8 - Employment status, medical support and Income as significant factors in Access to Essential Medicines
Corresponding Author(s) : Chinwe Christopher Obuaku-Igwe
African Sociological Review,
Vol. 21 No. 1 (2017): African Sociological Review
Abstract
Poor affordability (as a constraint to access to essential medicine) or lack of capacity to pay for
essential medicines has been associated more often with unemployed persons or low-income
earners. Even though there is a growing body of work on access to essential medicines in Nigeria,
no study has been conducted to determine the extent to which affordability varies across and
within social groups. Using six variables, this paper examines factors that have an impact on
essential medicine in Nassarawa state, Nigeria. It asks the question: in what ways does the
ability to purchase medicines depend on income, perceived unreasonable burden, age, gender,
medical aid and employment status? 1000 subjects who utilized primary healthcare facility
were randomly selected for the study. A standardized questionnaire was used to determine how
the burden of purchasing essential medicines varied across employment and income groups. Out
of the 1000 subjects, 640 were females; 360 males with a mean age of 37.4 and a response rate
of 90%.
Results: Two factors: ‘employment status and perceived unreasonable burden’ were significant
predictors of affordability (F (6,993) = 260.052092, P =.05, R2 = .611, employment status= P
<0.03 and burden= P <0.03). There was evidence to support that an individual’s employment
status has an effect on their ability to pay for essential medicine or treatment. There were
significant differences in affordability between individuals who had full time paid employment
and those who were either self-employed or without a fulltime paid employment, if all factors
are constant. Affordability coefficient increased by .35 for each income unit. In addition, there
were significant differences that bothered on the type of employment (paid employment vs selfemployed,
part time vs fulltime), membership of a medical aid and the number of people in the
household (Cohen’s d = (333.3 - 660) ⁄ 350.4283 = 0.932288.)
Conclusion: “Affordability” or the ability to pay for treatment, varied across and within
employment groups (status), an indication that greater access to essential medicine was found
to be correlated with fulltime paid employment and medical aid.
Keywords
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- Ojedokun, O. E., & Elugoke, N. O. (2016). Assessment of Human Development Status and Personal Ecological Footprints of Residents of Ile-Ife, Nigeria. European Journal of Sustainable Development, 5(3), 513-526.
- Onwujekwe, O. E., Uzochukwu, B. S., Obikeze, E. N., Okoronkwo, I., Ochonma, O. G., Onoka, C. A. & Okoli, C. (2010). Investigating determinants of out- of-pocket spending and strategies for coping with payments for healthcare in southeast Nigeria. BMC health services research, 10(1), 67.
- Onwujekwe, O., Hanson, K., & Uzochukwu, B. (2012). Examining inequities in incidence of catastrophic health expenditures on different healthcare services and health facilities in Nigeria.
- PLoS One, 7(7), e40811 Niëns, L. M., Cameron, A., Van de Poel, E., Ewen, M., Brouwer, W. B., & Laing, R. (2010). Quantifying the impoverishing effects of purchasing medicines: a cross-country comparison of the affordability of medicines in the developing world. PLoS medicine, 7(8), 1056.
- The Federal Ministry of Health & World Health Organization (2002) Baseline Assessment of the Pharmaceutical Sector. Federal Ministry of Health in collaboration with the World Health Organization Cameron, A., Ewen, M., Ross-Degnan, D., Ball, D., & Laing, R. (2009). Medicine prices, availability, and affordability in 36 developing and middle-income countries: a secondary analysis.
- The lancet, 373(9659), 240-249. McIntyre, D., Thiede, M., Dahlgren, G., & Whitehead, M. (2006). What are the economic consequences for households of illness and of paying for health care in low-and middle-income country contexts?. Social science & medicine, 62(4), 858-865.
- Wambebe, C., & Ochekpe, N. (2011). Pharmaceutical sector profile: Nigeria. Vienna: United Nations Industrial Development Organization Hancock K. E. “Can pay? Won’t pay?” or economic principles of affordability. Urban Studies 1993; 30: 127-45 Xu K. Household catastrophic health expenditure: a multicountry analysis. Lancet 2003.1016/S01406736 ( 03)138615 pmid: 12867110.
References
Ojedokun, O. E., & Elugoke, N. O. (2016). Assessment of Human Development Status and Personal Ecological Footprints of Residents of Ile-Ife, Nigeria. European Journal of Sustainable Development, 5(3), 513-526.
Onwujekwe, O. E., Uzochukwu, B. S., Obikeze, E. N., Okoronkwo, I., Ochonma, O. G., Onoka, C. A. & Okoli, C. (2010). Investigating determinants of out- of-pocket spending and strategies for coping with payments for healthcare in southeast Nigeria. BMC health services research, 10(1), 67.
Onwujekwe, O., Hanson, K., & Uzochukwu, B. (2012). Examining inequities in incidence of catastrophic health expenditures on different healthcare services and health facilities in Nigeria.
PLoS One, 7(7), e40811 Niëns, L. M., Cameron, A., Van de Poel, E., Ewen, M., Brouwer, W. B., & Laing, R. (2010). Quantifying the impoverishing effects of purchasing medicines: a cross-country comparison of the affordability of medicines in the developing world. PLoS medicine, 7(8), 1056.
The Federal Ministry of Health & World Health Organization (2002) Baseline Assessment of the Pharmaceutical Sector. Federal Ministry of Health in collaboration with the World Health Organization Cameron, A., Ewen, M., Ross-Degnan, D., Ball, D., & Laing, R. (2009). Medicine prices, availability, and affordability in 36 developing and middle-income countries: a secondary analysis.
The lancet, 373(9659), 240-249. McIntyre, D., Thiede, M., Dahlgren, G., & Whitehead, M. (2006). What are the economic consequences for households of illness and of paying for health care in low-and middle-income country contexts?. Social science & medicine, 62(4), 858-865.
Wambebe, C., & Ochekpe, N. (2011). Pharmaceutical sector profile: Nigeria. Vienna: United Nations Industrial Development Organization Hancock K. E. “Can pay? Won’t pay?” or economic principles of affordability. Urban Studies 1993; 30: 127-45 Xu K. Household catastrophic health expenditure: a multicountry analysis. Lancet 2003.1016/S01406736 ( 03)138615 pmid: 12867110.