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CC BY V4.0, Open Access
Journal article
The financial burden of noncommunicable diseases from out-of-pocket expenditure in sub-Saharan Africa: A scoping review
Health Promotion International, Vol.39, daae114
2024
Appears in Open Access via Read & Publish Agreements
Abstract
The growing financial burden of noncommunicable diseases (NCDs) in sub-Saharan Africa (SSA) hinders the attainment of the sustainable development goals. However, there has been no updated synthesis of evidence in this regard. Therefore, our study summarizes the current evidence in the literature and identifies the gaps. We systematically search relevant databases (PubMed, Scopus, ProQuest) between 2015 and 2023, focusing on empirical studies on NCDs and their financial burden indicators, namely, catastrophic health expenditure (CHE), impov-erishment, coping strategies, crowding-out effects and unmet needs for financial reasons (UNFRs) in SSA. We examined the distribution of the indicators, their magnitudes, methodological approaches and the depth of analysis. The 71 included studies mostly came from single-country (n = 64), facility-based (n = 52) research in low-income (n = 22), lower-middle-income (n = 47) and upper-middle-income (n = 10) countries in SSA. Approximately 50% of the countries lacked studies (n = 25), with 46% coming from West Africa. Cancer, cardiovascular disease (CVD) and diabetes were the most commonly studied NCDs, with cancer and CVD causing the most financial burden. The review revealed methodological deficiencies related to lack of depth, equity analysis and robustness. CHE was high (up to 95.2%) in lower-middle-income countries but low in low-income and upper-middle-income countries. UNFR was almost 100% in both low-income and lower-middle-income countries. The use of extreme coping strategies was most common in low-income countries. There are no studies on crowding-out effect and pandemic-related UNFR. This study underscores the importance of expanded research that refines the methodological estimation of the financial burden of NCDs in SSA for equity implications and policy recommendations. • Monitoring financial protection for noncommunicable diseases is important for identifying coverage gaps and targeting health promotion and prevention policies. • Financial protection is crucial for achieving universal health coverage and promoting healthy living and well-being in sub-Saharan Africa. • The study highlights major gaps in studies evaluating inequities associated with the financial burden of NCDs in sub-Saharan Africa. • This will promote health equity and make health promotion services more affordable and accessible for vulnerable populations. • This evidence in the indicators of financial protection can guide the design of health financing reforms to better support health promotion activities.
Details
- Title
- The financial burden of noncommunicable diseases from out-of-pocket expenditure in sub-Saharan Africa: A scoping review
- Authors/Creators
- Adelakun Odunyemi (Author)Md Tauhidul Islam (Author)Khurshid Alam (Author) - Murdoch University, Centre for Healthy Ageing
- Publication Details
- Health Promotion International, Vol.39, daae114
- Publisher
- Oxford University Press
- Identifiers
- 991005702368707891
- Copyright
- © The Author(s) 2024.
- Murdoch Affiliation
- Centre for Healthy Ageing; Centre for Molecular Medicine and Innovative Therapeutics
- Language
- English
- Resource Type
- Journal article
UN Sustainable Development Goals (SDGs)
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- 1.156.381 Maternal Health Equity
- Web Of Science research areas
- Health Policy & Services
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