Table 2.

Current context of medicine OOP payment in Ethiopia, 2021

Areas of emphasis	Quotes reflecting the opinions of participants
Overall opinion	‘…………Currently, there is a high level of health OOP among the general populace and medicine shares the majority, I think.’(Male, pharmacist 2, FMOH.) ‘……the current OOP payment among our members (insured under the CBHI scheme) is high, according to our reports from all corners of the country. Nowadays, the severity of OOP is increasing, even to the point when insured and subsided households are exposed.’ (Male, health officer 3, Ethiopian Health Insurance Agency.)
Circumstances of vulnerability	‘……in particular, emergency cases and non-communicable diseases are becoming increasingly costly.’ (Male, pharmacist 1, FMOH.) ‘…….mostly, a murmur heard concerning OOP from people in urban areas rather than rural residents.’ (Female, pharmacist 3, FMOH.)
Consequences on households (catastrophes, impoverishment and health crisis)	‘……medicine OOP payment, in my opinion, has the potential to push people to poverty. Patients with severe and complicated conditions, for example, patients are referred to our hospital and may stay for an extended period. Thus, if they (patients) begin to purchase medicine from outside the compound, they may be financially weakened. As a result, there is no question that it will be poor.’ (Male, pharmacist 7, Saint Paul Hospital Millennium Medical College.) ‘……Yes! there is health OOP in our society, but I think paying for medicines cannot push people into poverty. Because, currently, many options are affordable. For example, (government-run) health centres are available in every village and offer a majority of the services at affordable prices. So, I don’t think it (OOP) will push people to poverty.’’(Male, pharmacist 1, FMOH.) ‘………When an individual’s OOP is high, he or she may begin to look for other, less expensive intervention possibilities. As a result, unlawful conduct and the provision of hazardous and unqualified medicines through contraband may become possible. All of this, I believe, might lead to a “health crisis” in the country.’ (Male, pharmacist 2, FMOH.)

FMOH, Federal Ministry of Health; OOP, out-of-pocket.