Table 4.
Articles included in the review
| No. | Title | Study questions/aims | Study location (country) | Study design | Sample size | Data source | Period of study | Health area |
|---|---|---|---|---|---|---|---|---|
| 1. | (Xu et al. 2006b [48]) An empirical model of access to health care, health care expenditure and impoverishment in Kenya: learning from past reforms and lessons for the future | The impact of the Kenyan health financing system in the year 2003 on access to care and health spending. It will also shed light on the extent to which the prevailing system impoverished the population. | Kenya | Cross sectional | 8407 households 38,009 individuals |
Kenya health expenditure and utilisation survey 2003 | 2003 | General health care |
| 2. | (Onwujekwe et al. 2010 [65]) Are malaria treatment expenditures catastrophic to different socio-economic and geographic groups and how do they cope with payment? A study in southeast Nigeria | To determine the inequities in the household income depletion resulting from malaria treatment expenditures, the sacrifice of basic household needs [catastrophe] and the differences in payment strategies amongst different socio-economic and geographic groups in southeast Nigeria | Nigeria | Cross sectional | 2250 households | HH survey | Not reported | Malaria |
| 3. | (Kwesiga et al. 2015 [57]) Assessing catastrophic and impoverishing effects of health care payments in Uganda | To assess the catastrophic and impoverishing impact of paying for health care out of pocket in Uganda | Uganda | Cross sectional | 6800 households | Uganda national HH survey 2009/2010 | 2009–2010 | General health care |
| 4. | (Akazili et al. 2017 [64]) Assessing the catastrophic effects of out-of-pocket healthcare payments prior to the uptake of a nationwide health insurance scheme in Ghana | To assess the catastrophic effect of OOP health care payments in Ghana to highlight the extent to which the health system protects HHs from the financial consequences of paying OOP for health services. | Ghana | Cross sectional | 8687 households 36,488 individuals | Ghana living standard survey 2005/2006 | 2005–2006 | General health care |
| 5. | (Laokri et al. 2014 [40]) Assessing the economic burden of illness for tuberculosis patients in Benin: determinants and consequences of catastrophic health expenditures and inequities | To measure the risk, causes and consequences of catastrophic expenditures for tuberculosis and investigated potential inequities. | Benin | Cross sectional | 250 TB patients | HH Survey | 2008–2009 | TB |
| 6. | (Barasa et al. 2017 [52]) Assessing the impoverishing effects, and factors associated with the incidence of catastrophic health care payments in Kenya | The objectives of this study are to (1) examine the incidence and intensity of catastrophic health expenditures, (2) to examine the impoverishing effect of OOP health spending, and, (3) to explore factors that are associated with catastrophic health spending in Kenya. | Kenya | Cross sectional | 33,675 households | Kenya health expenditure and utilisation survey 2013 | 2013 | General health care |
| 7. | (Ichoku and Fonta, 2009 [41]) Catastrophic healthcare financing and poverty: empirical evidence from Nigeria | To analyse the incidence and severity of catastrophic healthcare financing using different definitions of catastrophic healthcare and to examine the links between this phenomenon and poverty. | Nigeria | Cross sectional | 7667 households | General household surveys of the federal office of statistics | 1999 | General health care |
| 8. | (Chuma and Maina, 2012 [59]) Catastrophic health care spending and impoverishment in Kenya | To estimates the burden of out-of-pocket payments in Kenya; the incidence and intensity of catastrophic health care expenditure and the effect of health spending on national poverty estimates. | Kenya | Cross sectional | 8414 households | Kenya health expenditure and utilisation survey 2007 | 2007 | General health care |
| 9. | (Buigut et al. 2015 [53]) Catastrophic health expenditure and its determinants in Kenya slum communities | To examine the incidence and determinants of catastrophic health expenditure amongst urban slum communities in Kenya | Kenya | Longitudinal | 8171 individuals | Indicator development for surveillance of urban emergency (IDSUE) | 2011–2013 | General health care |
| 10. | (Su et al. 2006 [44]) Catastrophic household expenditure for health care in a low-income society: a study from Nouna District, Burkina Faso | To quantify the extent of catastrophic household health care expenditure and determine the factors responsible for it in Nouna district, Burkina Faso | Burkina Faso | Cross sectional | 774 households | Nouna health district HH survey | 2000–2001 | General health care |
| 11. | (Sene and Cisse, 2015 [30]) Catastrophic out-of-pocket payments for health and poverty nexus: evidence from Senegal | The purpose of this study is to cast light on the determinants of catastrophic household out-of-pocket health expenditures and to assess their implications on poverty. | Senegal | Cross sectional | 17,891 households | Poverty monitoring survey 2011 | 2011 | General health care |
| 12. | (Dyer et al. 2013 [45]) Catastrophic payment for assisted reproduction techniques with conventional ovarian stimulation in the public health sector of South Africa: frequency and coping strategies | How often does out-of-pocket payment (OPP) for assisted reproduction techniques (ART) with conventional ovarian stimulation result in catastrophic expenditure for households? | South Africa | Experimental-prospective observational study | 135 ART couples | Hospitals survey | 2009–2011 | HIV-ART |
| 13. | (Brinda et al. 2014 [51]) Correlates of out-of-pocket and catastrophic health expenditures in Tanzania: results from a national household survey | To investigate the determinants influencing OOP health expenditure amongst the adult as well as the older population aged above 60 Years in Tanzania | Tanzania | Cross sectional | 3265 households 8297 individuals |
Tanzania national panel survey 2008/2009 | 2008–2009 | General health care |
| 14. | (Masiye et al. 2016 [49]) Does user fee removal policy provide financial protection from catastrophic health care payments? Evidence from Zambia | To examine the extent and patterns of financial protection from fees following the decision to abolish user fees in public primary health facilities. | Zambia | Cross sectional | 12,000 households 60,000 individuals |
Zambia health expenditure and utilisation survey 2014 | 2014 | General health care |
| 15. | (Arsenault et al., 2013 [55]) Emergency obstetric care in Mali: catastrophic spending and its impoverishing effects on households | To investigate the frequency of catastrophic expenditure for emergency obstetric care, explore its risk factors and assess the effects of these expenditures on households in the Kayes region, Mali | Mali | Case-control | 484 women | HH survey | 2008–2011 | Obstetric care |
| 16. | (Okoronkwo et al. 2015 [71]) Economic burden and catastrophic cost amongst people living with type2 diabetes mellitus attending a tertiary health institution in south-east zone, Nigeria | To assess the magnitude of economic burden borne and catastrophic costs incurred by PLWDs in Nigeria | Nigeria | Cross sectional | 308 People living with disability (PLWD) | Hospitals survey | 2011–2012 | Diabetes |
| 17. | (Ughasoro et al. 2014 [72]) Economic cost of treatment of childhood epilepsy in Enugu, southeast Nigeria | To determine the economic costs and the level of CHE due to childhood epilepsy | Nigeria | Cross sectional | 134 Patients | Hospitals survey | 2012 | Epilepsy |
| 18. | (Mills et al. 2012 [14]) Equity in financing and use of health care in Ghana, South Africa, and Tanzania: implications for paths to universal coverage | To report the results of a three-country study on the equity of health system financing and service use | Ghana; South Africa; Tanzania | Comparative study | Not reported | National HH survey | 2008 | General health care |
| 19. | (Onwujekwe et al. 2012 [63]) Examining inequities in incidence of catastrophic health expenditures on different healthcare services and health facilities in Nigeria | To estimate the level of CHE for different healthcare and facilities and their distribution across socio economic status | Nigeria | Cross sectional | 4473 households | HH survey | Not reported | General health care |
| 20. | (Onwujekwe et al. 2009 [61]) Examining catastrophic costs and benefit incidence of subsidised antiretroviral treatment (ART) programme in south-east. | To examine the extent to which costs of subsidised antiretroviral treatment programmes are catastrophic and the benefit incidence that accrues to different population groups | Nigeria | Cross sectional | 301 ART patients | Hospital database | Not reported | HIV-ART |
| 21. | (Onwujekwe et al. 2016 [38]) Examining geographic and socio-economic differences in outpatient and inpatient consumer expenditures for treating HIV/AIDS in Nigeria | To provide information and the resultant incidence of CHE from medical and non-medical expenditures incurred on outpatient visits [OPV] from different social-economic groups and geographical conditions. | Nigeria | Cross sectional | 1200 people living with HIV | HH survey | 2013 | HIV-ART |
| 22. | (Akinkugbe et al. 2012 [16]) Health financing and catastrophic payments for health care: evidence from household-level survey data in Botswana and Lesotho | To assess the degree of inequality in the distribution of health expenditure across wealth quintiles in Botswana and Lesotho. | Lesotho; Botswana | Comparative study | 6882 households (Lesotho) 6053 households (Botswana) |
HH expenditure survey 2002/2003 | 2002–2003 | General health care |
| 23. | (Castillo-Riquelme et al. 2008 [68]) Household burden of malaria in South Africa and Mozambique: is there a catastrophic impact? | To evaluate treatment seeking behaviour financial impact and time lost due to malaria events in southern Mozambique and eastern South Africa | South Africa; Mozambique | Comparative study | 827 households (South Africa) 828 households (Mozambique) |
HH survey | 2001–2002 | Malaria |
| 24. | [Ukwaja et al. 2013 [46, 50] Household catastrophic payments for tuberculosis care in Nigeria: incidence, determinants, and policy implications for universal health coverage | To investigate the incidence, intensity, distribution and correlates of catastrophic payments for TB care and policy implications for TB care and their primary care services | Nigeria | Cross sectional | 452 TB patients | HH survey | 2011 | TB |
| 25. | (Mchenga et al. 2017 [37]) Impoverishing effects of catastrophic health expenditures in Malawi | To Investigate the effect of catastrophic OOP on the incidence and depth of poverty in Malawi | Malawi | Cross sectional | 12,271 individuals | Integrated household survey 2010/2011 | 2010–2011 | General health care |
| 26. | (Ichoku et al. 2009 [36]) Incidence and intensity of catastrophic healthcare financing and impoverishment due to out-of- pocket payments in southeast Nigeria | To examine incidence and intensity of catastrophic health care financing and the impoverishing effects, as well as equity concerns due to OOP for healthcare in Southeast Nigeria. | Nigeria | Cross sectional | 1500 households | HH survey | Not reported | General health care |
| 27. | (Ilunga-Ilunga et al. 2015b [39]) Incidence of catastrophic health expenditures for households: an example of medical attention for the treatment of severe childhood malaria in Kinshasa reference hospitals, Democratic Republic of Congo | To estimate the incidence of catastrophic health expenditures incurred by households in which one child suffered severe malaria and subsequently attended Kinshasa referral hospital. | Democratic Republic of Congo | Cross sectional | 1350 children | HH survey | Not reported | Malaria |
| 28. | (Adisa, 2015 [43]) Investigating determinants of catastrophic health spending amongst poorly insured elderly households in urban Nigeria | To investigate the key determinants of CHE amongst poorly insured elderly households in Nigeria. | Nigeria | Cross sectional | 1176 households | Nigerian general HH panel survey 2010 | 2010 | General health care |
| 29. | (Cleary et al. 2013 [56]) Investigating the affordability of key health services in South Africa | To identify Characteristics of households that experience difficulties in affording health care | South Africa | Cross sectional | 3727 patients | Exit interviews | Not reported | Obstetric care/TB/ART |
| 30. | (Ataguba, 2012 [42]) Reassessing catastrophic health-care payments with a Nigerian case study | What might constitute fair indices of catastrophic payment, which explicitly recognise diminishing marginal utility of income as reflected in some principle of vertical equity? This paper aims to examine such indices and how best to assess them. |
Nigeria | Cross sectional | 19,518 households | Nigerian national living standard survey 2003/2004 | 2003–2004 | General health care |
| 31. | (Counts and Skordis-Worrall, 2016 [70]) Recognising the importance of chronic disease in driving healthcare expenditure in Tanzania: analysis of panel data from 1991 to 2010 | This study compares the level and predictors of expenditure on healthcare between chronic disease-affected (CDA) and unaffected (CDU) households in this region using 19-year panel data. | Tanzania | Longitudinal | 900 households 6353 individuals |
Modelled data–Kagera health development survey | 1991–2010 | Chronic disease |
| 32. | (Wang et al. 2016 [58]) The economic burden of chronic non-communicable diseases in rural Malawi: an observational study | To estimate both the HH direct, indirect and total costs due to CNCDs; and the economic burden households bear as a result of these costs in Malawi | Malawi | Cross sectional | 1199 households 5643 individuals |
HH survey | 2012 | Chronic non-communicable |
| 33. | (Beaulière et al. 2010 [54]) The Financial burden of morbidity in HIV-infected adults on antiretroviral therapy in Côte d’Ivoire | To estimate the financial burden of health care for households with HIV-infected adults taking antiretroviral therapy (ART]) in Côte d’Ivoire. | Côte d’Ivoire | Cross sectional | 1190 adults | HH survey | 2007 | HIV-ART |
| 34. | (Xu et al., 2006a [47]) Understanding the impact of eliminating user fees: utilisation and catastrophic health expenditures in Uganda | Examine changes in utilisation and catastrophic health expenditure | Uganda | Cross sectional | 6655 households 33,988 individuals |
Social economic survey 1997, 2000, 2003 | 1997, 2000, 2003 | General health care |