Challenges in healthcare financing for surgery in sub-Saharan Africa — Okoroh 2021

One-third of the global disease burden is surgical conditions, but 5 billion people lack surgery. By 2030, the Lancet Commission on Global Surgery, Obstetrics, and Anesthesia (LCOGS) recommended reducing catastrophic health expenditures (CHEs) to improve access. In sub-Saharan Africa (SSA), 90% of the extreme poor live, this is crucial. We present a narrative review of four SSA surgical care CHE studies published since 2015. We discuss healthcare financing in the countries and summarize the authors' key findings on OOP and CHEs. The studies enrolled 130 to 300 patients and collected direct OOPs via chart review of health costs or patient interviews. Transportation and lost wages determined indirect costs. Health costs exceeding 10% of GDP per capita or household income were CHEs. Despite free healthcare, 60%-90% of surgical patients had CHEs. OOPs for medicines and anesthesia should be covered by health insurance. In some cases, indirect transportation and wage costs drove surgery CHEs. Without filling these gaps, more SSA patients will risk impoverishment for surgery.

Okoroh, J. S., & Riviello, R. (2021). Challenges in healthcare financing for surgery in Sub-Saharan Africa. Pan African Medical Journal, 38. https://doi.org/10.11604/pamj.2021.38.198.27115