Assessment of Health Financing Mechanisms and Out-of-Pocket Expenditure for Essential Medicines in Benue State

Out-of-pocket payments for medicines remain the primary healthcare financing mechanism for most households in Benue State, creating financial barriers to treatment and catastrophic health expenditure among the most vulnerable populations. This study assessed health financing mechanisms, out-of-pocket expenditure on essential medicines, and catastrophic health spending among households in Makurdi LGA, Benue State, North Central Nigeria. A household cross-sectional survey was conducted among 280 households selected through systematic random sampling. A structured questionnaire collected data on health financing sources, medicine expenditure in the preceding month, household income, NHIS enrolment status, and coping mechanisms for health payments. Catastrophic health expenditure was defined as out-of-pocket payments exceeding 10 percent of total household expenditure. Results showed that 91.4 percent of households relied primarily on out-of-pocket payment for medicines. NHIS enrolment was reported by only 12.1 percent of surveyed households. Catastrophic health expenditure from medicine costs occurred in 24.6 percent of households in the preceding month. Low-income households spent proportionally four times more on medicines as a share of income than high-income households. Coping strategies included borrowing (54.3 percent) and reducing food expenditure (38.6 percent). The study recommends accelerating NHIS coverage expansion to informal sector households, implementing the Basic Health Care Provision Fund medicine benefit package, and establishing community medicine revolving funds as complementary financial protection mechanisms in Benue State.

Keywords: health financing, out-of-pocket expenditure, essential medicines, Benue State, health equity