Table 4 Articles included in the review

1.

(Xu et al. 2006b [48]) An empirical model of access to health care, health care expenditure and impoverishment in Kenya: learning from past reforms and lessons for the future

The impact of the Kenyan health financing system in the year 2003 on access to care and health spending. It will also shed light on the extent to which the prevailing system impoverished the population.

Kenya

Cross sectional

8407 households

38,009 individuals

Kenya health expenditure and utilisation survey 2003

2003

General health care

2.

(Onwujekwe et al. 2010 [65]) Are malaria treatment expenditures catastrophic to different socio-economic and geographic groups and how do they cope with payment? A study in southeast Nigeria

To determine the inequities in the household income depletion resulting from malaria treatment expenditures, the sacrifice of basic household needs [catastrophe] and the differences in payment strategies amongst different socio-economic and geographic groups in southeast Nigeria

Nigeria

Cross sectional

2250 households

HH survey

Not reported

Malaria

3.

(Kwesiga et al. 2015 [57]) Assessing catastrophic and impoverishing effects of health care payments in Uganda

To assess the catastrophic and impoverishing impact of paying for health care out of pocket in Uganda

Uganda

Cross sectional

6800 households

Uganda national HH survey 2009/2010

2009–2010

General health care

4.

(Akazili et al. 2017 [64]) Assessing the catastrophic effects of out-of-pocket healthcare payments prior to the uptake of a nationwide health insurance scheme in Ghana

To assess the catastrophic effect of OOP health care payments in Ghana to highlight the extent to which the health system protects HHs from the financial consequences of paying OOP for health services.

Ghana

Cross sectional

8687 households 36,488 individuals

Ghana living standard survey 2005/2006

2005–2006

General health care

5.

(Laokri et al. 2014 [40]) Assessing the economic burden of illness for tuberculosis patients in Benin: determinants and consequences of catastrophic health expenditures and inequities

To measure the risk, causes and consequences of catastrophic expenditures for tuberculosis and investigated potential inequities.

Benin

Cross sectional

250 TB patients

HH Survey

2008–2009

TB

6.

(Barasa et al. 2017 [52]) Assessing the impoverishing effects, and factors associated with the incidence of catastrophic health care payments in Kenya

The objectives of this study are to (1) examine the incidence and intensity of catastrophic health expenditures, (2) to examine the impoverishing effect of OOP health spending, and, (3) to explore factors that are associated with catastrophic health spending in Kenya.

Kenya

Cross sectional

33,675 households

Kenya health expenditure and utilisation survey 2013

2013

General health care

7.

(Ichoku and Fonta, 2009 [41]) Catastrophic healthcare financing and poverty: empirical evidence from Nigeria

To analyse the incidence and severity of catastrophic healthcare financing using different definitions of catastrophic healthcare and to examine the links between this phenomenon and poverty.

Nigeria

Cross sectional

7667 households

General household surveys of the federal office of statistics

1999

General health care

8.

(Chuma and Maina, 2012 [59]) Catastrophic health care spending and impoverishment in Kenya

To estimates the burden of out-of-pocket payments in Kenya; the incidence and intensity of catastrophic health care expenditure and the effect of health spending on national poverty estimates.

Kenya

Cross sectional

8414 households

Kenya health expenditure and utilisation survey 2007

2007

General health care

9.

(Buigut et al. 2015 [53]) Catastrophic health expenditure and its determinants in Kenya slum communities

To examine the incidence and determinants of catastrophic health expenditure amongst urban slum communities in Kenya

Kenya

Longitudinal

8171 individuals

Indicator development for surveillance of urban emergency (IDSUE)

2011–2013

General health care

10.

(Su et al. 2006 [44]) Catastrophic household expenditure for health care in a low-income society: a study from Nouna District, Burkina Faso

To quantify the extent of catastrophic household health care expenditure and determine the factors responsible for it in Nouna district, Burkina Faso

Burkina Faso

Cross sectional

774 households

Nouna health district HH survey

2000–2001

General health care

11.

(Sene and Cisse, 2015 [30]) Catastrophic out-of-pocket payments for health and poverty nexus: evidence from Senegal

The purpose of this study is to cast light on the determinants of catastrophic household out-of-pocket health expenditures and to assess their implications on poverty.

Senegal

Cross sectional

17,891 households

Poverty monitoring survey 2011

2011

General health care

12.

(Dyer et al. 2013 [45]) Catastrophic payment for assisted reproduction techniques with conventional ovarian stimulation in the public health sector of South Africa: frequency and coping strategies

How often does out-of-pocket payment (OPP) for assisted reproduction techniques (ART) with conventional ovarian stimulation result in catastrophic expenditure for households?

South Africa

Experimental-prospective observational study

135 ART couples

Hospitals survey

2009–2011

HIV-ART

13.

(Brinda et al. 2014 [51]) Correlates of out-of-pocket and catastrophic health expenditures in Tanzania: results from a national household survey

To investigate the determinants influencing OOP health expenditure amongst the adult as well as the older population aged above 60 Years in Tanzania

Tanzania

Cross sectional

3265 households

8297 individuals

Tanzania national panel survey 2008/2009

2008–2009

General health care

14.

(Masiye et al. 2016 [49]) Does user fee removal policy provide financial protection from catastrophic health care payments? Evidence from Zambia

To examine the extent and patterns of financial protection from fees following the decision to abolish user fees in public primary health facilities.

Zambia

Cross sectional

12,000 households

60,000 individuals

Zambia health expenditure and utilisation survey 2014

2014

General health care

15.

(Arsenault et al., 2013 [55]) Emergency obstetric care in Mali: catastrophic spending and its impoverishing effects on households

To investigate the frequency of catastrophic expenditure for emergency obstetric care, explore its risk factors and assess the effects of these expenditures on households in the Kayes region, Mali

Mali

Case-control

484 women

HH survey

2008–2011

Obstetric care

16.

(Okoronkwo et al. 2015 [71]) Economic burden and catastrophic cost amongst people living with type2 diabetes mellitus attending a tertiary health institution in south-east zone, Nigeria

To assess the magnitude of economic burden borne and catastrophic costs incurred by PLWDs in Nigeria

Nigeria

Cross sectional

308 People living with disability (PLWD)

Hospitals survey

2011–2012

Diabetes

17.

(Ughasoro et al. 2014 [72]) Economic cost of treatment of childhood epilepsy in Enugu, southeast Nigeria

To determine the economic costs and the level of CHE due to childhood epilepsy

Nigeria

Cross sectional

134 Patients

Hospitals survey

2012

Epilepsy

18.

(Mills et al. 2012 [14]) Equity in financing and use of health care in Ghana, South Africa, and Tanzania: implications for paths to universal coverage

To report the results of a three-country study on the equity of health system financing and service use

Ghana; South Africa; Tanzania

Comparative study

Not reported

National HH survey

2008

General health care

19.

(Onwujekwe et al. 2012 [63]) Examining inequities in incidence of catastrophic health expenditures on different healthcare services and health facilities in Nigeria

To estimate the level of CHE for different healthcare and facilities and their distribution across socio economic status

Nigeria

Cross sectional

4473 households

HH survey

Not reported

General health care

20.

(Onwujekwe et al. 2009 [61]) Examining catastrophic costs and benefit incidence of subsidised antiretroviral treatment (ART) programme in south-east.

To examine the extent to which costs of subsidised antiretroviral treatment programmes are catastrophic and the benefit incidence that accrues to different population groups

Nigeria

Cross sectional

301 ART patients

Hospital database

Not reported

HIV-ART

21.

(Onwujekwe et al. 2016 [38]) Examining geographic and socio-economic differences in outpatient and inpatient consumer expenditures for treating HIV/AIDS in Nigeria

To provide information and the resultant incidence of CHE from medical and non-medical expenditures incurred on outpatient visits [OPV] from different social-economic groups and geographical conditions.

Nigeria

Cross sectional

1200 people living with HIV

HH survey

2013

HIV-ART

22.

(Akinkugbe et al. 2012 [16]) Health financing and catastrophic payments for health care: evidence from household-level survey data in Botswana and Lesotho

To assess the degree of inequality in the distribution of health expenditure across wealth quintiles in Botswana and Lesotho.

Lesotho; Botswana

Comparative study

6882 households (Lesotho)

6053 households (Botswana)

HH expenditure survey 2002/2003

2002–2003

General health care

23.

(Castillo-Riquelme et al. 2008 [68]) Household burden of malaria in South Africa and Mozambique: is there a catastrophic impact?

To evaluate treatment seeking behaviour financial impact and time lost due to malaria events in southern Mozambique and eastern South Africa

South Africa; Mozambique

Comparative study

827 households (South Africa)

828 households (Mozambique)

HH survey

2001–2002

Malaria

24.

[Ukwaja et al. 2013 [46, 50] Household catastrophic payments for tuberculosis care in Nigeria: incidence, determinants, and policy implications for universal health coverage

To investigate the incidence, intensity, distribution and correlates of catastrophic payments for TB care and policy implications for TB care and their primary care services

Nigeria

Cross sectional

452 TB patients

HH survey

2011

TB

25.

(Mchenga et al. 2017 [37]) Impoverishing effects of catastrophic health expenditures in Malawi

To Investigate the effect of catastrophic OOP on the incidence and depth of poverty in Malawi

Malawi

Cross sectional

12,271 individuals

Integrated household survey 2010/2011

2010–2011

General health care

26.

(Ichoku et al. 2009 [36]) Incidence and intensity of catastrophic healthcare financing and impoverishment due to out-of- pocket payments in southeast Nigeria

To examine incidence and intensity of catastrophic health care financing and the impoverishing effects, as well as equity concerns due to OOP for healthcare in Southeast Nigeria.

Nigeria

Cross sectional

1500 households

HH survey

Not reported

General health care

27.

(Ilunga-Ilunga et al. 2015b [39]) Incidence of catastrophic health expenditures for households: an example of medical attention for the treatment of severe childhood malaria in Kinshasa reference hospitals, Democratic Republic of Congo

To estimate the incidence of catastrophic health expenditures incurred by households in which one child suffered severe malaria and subsequently attended Kinshasa referral hospital.

Democratic Republic of Congo

Cross sectional

1350 children

HH survey

Not reported

Malaria

28.

(Adisa, 2015 [43]) Investigating determinants of catastrophic health spending amongst poorly insured elderly households in urban Nigeria

To investigate the key determinants of CHE amongst poorly insured elderly households in Nigeria.

Nigeria

Cross sectional

1176 households

Nigerian general HH panel survey 2010

2010

General health care

29.

(Cleary et al. 2013 [56]) Investigating the affordability of key health services in South Africa

To identify Characteristics of households that experience difficulties in affording health care

South Africa

Cross sectional

3727 patients

Exit interviews

Not reported

Obstetric care/TB/ART

30.

(Ataguba, 2012 [42]) Reassessing catastrophic health-care payments with a Nigerian case study

What might constitute fair indices of catastrophic payment, which explicitly recognise diminishing marginal utility of income as reflected in some principle of vertical equity?

This paper aims to examine such indices and how best to assess them.

Nigeria

Cross sectional

19,518 households

Nigerian national living standard survey 2003/2004

2003–2004

General health care

31.

(Counts and Skordis-Worrall, 2016 [70]) Recognising the importance of chronic disease in driving healthcare expenditure in Tanzania: analysis of panel data from 1991 to 2010

This study compares the level and predictors of expenditure on healthcare between chronic disease-affected (CDA) and unaffected (CDU) households in this region using 19-year panel data.

Tanzania

Longitudinal

900 households

6353 individuals

Modelled data–Kagera health development survey

1991–2010

Chronic disease

32.

(Wang et al. 2016 [58]) The economic burden of chronic non-communicable diseases in rural Malawi: an observational study

To estimate both the HH direct, indirect and total costs due to CNCDs; and the economic burden households bear as a result of these costs in Malawi

Malawi

Cross sectional

1199 households

5643 individuals

HH survey

2012

Chronic non-communicable

33.

(Beaulière et al. 2010 [54]) The Financial burden of morbidity in HIV-infected adults on antiretroviral therapy in Côte d’Ivoire

To estimate the financial burden of health care for households with HIV-infected adults taking antiretroviral therapy (ART]) in Côte d’Ivoire.

Côte d’Ivoire

Cross sectional

1190 adults

HH survey

2007

HIV-ART

34.

(Xu et al., 2006a [47]) Understanding the impact of eliminating user fees: utilisation and catastrophic health expenditures in Uganda

Examine changes in utilisation and catastrophic health expenditure

Uganda

Cross sectional

6655 households

33,988 individuals

Social economic survey 1997, 2000, 2003

1997, 2000, 2003

General health care