Addressing Healthcare Vulnerabilities in Africa (AHCV)
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- ItemAddressing the Drivers of Food Security in Zambia During the COVID-19 Pandemic(African Economic Research Consortium, 2024-04-09) Bwalya, Richard; Chitalu, M. Chama-ChilibaSince the onset of the COVID-19 pandemic, there have been growing concerns about the impact of the pandemic on household food security (Nguyen et al., 2021; Cable et al., 2021; and Paslakis et al., 2020). Available studies show that economic effects of the COVID-19 pandemic is proportionately affect members of the society, depending on factors such as socio-economic status, livelihood strategies, and access to markets. However, though informative, these studies tend to be based on small sample sizes, limited geographical coverage or both, and thus less useful for informing the design of effective recovery strategies that lead to more resilient national food systems (Bene et al. 2021). As a contribution to addressing this information gap, this paper investigated changes in household food security and its drivers in Zambia between the pre pandemic and COVID-19 periods, with the objective of identifying significant drivers of food security and understand how they changed during the pandemic.
- ItemHealth Expenditure Shocks Worsened Household Poverty Amidst COVID-19 in Uganda(African Economic Research Consortium, 2024-04-09) Mpuuga, Dablin; Nakijoba, Sawuya; Yawe, Bruno L.Amidst the COVID-19 pandemic a lot changed regarding health care financing, both globally and nationally – in Uganda. Households faced unprecedented economic constraints and were forced to make hard expenditure choices including whether and how to spend on health care. Relatedly, the number of poor Ugandans increased from eight million in 2016/17 to 8.3 million in 2019/20, but it was still not clear how much of this impoverishment can be attributed to health xpenditure shocks amidst the pandemic. In addition, Uganda has consistently fallen short on living up to the 2001 Abuja Declaration expectations of allocating at least 15% of her national budget each year to improving the healthcare system. The size of the health sector budget has been less than half of the declaration requirement for the past five years (see Figure 1). More precisely, the health sector budget as a share of the total budget and GDP has averaged 6.4% and 1.9% respectively in the financial years 2018/19 to 2022/23. The absence of a national health insurance scheme implies that a huge health care financing burden, is borne by the households who pay for health care directly by out-of-pocket payments (OOPs).
- ItemEffect of COVID-19 on Catastrophic Medical Spending and Forgone Care in Nigeria(African Economic Research Consortium, 2024-04-09) Edeh, Henry C.; Nnamani, Alexander Uchenna; Ozor, Jane O.According to World Health Organization (WHO, 2005; 2010; 2017), countries need to fund their health systems through general revenues or premium contributions of social health insurance, complemented with government revenues, to achieve UHC and financial protection. However, government funding for health in Nigeria remains generally inadequate and many households still suffer financial hardship resulting from high OOP medical spending (Edeh, 2022). OOP medical spending in Nigeria is still up to 75%, which is well above the WHO recommended 15-20% for the achievement of financial protection (World Bank, World Development Indicator (WDI), 2021). This excess reliance on OOP spending for medical bills tempts households to forgo medical care, deepens unequal access to quality health care and exposes Nigeria households to incurring catastrophic health expenditure (CHE) (Amos et al., 2016). The COVID-19 pandemic may have worsened the situation, since it led to decline in household income. Hence, our study estimates the effect of COVID-19 on catastrophic medical spending and forgone medical care in Nigeria.
- ItemFrom Crisis to Coverage: Kenya's Healthcare Revolution(African Economic Research Consortium, 2024-04-09) Muriithi, Moses; Oleche, Martine; Kiarie , Francis; Mwangi, TabithaIn Kenya, the majority of the households are unable to afford health care due to financial constraints as demonstrated by a high health finance vulnerability index. The existing health financing model that is heavily reliant on out-of-pocket payments, therefore, presents a significant barrier to healthcare access. The situation is especially critical when the country is faced with a health shock like the recent COVID-19 pandemic. Developing nations like Kenya are characterized by high poverty and unemployment rates further worsening the financial ability of the citizens to afford healthcare. To ensure equitable and quality healthcare access to all as envisaged in Sustainable Development Goal 3, Kenya must urgently reform its healthcare financing system, reducing the burden of out-of-pocket expenses and embracing more sustainable funding sources.
- ItemCatastrophic Effects of COVID-19 Health Expenditure Shocks and Multidimensional Poverty in Ghana: What Financing Mechanisms Mattered?(African Economic Research Consortium, 2024-04-09) Ayanore, Martin; Avenyo, Elvis; Osei, DavinaIn Ghana, both direct and in-direct effects of the pandemic on health and health outcomes became prolonged during the second and third waves of the pandemic. Despite seemingly obvious disruption this brought to the health system and health care utilisation, there is paucity of published literature on the effects to household health expenditures among diverse socio economic groups, including the poor. No known study has examined the magnitude and extent to which these possible payments, if they existed impacted the vulnerable, particularly poor households. Also, several key questions remain answered in the literature. To what extent has COVID-19 impacted on out-of-pocket (OOP) payments as a share of total household expenditures during the pandemic? What are the determinants of COVID-19-related CHEs? How did CHE shocks impact multi-dimensionally poor households and how did they mitigate such shocks? This policy brief answers these questions and examines the policy implications of financing mechanisms and their impact during health emergencies.