Issues in equitable health financing in South Eastern Nigeria: Socio-economic and geographic differences in households' illness expenditures and policy makers' views on the financial protection of the poor

Authors

  • Obinna Onwujekwe,

    Corresponding author
    1. Health Policy Research Group, College of Medicine, University of Nigeria, Enugu, Nigeria
    2. Department of Health Administration and Management, College of Medicine, University of Nigeria, Enugu, Nigeria
    • Department of Health Administration and Management, College of Medicine, University of Nigeria, Enugu-Campus, PMB 01129 UNTH Enugu, Nigeria.
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  • Chima Onoka,

    1. Health Policy Research Group, College of Medicine, University of Nigeria, Enugu, Nigeria
    2. Department of Community Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
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  • Benjamin Uzochukwu,

    1. Health Policy Research Group, College of Medicine, University of Nigeria, Enugu, Nigeria
    2. Department of Community Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
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  • Eric Obikeze,

    1. Health Policy Research Group, College of Medicine, University of Nigeria, Enugu, Nigeria
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  • Nkoli Ezumah

    1. Health Policy Research Group, College of Medicine, University of Nigeria, Enugu, Nigeria
    2. Department of Sociology/Anthropology, University of Nigeria, Nsukka, Nigeria
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Abstract

This study examined the socio-economic and geographic differences in illness occurrence and levels of expenditures in South Eastern Nigeria, together with policymaker and healthcare provider views on how to alleviate the financial burdens placed on the poorest by existing payment mechanisms. We found no evidence of differences across socio-economic group in illness occurrence but there was inequity in expenditures, payment mechanisms used and sources of funds to cope with the burden of payments. Policymakers and facility managers were found to assume that households have the capacity to cope with healthcare payments and there is no functioning system of fee exemptions. Policies are needed to protect the poor and other vulnerable groups against the financial risk of ill-health. Copyright © 2009 John Wiley & Sons, Ltd.

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