Affiliation:
1. Department of Social Medicine, Maastricht University, CAPHRI, Maastricht, The Netherlands
Abstract
Abstract
Background
In countries with out-of-pocket (OOP) payment systems for healthcare, the combination of chronic disease and poverty can have damaging socio-economic and health impacts for affected households. Using a life course perspective, this article aims to explore how Nepalese people struggle with, experience and adapt to chronic disease, poverty and their consequences, and how chronic diseases and poverty reinforce each other.
Methods
In-depth semi-structured interviews were conducted with 21 chronically ill Nepalese people with one or more chronic diseases and/or their caretakers. Data were transcribed and analysed thematically.
Results
The adaptation strategies for the consequences of the huge OOP costs make patients and their households financially disadvantaged. The impoverishment has major social impacts and often persists across generations. The situation forces people to choose between avoiding medical treatment or further impoverishing their families.
Conclusions
This study explored how chronically ill Nepalese people struggle with socio-economic and health consequences of OOP payments for their disease. The article sheds light on circumstances and adaptation strategies that obstruct every attempt to escape from the vicious cycle of the poverty trap. Hence poverty and health adversities accumulate across generations and contribute to greater health expenditures, worse health outcomes and severely compromised social life.
Publisher
Oxford University Press (OUP)
Subject
Public Health, Environmental and Occupational Health,General Medicine,Health (social science)
Reference66 articles.
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2. People’s perspectives on access to healthcare services in a rural district of Nepal;Poudel;J Nepal Med Assoc.,2012
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