The family ability to pay for health care expenditures on malaria treatment in Cameroon

Abstract

This thesis is concerned with the development of a methodology for identifying indicators of family's ability to pay for health care expenditures on malaria treatment. It also examines the possible trade-off between health care and other basic needs such as education and food amongst the common family responses to payment difficulties under the combined user fee burdens from various essental social sectors in Cameroon. The assumption underlying the analysis is that from the perspective of family as a whole, the affordability of costs for primary health care together with other basic services is pertinent to reach the goals of Health For All by year 2000. The descriptive cross-sectional family survey has bee designed for data collction. The data are used to estimate two binomial logit models. a multiomial logit model (choice of copig=n strategies : forego eduction. cut food consumption, sell productive assets, or borrow cash). and a multiple regression model for health care expenditures on malaria teatment. Since the approach is methodological. the questionnaire is developed. but the real data are not collected in the field. Hypothetical data denerated from three different multipurpose family surveys are used to test the models. The main empirical result of this study is that the family's ability to pay for malaria treatment costs is responsive to changes in income. savings, fee exemptions, insurane co-payment, productive assets ownership (e.g. land). percapita consumption, family size. number of employed members in the family, number of children under five years old. number pregnant women. preventive measures. sex of head of the family. principal source of income. and residence. This finding is comparable to other studies on the affordability of health care in developing countries. The results of this study outline some specific indicators which should be used by health staff when grating fee exemptions. It also demonstrates that policy initiatives must be appropriate to local contexts and disease patterns with more emphasis on preventive measures. Although, the methodological decisions for improving equity access to health care of the poor families can be ascertained. the conclusion argues that only where those findings are indeed robust should they be emphasized and confirmed with the real primary data collected through the proposed questionnaire at the level of families. Finally, this study has its limitations. All coping strategies are not investigated. For example, the consequences of the decision to delay or not seeking treatment. In addition. many of the issues of ability to pay require qualitative indepth investigation of amily priority-setting and expenditure patterns.