The Impoverishment Effect of Out-of-Pocket Expenditure for Hypertension in Ghana

The rising prevalence of hypertension in Ghana and the associated household expenditures have become major policy concerns. High out-of-pocket (OOP) payments restrict access to care and increase the risk of impoverishment. This study examines the level and effect of household impoverishment due to care-seeking for hypertension in Ghana.

We analyzed data from a catastrophic health expenditure survey conducted between December 2023 and February 2024 at 2 primary healthcare facilities: Weija Gbawe Municipal Hospital (WGMH) and Shai Osudoku District Hospital (SODH) in the Greater Accra Region. The analysis involved descriptive statistics and estimation of the impact of OOP payment on impoverishment, including a pen's parade of household per capita expenditure.

The findings show that OOP led to an increase in the poverty headcount by 3.14% and 0.26% using US dollars $2.15/per day and $3.65/per day, respectively. At a lower threshold, the household poverty gap increased from $40.10 to $46.57 and widened from $83.86 to $90.79. The normalized poverty gap grew from 62.17% to 72.20% at a lower poverty line and from 76.58% to 82.92% at the higher threshold. It also emerged that the normalized mean poverty also increased from 61.78% to 69.62% at a poverty threshold of $2.15 and from 129.8% to 141.92% at $3.65 of the poverty line.

Our findings suggest that without financial risk protection, households are likely to be pushed into extreme poverty because of expenditures on hypertension care. Urgent intervention is needed to mitigate the impoverishing effects of noncommunicable diseases in Ghana.