OBJECTIVES

Tuberculosis (TB) patients often incur catastrophic total costs (>20% of household income) due to illness, as well as to seeking and receiving health care. Such costs can create access and adherence barriers which can affect health outcomes and increase risk of transmission of disease. Coping mechanisms, such as selling household assets or taking children out of school, using up savings, and borrowing to defray TB costs can impair household economy for years. This study determines the proportion of TB households experiencing catastrophic total cost due to TB and coping mechanisms they adopt to defray such costs.

METHODS

We used a validated WHO TB “patient cost tool” to collect demographic, cost and social protection data from 1,178 participants under the National Tuberculosis and Leprosy Program, at 67 health facilities across the country. A random cluster sampling approach was used to ensure national representativeness of the data.

RESULTS

Of the 1,178 participants, 69.4% were male, 56.2% were the main household income earners prior to the disease, and 48.6% had attained only elementary level education. 47.4% were below poverty line at the time of interview and the median annual income was USD 1,252; estimated based on consumption data. 53.1% of household experienced catastrophic total costs due to TB. 81.2% of participants with Multi-Drug resistant TB and 47.2% of those with drug sensitive TB had at least sold assets, used up savings or borrowed money to defray TB costs. 11.8% reported taking children out of school.

CONCLUSIONS

Tuberculosis affected households experience catastrophic total costs. Such households adopt coping strategies such as sale of assets, using up savings and borrowing money that further worsen their economic livelihoods. There is urgent need to put social protection systems in place to protect TB households from its economic burdens.