Drivers of Catastrophic Health Expenditure Among Women of Reproductive Age in Ekiti State, Nigeria
- AIOR Admin
- Oct 15
- 2 min read
Peter Oshaji, Chike Nwangwu, O. A. Mohammed
NOIPolls Limited, Abuja, Nigeria
Catastrophic health expenditure (CHE) remains a major barrier to universal health coverage (UHC) in low- and middle-income countries (LMICs), disproportionately affecting women of reproductive age who often shoulder the burden of healthcare costs within households. This study examined the determinants of CHE among women of reproductive age in Ekiti State, Nigeria, under the State’s health insurance scheme (ULERAWA). Using data from 232 women of reproductive age, logistic regression, cross-tabulation and chi-square test were applied to assess the influence of socio-demographic, household, and health system–related variables on CHE. Results revealed that all socio-demographic characteristics, including urban–rural residence, age, marital status, ethnicity, education, and occupation, were significantly associated with CHE (p < .05). Household factors such as headship (female headed households), household size, monthly income, and wealth quintile also emerged as strong predictors, indicating that both poverty and household structure contribute to financial vulnerability. Among health system determinants, type of treatment facility, frequency of utilization, and illness episodes significantly predicted CHE. The cost of drugs was the single most influential driver (OR = 35.9, p < .001), underscoring the critical role of pharmaceutical expenses. Indirect costs such as transport further heightened household risk. These findings align with cross-country evidence from Ghana, Kenya, Rwanda, and Ethiopia, where drug costs, recurrent illness, and indirect service expenses persist as major causes of CHE despite insurance coverage. The study concludes that while ULERAWA has expanded access, its financial protection function remains limited. Policy reforms should prioritize subsidized essential medicines, coverage of indirect costs, and targeted support for low-income and female-headed households to strengthen equity and resilience against CHE.
Comments