Assessing Medical Impoverishment by Cause

This paper evaluates the consequences of universal public finance (UPF) for tuberculosis treatment in India using extended cost-effectiveness analysis (ECEA). The authors evaluated the impact of UPF on health gains, financial consequences, and catastrophic health expenditures, and concluded that the health gains and insurance value of UPF would accrue mostly to the poor. However, reductions in out-of-pocket expenditures were found to be more uniformly distributed across income quintiles. A variant on the base case suggests…

Providing HIV testing at health facilities remains the most common approach to ensuring access to HIV treatment and prevention services for the millions of undiagnosed HIV-infected individuals in sub-Saharan Africa. The authors sought to explore the costs of providing these services across three southern African countries with high HIV burden.Primary costing studies were undertaken in 54 health facilities providing HIV testing services (HTS) in Malawi, Zambia and Zimbabwe. Routinely collected monitoring and evaluation data for…

The growing burden of non-communicable diseases (NCDs) in low- and middle-income countries may have implications for health system performance in the area of financial risk protection, as measured by catastrophic health expenditure (CHE). This article compares non-communicable diseases catastrophic health expenditure to the CHE cases caused by communicable diseases across health systems to examine whether: (1) disease burden and catastrophic health expenditure are linked, (2) Catastrophic health expenditures secondary to NCDs disproportionately affect wealthier households and (3) whether the drivers…