Free access to antiretroviral treatment and protection against the risk of catastrophic health expenditure in people living with HIV: evidence from Cameroon
In: ISSN: 1472-6963 ; BMC Health Services Research ; https://inserm.hal.science/inserm-03219650 ; BMC Health Services Research, 2021, 2021
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Zugriff:
International audience ; Background: To foster access to care and reduce the burden of health expenditures on people living with HIV (PLHIV), several sub-Saharan African countries, including Cameroon, have adopted a policy of removing HIV-related fees, especially for antiretroviral treatment (ART). We investigate the impact of Cameroon's free antiretroviral treatment (ART) policy, enacted in May 2007, on catastrophic health expenditure (CHE) risk according to socioeconomic status, in PLHIV enrolled in the country's treatment access program. Methods: Based on primary data from two cross-sectional surveys of PLHIV outpatients in 2006-2007 and 2014 (i.e., before and after the policy's implementation, respectively), we used inverse propensity score weighting to reduce covariate imbalances between participants in both surveys, combined with probit regressions of CHE incidence. The analysis included participants treated with ART in one of the 11 HIV services common to both surveys (n = 1275). Results: The free ART policy was associated with a significantly lower risk of CHE only in the poorest PLHIV while no significant effect was found in lower-middle or upper socioeconomic status PLHIV. Unexpectedly, the risk of CHE was higher in those with middle socioeconomic status after the policy's implementation. Conclusions: Our findings suggest that Cameroon's free ART policy is pro-poor. As it only benefitted PLHIV with the lowest socioeconomic status, increased comprehensive HIV care coverage is needed to substantially reduce the risk of CHE and the associated risk of impoverishment for all PLHIV.
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Free access to antiretroviral treatment and protection against the risk of catastrophic health expenditure in people living with HIV: evidence from Cameroon
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Autor/in / Beteiligte Person: | Bousmah, Marwân-Al‐qays ; Nishimwe, Marie, Libérée ; Kuaban, Christopher ; Boyer, Sylvie ; Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD) ; Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM) ; Santé, vulnérabilités et relations de genre au sud (SAGESUD - ERL Inserm U1244) ; Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre population et développement (CEPED - UMR_D 196) ; Institut de Recherche pour le Développement (IRD)-Université Paris Cité (UPCité)-Institut de Recherche pour le Développement (IRD)-Université Paris Cité (UPCité) ; Centre population et développement (CEPED - UMR_D 196) ; Institut de Recherche pour le Développement (IRD)-Université Paris Cité (UPCité) ; University of Yaoundé Cameroun |
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Zeitschrift: | ISSN: 1472-6963 ; BMC Health Services Research ; https://inserm.hal.science/inserm-03219650 ; BMC Health Services Research, 2021, 2021 |
Veröffentlichung: | HAL CCSD ; BioMed Central, 2021 |
Medientyp: | academicJournal |
DOI: | 10.1186/s12913-021-06331-5 |
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