Abstract
This study investigates healthcare utilization and out-of-pocket (OOP) expenses across Nigeria's northwestern states. Using primary data from household surveys and secondary data on state healthcare budgets, the study employs the frequency method and generalised logit regression model, it examines socio-economic and demographic determinants affecting healthcare access and expenditure. Results reveal that households spend an average of ₦73,347.24 annually on healthcare, equivalent to 14.81% of their income, surpassing the CHE threshold of 10%. Jigawa and Kaduna states exhibit the highest CHE percentages, at 15.94% and 15.82%, respectively, while Zamfara records the lowest at 11.92%. Rural households bear greater financial strain due to limited health insurance coverage (19% compared to 50% in urban areas) and reliance on coping strategies such as borrowing or selling assets. The study underscores the need for policy reforms, including expanded health insurance, subsidized healthcare for vulnerable states, and improved budget efficiency. These measures are crucial to alleviating the financial burden of healthcare, addressing urban-rural disparities, and achieving equitable access to health services in the region.
Keywords:
healthcare utilization; out-of-pocket expenses; health insurance coverage
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