Household Primary Healthcare Expenditure and Its Effect on Under-5 Child Health Outcomes in Lagos State (A Case Study of Lagos Mainland and Badagry LGA)

Abstract

Healthcare in Nigeria is predominantly funded through out-of-pocket spending by
households. Providing financial protection from exorbitant out-of-pocket expenses is an
important tool for a country’s health system to ensure equitable access to care. A
household without such protection may be forced to pay huge medical bills to treat an
ailing family member, exposing it to financial catastrophe and impoverishment. This
study assessed household’s health expenditure patterns and its effect on under-5 child
outcomes, the study adopted a cross-sectional design approach, a combined sum of 548
households (Lagos Mainland 363 and Badagry 221) was surveyed. Data obtained were
subjected to descriptive and Kaplan-Meier Survival analyses. The results indicated that
malaria (52.1%) was endemic among households, in terms of household healthcare
expenditure; out-of pocket (84%) had the highest coverage in comparison with National
Health Insurance (7%).Furthermore, out-of pocket health expenditure burden was
concentrated among the poorest (20.6%) socio-economic class. Finally, the probability of
a child reaching his 5th birthday was a function of location of household residency and its
socio-economic status, (Lagos mainland) 0.00 Sig value<Pvalue0.05<0.22 Sig value(Badagry),
given an estimated 18.8% of sample households would experience under-5 child mortality
.High levels of catastrophic health care expenditure exist in Lagos State, thus in a bid to
improve universal health coverage and reduce the prevalence of catastrophic health
expenditure, this study recommend the need for a policy development focused on the
restructuring of the National Health Insurance Scheme (NHIS), Introduction of
community based health insurance scheme and massive reduction in households income
disparities.