RESEARCH PAPER
The effect of HIV/AIDS on household’s healthcare expenditure and income in Addis Ababa: a propensity score matching approach
Submission date: 2017-04-09
Final revision date: 2018-01-13
Acceptance date: 2018-01-16
Publication date: 2018-05-21
HIV & AIDS Review 2018;17(2):103-110
KEYWORDS
TOPICS
ABSTRACT
Introduction:
The focus of this paper is to assess the effect of HIV/AIDS on household healthcare expenditure and income by comparing HIV-affected households with non-affected ones.
Material and methods:
Primary data was collected using structured and pretested questionnaires in Addis Ababa, Ethiopia, in the period between January and February 2015. A total of 240 households were interviewed, 149 of which were HIV-affected households and the remaining 91 were non-affected. Since the sample of HIV-affected households was non-random and there is a strong risk of selection biases because of pre-existing differences between the two groups, direct comparisons of the outcomes may be misleading. This is because the existence of confounding factors creates biases in the estimation of average treatment effects on the outcome variables. To reduce this bias and to control confounding factors, propensity score matching methods were employed.
Results:
The total monthly health expenditure of the affected households were on average 375 Ethiopian Birr (about $ 18) higher than the non-affected households. The share of health expenditure on total expenditure was also found approximately 14 percentage point higher than the non-affected. On the other hand, the monthly per capita income, the share of expenditure on food were considerably lower among the affected households. The average treatment effect on the treated for the share of expenditure on food was 13 to 19 percentage point lower. The HIV-affected households had lost, on average, 6 more workdays than the non-affected.
Conclussion:
The study concluded that the economic burden of HIV falls mainly on the affected household members and their families. Some policy measures should be designed targeting the affected households to mitigate the economic burden arises from HIV/AIDS and to improve the household’s welfare. Alternative social support mechanisms like healthcare financing in the form of prepayment and strengthening households’ economic activities by creating job opportunities and facilitating loan services from micro credit associations would mitigate the burden for households.
The focus of this paper is to assess the effect of HIV/AIDS on household healthcare expenditure and income by comparing HIV-affected households with non-affected ones.
Material and methods:
Primary data was collected using structured and pretested questionnaires in Addis Ababa, Ethiopia, in the period between January and February 2015. A total of 240 households were interviewed, 149 of which were HIV-affected households and the remaining 91 were non-affected. Since the sample of HIV-affected households was non-random and there is a strong risk of selection biases because of pre-existing differences between the two groups, direct comparisons of the outcomes may be misleading. This is because the existence of confounding factors creates biases in the estimation of average treatment effects on the outcome variables. To reduce this bias and to control confounding factors, propensity score matching methods were employed.
Results:
The total monthly health expenditure of the affected households were on average 375 Ethiopian Birr (about $ 18) higher than the non-affected households. The share of health expenditure on total expenditure was also found approximately 14 percentage point higher than the non-affected. On the other hand, the monthly per capita income, the share of expenditure on food were considerably lower among the affected households. The average treatment effect on the treated for the share of expenditure on food was 13 to 19 percentage point lower. The HIV-affected households had lost, on average, 6 more workdays than the non-affected.
Conclussion:
The study concluded that the economic burden of HIV falls mainly on the affected household members and their families. Some policy measures should be designed targeting the affected households to mitigate the economic burden arises from HIV/AIDS and to improve the household’s welfare. Alternative social support mechanisms like healthcare financing in the form of prepayment and strengthening households’ economic activities by creating job opportunities and facilitating loan services from micro credit associations would mitigate the burden for households.
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