A household survey was conducted in Anambra state to provide the requisite evidence for the state governments and assess 1) current levels of out of pocket (OOP) expenditure and financial protection against catastrophic health expenditure, 2) household utilization of health services, 3) willingness to pay for healthcare financial protection, and 4) catastrophic payments for healthcare.
Financial risk protection and prepayment schemes are known to support greater and more effective utilization of healthcare services and ultimately improvement in health outcomes. But coverage of such schemes remains very low even when households are willing to pay for the needed protection from catastrophic and impoverishing healthcare expenditures.
In the absence of adequate budgetary funding of healthcare delivery, households continued to bear the greatest financial burden, which is estimated nationally at about 72 percent of total health expenditures. These data contributed to estimating the Sub-National Health Account (SNHA) for Anambra state and informed development of appropriate policies and strategies to reduce the burden of health expenditures on poor households.
The study complied with high ethical standards involving human subjects. The study protocol was approved by the Anambra State Health Research Ethics Committee of Nigeria (ASHREC). Letters of intent were submitted to the state and sampled local governments detailing the survey procedures, and ethical approval was obtained prior to commencement of the survey. No amendment to the protocol or informed consent process was implemented without prior approval. All the study personnel were trained on relevant aspects of good ethical standards relevant to the survey. Commitments to abide with the ethical standards were extracted from them.
Similar studies were conducted by CHECOD in Rivers, Cross River, Bauchi and Sokoto States funded by USAID Health Finance and Governance (HFG) Project & Kaduna State funded By Health Strategy and Delivery Foundation (HSDF).
