Treatment-Seeking Behaviour, Cost Burdens and Coping Strategies Among Rural and Urban Households in Coastal Kenya: An Equity Analysisr Title Here
iHEA 2007 6th World Congress: Explorations in Health Economics Paper
Ill-health can inflict costs on households directly through cash spending on treatment and indirectly through impacting on labour productivity. The financial burden can be high, and for poor households contribute significantly to declining household welfare. We investigated socio-economic inequities in self-reported illnesses, treatment-seeking behaviour, cost burdens and coping strategies in a rural and urban setting along the Kenyan coast. Multiple methods were used including: a survey of 294 rural and 576 urban households, 9 focus group discussions and 9 in-depth interviews in each setting.
Key findings were significantly higher levels of reported chronic and acute conditions in the rural compared to the urban setting, differences in treatment-seeking patterns by socio-economic status and by setting, and regressive cost burdens in both areas. These data suggest the need for increased governmental and non-governmental efforts towards protecting the poor from catastrophic illness cost burdens. Promising options include careful elimination of user fees, at least in targeted hardship areas, developing more flexible charging systems where fees are maintained, and improving quality of care in all facilities. The data also strongly support the need for a multi-sectoral approach to protecting households. Potential interventions beyond the health sector include supporting the social networks that are key to household livelihood strategies and promoting micro-finance schemes that enable small amounts of credit to be accessed with minimal interest rates.
Keywords: equity, cost burdens, coping strategies, catastrophic, Kenya
JEL Classification: I19
Date posted: June 27, 2007
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