I.Y. Adeoye[1], K. Ogungbemi[1], A. Adaoha[1], A. Adedayo[2]

Background: Out-of-pocket expenditure on HIV/AIDS services and goods is a component in national HIV/AIDS accounts that is most difficult to measure. Despite the increasing need for national data on out-of-pocketexpenditure (OOP) on HIV/AIDS, only few countries have data on it. Interestingly, healthcare financing in Nigeria is largely from out-of-pocket payments. Although HIV-related treatment is free; there are out-of pocket expenditures that people with HIV incur to maintain their health. Out-of-pocket expenditure(OOP) on health is defined as direct and indirect expenses incurred by an individual/household to maintain their health.

Methods: This assessment was undertaken in 26 health facilities and among 485 people living with HIV/AIDS in five Nigerian states using a cross-sectional study design by providing a retrospective account of household spending on HIV services.

Results: Total annual OOP for HIV services in 2009 and 2010 were $159,969,744 and $189,647,568 respectively. The proportion of household income spent on HIV care was 14.5%; PMTCT services for labor/delivery:25% and ART:3.1%. Total annual OOP expenditure on condoms in 2009: $8,633,252 and 2010: $10,235,591. About 55% of the out-of-pocket expenditure was paid through self-financing and household incomes. Few households (6%) sold personal items to pay for HIV care & services. The household expenditure pattern was as follows: healthcare (23.0%), food (33.5%) and transport (13.1%). Based on an average annual spending of $528 on HIV, an individual spent about 39% of their personal income on HIV care/services.

Conclusions: Out-of-pocket expenditure as a percentage of private expenditure in Nigeria among people living with HIV is a burden, an indication that governments at all levels are not making adequate investments in health. There is a need to increase funding for HIV/AIDS management programs to prevent patients having to incur extra-expenses to get their diagnostics and interventions from fee-charging facilities.

Source: AIDS2012