Michael Nnachebe Onah|Veloshnee Govender
Out-of-Pocket Payments, Health Care Access and Utilisation in South-Eastern Nigeria: A Gender Perspective
University of the Witwatersrand|University of Cape Town
outofpocket oop payments severe consequences health care access utilisation especially catastrophic poor although women comprise majority poor nigeria globally implications oop payments health care access gender perspective received little attention study seeks fill gap using combination quantitative qualitative analysis investigate gendered impact oops healthcare utilisation southeastern nigeria 411 households surveyed six singlesex focus group discussions conducted study confirmed socioeconomic demographic vulnerability femaleheaded households fhhs contributed genderbased interhousehold differences healthcare access cost burden choices healthcare providers methods funding healthcare coping strategies fhhs higher cost burdens seeking care untreated morbidity maleheaded households mhhs affordability reason seeking care also high utilisation patent medicine vendors pmvs households pmvs drug vendors unregulated likely offer lowquality treatment trained personnel oop payment predominantly means healthcare payment households households spoke difficulties associated repaying healthrelated debt implications medical poverty trap recommended removal user fees introduction prepayment schemes regulating pmvs considered improve access provide protection debt fhhs mhhs vulnerability widows special concern efforts improve healthcare access broader efforts empower encouraged poor households