures. Similarly, in Tanzania, the poor make most payments. On the other hand, Uganda’s records showed the burden of catastrophic expenditures is borne by the rich,” he reports reads in part.

The researchers, Dr Sarah Sewanyana and Dr Ibrahim Kasirye examined how the burden of out of pocket health expenditures varies with different thresholds for financial catastrophe through analyzing surveys done in the five countries and found that households with low non-food expenditures are more likely to incur catastrophic payments with the exception of where catastrophic payments increase with the increase of non-food household expenditures.

When they looked at consulting a health practitioner, the researchers found Ethiopia and Nigeria had the largest proportion of individuals who had not consulted a provider for an illness in the past month at 22 percent and 21 percent respectively. In order to reduce this burden, Dr Sewanyana says public health expenditures need to be expanded as an alternative since poorer people cannot afford healthcare at all.

However, this research comes out at the time when Uganda is planning an introduction of the national health insurance which is being mooted as the magic that will make the country attain its healthcare gains and solve the immense out of pocket expenditure on health that has thrown many families into poverty.

But this research suggests that even with relatively high health insurance coverage in countries like Tanzania, there’s still a high share of out of pocket payments meaning that some people in those countries remain unprotected from catastrophic expenses.

To the policymakers, the researcher say their findings call for renewed attention to expanding public revenues as the most sustainable methods of financing health expenditure considering the high level of deprivation.

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