Abstract:
Introduction: Out-of pocket payment is the principal payment mechanism in developing countries. Every year,44 million households, or more than 150 million individuals, throughout the world face catastrophic expenditure, and about 25 million households or more than 100 million individuals are pushed into poverty due to out-of-pocket spending. It pushes households to be deep seated in to poverty trap, aggravate inequity in health care and incur double burden opportunity cost on households when fall ill. Objective: The aim of this study was to assess the extent of catastrophic out-of-pocket health expenditure and its associated factors among rural households in Mandura Woreda, Benishangul Gumuz Regional State Western Ethiopia, in 2017. Methods: Community based cross-sectional study design was used to assess catastrophic out of pocket health expenditure and associated factors among rural households using multistage sampling technique to select 486 households. Epi info version 7was used for data entry and SPSS version 20 was used for analysis. The logit model was used to analyze the determinants of catastrophic out of pocket expenditure. The significance of the parameters was tested by P value and 95% CI. The model adequacy was checked by using hosmer-lemshow test (p=0.96). Result: In this study the extent of catastrophic expenditure was 22.5% and sex of household head with AOR=0.466at 95% CI (0.263, 0.826), working adults with AOR=2.39 at 95 % CI (1.216, 4.458),vulnerable member’s with AOR=3.169 at 95% CI(1.007, 9.966)and chronic illnesses with AOR=0.239at 95% CI (0.103, 0.553)in households were significant factors for catastrophic health expenditure. Conclusion: The magnitude of catastrophic expenditure was 22.5%which is relatively high. Hence. out of pocket health expenditure had catastrophic effect on some households. Therefore there is a need to develop financial risk protection systems to bring equity in health care service.