The Prevalence of Household Catastrophic Health Expenditure in Nigeria: A Rural-Urban Comparison

Background: Catastrophic health expenditure occurs when the burden of Out-of-pocket health expenditure has reached a certain level that a household must forego the expenditure on other basic needs of life to meet the health expenses of its member(s) of the household. Worldwide, over 44 million households suffer annually from financial catastrophe. This study intends to determine the prevalence of household catastrophic health expenditure amongst rural and urban communities in Ekiti, Nigeria. Methodology: This is a comparative cross-sectional study of households within selected rural and urban communities in Ekiti State, Nigeria. A pre-tested interviewer-administered semi-structured questionnaire was used to collect data over a period of 4 months from a sample of 1,000 household heads, using a multistage sampling technique. Data obtained were then entered using the SPSS version 20 and analysed with STATA 12. Two different methodologies were used to calculate household catastrophic health expenditure, with sensitivity analysis done. Univariate analysis were used to describe the population in relation to relevant variables. Result: The prevalence of household catastrophic health expenditure is high using the two methodological calculations. It was significantly higher in the rural areas, 18.5% than the urban areas, 12.8% (p=0.015) for first method; it was also higher in the rural areas, 8.3% compared to the urban areas, 2.5% (p<0.001) for the second method. Conclusion: Prevalence of household catastrophic health expenditure is high in Nigeria, but worse in the rural areas. It's therefore vital to establish financial and social intervention mechanisms that can protect households from incurring catastrophic health expenditure.