The European Journal of Health Economics

, Volume 19, Issue 4, pp 521–532 | Cite as

Determinants of catastrophic health expenditure in Nigeria

Original Paper



Catastrophic health expenditure is a measure of financial risk protection and it is often incurred by households who have to pay out of pocket for health care services that are not affordable. The study assessed the determinants of catastrophic health expenditure among households in Nigeria.


Secondary data from the Harmonized Nigeria Living Standard Survey (HNLSS) of 2009/10 was utilized to assess factors associated with catastrophic health expenditure in Nigeria. Household and individual characteristics associated with catastrophic health expenditure were determined using bivariate analysis and multivariate logistic regression.


Results showed that irrespective of the threshold for the two concepts of total household expenditure and non-food expenditure, having household members aged between 6 and 14 years, having household members aged between 15 and 24 years, having household members aged between 25 and 54 years, having no education, having primary education, having secondary education, lack of health insurance coverage, visiting a private health facility, households living in north central zone, households living in north east zone and having household members with non-chronic illnesses were factors that increase the risk of incurring catastrophic health expenditure among households.


Policy-makers and political actors need to design equitable health financing policies that will increase financial risk protection for people in both the formal and informal sectors of the economy.


Out-of-pocket payments Catastrophic health expenditure Harmonized Nigeria Living Standard Survey Financial risk protection Health equity 

JEL Classification




We acknowledge Mr. Sunday J. Ichedi and Mr. Leo Sanni of the National Bureau of Statistics for providing access to the micro data of the Harmonized Nigeria Living Standard Survey (HNLSS) 2009/10.

Compliance with ethical standards

Informed consent

The authors declare that they have no conflicts of interest.

Ethical approval

The study used secondary data, hence ethical approval is not applicable.


There was no funding support for this study.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Bolaji Samson Aregbeshola
    • 1
  • Samina Mohsin Khan
    • 2
  1. 1.Department of Community Health and Primary Care, College of MedicineUniversity of LagosLagosNigeria
  2. 2.Department of Public Health SciencesKarolinska InstitutetStockholmSweden

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