Examining out-of-pocket expenditures on reproductive and sexual health among the urban population of Nepal
Puri, Mahesh, Hortsman, Ronald, Matthews, Zoë, Falkingham, Jane, Padmadas, Sabu and Devkota, Sekhar (2008) Examining out-of-pocket expenditures on reproductive and sexual health among the urban population of Nepal. Population Review, 47, (2), 50-66. (doi:10.1353/prv.0.0006)).
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Description/Abstract
Poor health is unpredictable and, in circumstances where a significant fraction of the household
expenditure is required for purchasing health care, can have disruptive impact on household
budgets and an impoverishing effect on living standards. This article provides an account of a
recently-completed representative cross-sectional survey on out-of-pocket costs for reproductive
and sexual health (RSH) care in urban Nepal. The study, which is the first of its kind, was
conducted in nine towns of Nepal covering about 50% of the total urban population of the
country. The survey used a two-stage cluster sample design and face-to-face structured interviews
were carried out with 1,669 respondents from 992 households. Overall, 1.1% of total annual
household expenditure was spent on RSH excluding HIV/AIDS care and 2.9% was directed
towards costs associated with HIV/AIDS care. The costs related to emergency obstetric care were
the highest; 9% of the total health care expenditure went on the payments for obstetric care alone.
The distribution of out-of pocket expenditure by the major components of RSH care services
shows that almost half of all out-of-pocket payments were spent on maternal care (46%),
followed by STIs (27%) and RTIs (13%) respectively. Out-of-pocket expenditure on family
planning and related care was modest, accounting for about 7% of overall RSH spending. This is
attributed to the supply of contraceptives and related services free-of-charge mainly from public
facilities. A high share of out-of-pocket expenditure to total health financing is considered as a
major concern in any health financing system, and in Nepal this can be seen as a major
impediment to achieving poverty reduction and the Millennium Development Goals.
| Item Type: | Article |
|---|---|
| ISSNs: | 0032-471X (print) |
| Keywords: | out-of-pocket, expenditure, reproductive health, nepal |
| Subjects: | H Social Sciences > HN Social history and conditions. Social problems. Social reform H Social Sciences > HA Statistics R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine |
| Divisions: | University Structure - Pre August 2011 > School of Social Sciences > Social Statistics |
| Item ID: | 65157 |
| Date Deposited: | 05 Feb 2009 |
| Last Modified: | 02 Mar 2012 13:12 |
| Contributors: | Puri, Mahesh (Author) Hortsman, Ronald (Author) Matthews, Zoë (Author) Falkingham, Jane (Author) Padmadas, Sabu (Author) Devkota, Sekhar (Author) |
| Date: | 2008 |
| Status: | Published |
| URI: | http://eprints.soton.ac.uk/id/eprint/65157 |
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