Catastrophic Health Expenditure and Impoverishment Amongst Hepatitis B Patients in a Resource-Poor Setting

Abstract

Introduction: The economic burden of managing hepatitis B has become a concern because viral hepatitis disease is a global public health problem that resulted in more deaths in 2016 than HIV and AIDs, Tuberculosis and Malaria individually. This study aimed at estimating the catastrophic health expenditure associated with managing hepatitis B, the predictors of the same and the impoverishing effect that management of hepatitis B has on affected households. Methods: A facility-based cross-sectional survey involving 135 hepatitis B patients selected through a two-stage sampling. Data was collected using a structured interviewer administered questionnaire and analyzed using SPSS version 25. Results: The average age of the respondents is 41, 60% male, 40% female. About 71% were married, and nearly two-thirds had tertiary education. Most (90.9%) paid for treatment out-of-pocket, only 7.6% had health insurance, and 1.5% were employer-covered. 71.1% of households spent over 10% of total expenditure on hepatitis B treatment, leading to financial catastrophe. Prevalence of Catastrophic health expenditure (CHE) was 71.1%, with a 20% overshoot and a mean positive overshoot of 28.1%. Being employed was protective against CHE. (OR=0.71; 95%CI=1.12 – 1.97) Post-treatment, 25.2% fell into poverty, and 21.5% into extreme poverty. Conclusion: Majority of hepatitis B patients pay out-of-pocket for healthcare. A major proportion of them are in financial catastrophe as a result of paying for treatment. The heavy reliance on out-of-pocket payment exposes the households of hepatitis B patients to catastrophic health expenditure and treatment of the condition impoverishes the affected households.