Associations between Health Needs, Utilization Factors, and Catastrophic Healthcare Expenditure in Bauchi State

Abstract

Introduction: Catastrophic healthcare expenditure (CHE) poses a significant financial burden on households, particularly in low-resource settings like Bauchi State, Nigeria, where out-of-pocket (OOP) payments dominate healthcare financing. Understanding the interplay between health needs, utilization factors, and CHE is critical for developing targeted interventions to mitigate financial hardship. Objective: This study examined the associations between health needs, healthcare utilization factors, and CHE among households in Bauchi State, Nigeria, using a mixed-methods approach.

Methods: Employed a cross-sectional design to examine the associations between health needs, healthcare utilization factors, and catastrophic healthcare expenditure (CHE) involving 986 households. Quantitative data were analyzed using descriptive and inferential statistics (logistic regression).

Results: The prevalence of CHE was 41.5%, with a mean overshoot of ₦80,291.13 (SD = ₦92,568.99). Key predictors of CHE included: Predisposing factors: Younger household heads, male-headed households, lower educational attainment, larger household size, and rural residence. Enabling factors: Lack of health insurance, reliance on OOP payments, and lower income levels. Need factors: Presence of children under five, chronic illnesses, and inpatient healthcare utilization.

Conclusion: CHE is highly prevalent in Bauchi State, disproportionately affecting vulnerable households. Strengthening health insurance coverage, expanding subsidized healthcare services, and addressing systemic barriers to access are essential to reducing financial hardship. Policy reforms should prioritize equitable healthcare financing to achieve Universal Health Coverage (UHC) and Sustainable Development Goals (SDGs) related to health and poverty reduction.