Comparison of incidence of catastrophic health expenditure among tuberculosis patients in public and private health facilities in Kaduna state, Nigeria, 2016
Bola Biliaminu Lawal1,&, Mohammed Sambo2, Muawiya Sufiyan2, Lawal Ahmadu2, Abdulhakeem Olorukooba2, Damiane Lawong3, Sulaiman Bashir2, Bashir Zakariyya4, Hadiza Sulaiman2
1Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria, 2Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria, 3Department of Economics, Ahmadu Bello University, Zaria, Nigeria, 4KNCV/Challenge TB, Abuja, Nigeria
Bola Biliaminu Lawal, Nigeria Field Epidemiology and Laboratory Training Programme, Asokoro, Abuja, Nigeria
despite providing free tuberculosis (TB) diagnosis and treatment services, TB patients still incur financial hardship while seeking for care. Involving private health facilities through Public-Private Mix (PPM) has been identified by World Health Organization as a strategy for eliminating catastrophic health expenditure (CHE) due to TB. There is paucity of studies comparing the incidence of CHE in public and private health facilities in Nigeria. We compared the incidence of CHE due to TB among patients in public and private health facilities rendering TB Directly Observed Treatment Short-course (DOTS) services in Kaduna State.
we conducted a comparative longitudinal study in 2016, recruiting 274 pulmonary
TB patients, 137 from public health facilities and 137 from private health facilities
using a multi-stage sampling technique. We collected data using a questionnaire
adapted from a tool developed by USAID. CHE was measured using a threshold of
out of pocket (OOP) health expenditure ≥ 40% of non-food expenditure.
Bi-variate analysis and binary logistic regression were used to test for association
and control for confounders respectively with statistical significance determined
at p < 0.05. Data was analyzed using SPSS version 23.0 software.
the average cost per TB patient successfully treated from the patient's perspective was US$485.7 in private health facilities and US$262.9 in public health facilities (t = -2.787, p = 0.006). There was a statistically significant difference in the incidence of CHE due to TB between patients in public health facilities (21.2%) and private health facilities (13.1%) (AOR= 2.87, 95% CI = 1.224 - 6.731, p = 0.015).
the incidence of CHE due to TB was higher in public health facilities compared to private health facilities. We recommend that efforts to reduce OOP expenditure (e.g. home management of TB) among TB patients in public health facilities in Kaduna State should be explored.
Nigeria CDC/Nigeria Field Epidemiology and Laboratory Training Programme 2<sup>nd</sup> Annual Scientific Conference (Abuja)
To create a platform for epidemiologists and public health physicians to share their scientific works, NCDC/NFELTP organized the 2nd annual scientific conference with the theme "strengthening one health through field epidemiology training" at Transcorp Hilton Hotel, Abuja, Nigeria from July 5-7, 2017. The objectives of the conference were to provide residents and graduates a forum to share findings from their field activities; provide training opportunity for trainees on scientific communication; provide an opportunity for epidemiological networking as well as create a forum to discuss pertinent public health issues. In attendance were dignitaries from the United States Centers for Disease Control and Prevention (CDC), USAID, WHO, Africa CDC, Ministries Departments and Agencies, University officials and other implementing partners. With the current rise in zoonotic diseases, the conference also featured a two-day pre-conference workshop on One Health which prioritized zoonotic infectious diseases in Nigeria using standardized prioritization methods. A second workshop focused on antimicrobial resistance. There were 38 oral presentations, 60 poster presentations and 2 plenary sessions. The presentations covered various sub-themes ranging from outbreak investigations, case management, health system strengthening, vaccine preventable diseases, communicable diseases and surveillance. The conference featured a National Night and climaxed with awards to outstanding presenters.
Dates: 05 Jul 17 - 07 Jul 17
Venue: Transcorp Hilton Hotel
Organizers: Nigeria Centre for Disease Control / Nigeria Field Epidemiology and Laboratory Training Programme
Contact person: Dr Patrick Nguku (email@example.com)