Assessing Catastrophic Health Expenditure among Iraqi  Households: A Cross-Sectional Study

Zainab  Abodi; Ghobad  Moradi; Yousef  Moradi; Amjad Mohamadi  Bolbanabad; Hayedeh  Hoorsan

doi:10.18502/ijph.v54i6.18907

Zainab Abodi Department of Health Care Management, SR.C., Islamic Azad University, Tehran, Iran
Ghobad Moradi Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
Yousef Moradi Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
Amjad Mohamadi Bolbanabad Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
Hayedeh Hoorsan Department of Nursing-Midwifery, Sa.C., Islamic Azad University, Sanandaj, Iran

DOI: https://doi.org/10.18502/ijph.v54i6.18907

Keywords: Catastrophic health expenditures (CHE); Health system; Iraq

Abstract

Background: Catastrophic health expenditures can lead to severe household financial burdens, exacerbating poverty and limiting access to necessary health services. This study examined the prevalence and determinants of catastrophic health expenditures among households in six provinces of Iraq.

Methods: A cross-sectional design was employed, gathering data from 2,400 households in Baghdad, Wasit, Karbala, An-Najaf, Babil, and Maysan in 2023. A two-stage cluster sampling method was utilized, selecting 400 households from each province. Data were collected using WHO "World Health Survey" questionnaire, focusing on health expenditures and household income. Catastrophic health expenditures as defined as out-of-pocket costs exceeding 40% of a household’s capacity to pay. Statistical analyses, including logistic regression with calculating adjusted odds ratio, were performed using STATA14 software.

Results: Overall, 246 households (12.6%) faced Catastrophic health expenditures, with a higher prevalence among female heads of households (13.1%) compared to males (12.6%). The multivariate logistic regression analysis indicated that households with 4 to 6 members had 1.52 times higher odds of facing catastrophic health expenditures (AOR=1.52, CI: 1.06 to 2.20). Furthermore, the poorest households had an AOR of 95.28 for experiencing catastrophic health expenditures (OR=95.28, CI: 13.12 to 691.49).

Conclusion: This study underscores the urgent need for tailored policies to reduce the impact of CHE on Iraqi households. By improving access to healthcare and promoting equitable health insurance enrollment, policymakers can alleviate financial strain and support the health and well-being of vulnerable communities.