Economic burden and psycho-social implications of Non- Communicable Diseases on adults and their households in South-west Nigeria
Abstract
Background: Non-communicable diseases (NCDs), are associated with significant economic and psycho-social burden on sufferers.
Objective: To compare the economic burden of disease management on adults with NCDs and control subjects in Ogbomoso, Nigeria.
Method: A total of 322 participants consisting of 165 adults with at least one of two NCDs - hypertension and diabetes mellitus- and 157 controls (without NCDs) were recruited by stratified random sampling method. The participants were evaluated for the economic burden and psycho-social implications of NCDs on them and on their households.
Results: The presence of NCDs was associated with significantly higher psycho-social implication on the subjects including poorer patient-reported personal health assessment, higher frequency of hospital visits and longer average total hours of hospital visits compared to the controls. A significant proportion of subjects with NCDs depended on family supports for their hospital bills (32.7% vs. 7.6%). The total average monthly health expenditure among subjects with NCDs was significantly higher. Catastrophic health expenditure was found in 12.1% of subjects with NCDs who indicated their hospital bills were far higher than their total monthly wages.
Conclusion: The management of NCDs is associated with significantly higher psycho-social and economic impact on affected individuals. There is a need for appropriate health insurance scheme and health system financing programs to reduce economic and psycho-social burdens, minimise long-term complications and improve quality of life.
References
2. Health Reform Foundation of Nigeria (HERFON). Diabetes to top cause of death in 2015. Available at www.vanguardngr.com/2011/10/diabetes-to-top-cause-of-death-in-2015-healthgroup. Accessed 15th December 2017.
3. Remais JV, Zeng G, Li G, Tian L, Engelgau MM. Convergence of non-communicable and infectious diseases in low- and middle-income countries. Int J Epidemiol 2013; 42(1): 221-7.
4. Ekpenyong CE, Udokang NE, Akpang EE, Samson TK. Double burden, non-communicable diseases and risk factors evaluation in sub-Saharan Africa: The Nigerian Experience. Eur J Sustainable Dev 2012; 1(2): 249-70.
5. Miranda JJ, Kinra S, Casas JP, Davey Smith G, Ebrahim S. Non-communicable diseases in low- and middle-income countries: context, determinants and health policy. Trop Med Int Health 2008; 13(10): 1225-34.
6. Kankeu HT, Saksena P, Hu Ke, Evans DB. The financial burden from non- communicable diseases in low and middle- income countries: a literature review. Health Res Policy Systems 2013; 11: 31. DOI: 10.1186/1478-4505-11-31.
7. McIntyre D, Thiede M, Dahlgren G, Whitehead M. What are the economic consequences for households of illness and of paying for health care in low- and middle-income country contexts? Soc Sci Med 2006; 62: 858–65.
8. Engelgau M, Rosenhouse S, El-Saharty S, Mahal A. The economic effect of non-communicable diseases on households and nations: a review of existing evidence. J Health Comm 2011; 16: 75–81.
9. Onoka CA, Hanson K, Hanefeld J. Towards universal coverage: a policy analysis of the development of the National Health Insurance Scheme in Nigeria. Health Policy Plan 2015; 30(9): 1105-17.
10. Robinson HM, Hort K. Non-communicable diseases and health systems reform in low-and-middle-income countries. Pac Health Dialog 2012; 18(1): 179-90.
11. Bakare AS. Measuring the Income Inequality in Nigeria: the Lorenz Curve and Gini Co-efficient Approach. Am J Econ 2012; 2(1): 47-52.
12. Oni T, Unwin N. Why the communicable/non-communicable disease dichotomy is problematic for public health control strategies: implications of multimorbidity for health systems in an era of health transition. Int Health 2015; 7(6): 390-9.
13. Boutayeb A. The double burden of communicable and non-communicable diseases in developing countries. Trans R Soc Trop Med Hyg. 2006; 100(3): 191-9.
14. Amuna P, Zotor FB. Epidemiological and nutrition transition in developing countries: impact on human health and development. Proc Nutr Soc 2008; 67(1): 82-90.
15. John EU. The Impacts of User Fees on Health Services in Sub-Saharan African Countries: A Critical Analysis of the Evidence. Am J Pub Health Res 2013; 1(8): 196-202.
16. Abegunde D, Stanciole A. An estimation of the economic impact of chronic noncommunicable diseases in selected countries. A working paper. World Health Organization Department of Chronic Diseases and Health Promotion (CHP) http://www.who.int/chp. Accessed on the 18th December 2017.
17. Engelgau MM, Karan A, Mahal A. The Economic impact of Non-communicable Diseases on households in India. Global Health. 2012; 8: 9. doi.10.1186/1744-8603-8-9.
18. Temu F, Leonhardt M, Carter J, Thiam S. Integration of non-communicable diseases in health care: tackling the double burden of disease in African settings. Pan Afr Med J 2014; 18: 202.
19. Schofield D, Passey M, Percival R, Shrestha R, Callander E, Kelly S: Retiring early with cardiovascular disease - impact on individual’s financial assets. Int J Cardiol 2010; 92: 125–6.
20. Barrett AM, Colosia AD, Boye KS, Oyelowo O. Burden of Obesity: 10-year Review of the Literature on Costs in Nine Countries. Toronto, Canada: ISPOR 13th Annual International Meeting; 2008.
21. Langa KM, Fendrick AM, Chernew ME, Kabeto MU, Paisley KL, Hayman JA. Out-of-pocket health-care expenditures among older Americans with cancer. Value Health 2004; 7: 186–94.
22. Wang Q, Brenner S, Kalmus O, Banda HT, De Allegri M. The economic burden of chronic non-communicable diseases in rural Malawi: an observational study. BMC Health Serv Res 2016; 16: 457-60.
23. Jaspers L, Colpani V, Chaker L, van der Lee SJ, Muka T, Imo D, et al. The global impact of non-communicable diseases on households and impoverishments: a systematic review. Eur J Epidemiol 2015; 30(3): 163-88.
24. Maiyaki MB, Garbati MA. The burden of non-communicable diseases in Nigeria; in the context of globalization. Ann Afr Med 2014; 13(1): 1-10.
25. Janssens W, Goedecke J, de Bree GJ, Aderibigbe SA, Akande TM, Mesnard A. The financial burden of Non-communicable diseases in rural Nigeria: Wealth and gender heterogeneity in health care utilization and health expenditure. PLoS One. 2016; 11(11): e0166121.
26. Muka T, Imo D, Jaspers L, Colpani V, Chaker L, van der Lee SJ, et al. The global impact of non-communicable diseases on healthcare spending and national income: a systematic review. Eur J Epidemiol. 2015; 30(4): 251-77.
27. World Health Organization. Global burden of disease report, Nigeria available on http://www.healthdata.org/nigeria. Accessed 22nd January 2018.
28. Mensah GA. Tackling non-communicable diseases in Africa: Caveat Lector. Health Educ Behav 2016; 43(1): 7S-13S.
29. Amuyunzu-Nyamongo M, Owuor JO, Blanchard C. The consortium for NCD prevention and control in sub-Saharan Africa (CNCD-Africa): from concept to practice. Glob Health Promot. 2013; 20(4): 97-103.
Copyright (c) 2018 Annals of Health Research

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The articles and other materials published in the Annals of Health Research are protected by the Nigerian Copyright laws. The journal owns the copyright over every article, scientific and intellectual materials published in it. However, the journal grants all authors, users and researchers access to the materials published in the journal with the permission to copy, use and distribute the materials contained therein only for academic, scientific and non-commercial purposes.