Factors associated with catastrophic health care expenditure in South Wollo province, Ethiopia: A cross-sectional study

Ethiopia is an underfinanced country when compared to the Sub-Saharan average. Direct payment has a high account in Ethiopia and inhibits access to health services for the poor. We aimed to identify the factors associated with catastrophic health expenditure (CHE) in the South Wollo Zone, Ethiopia. A community-based cross-sectional study was conducted. A two-stage sampling technique was used to get a total of 494 households. The data were entered using Epi data version 4.6 and analysed using STATA version 14.1 software for binary logistic regression analysis. A multivariable logistic regression analysis was done to identify the factors associated with CHE. The total magnitude of CHE was found to be 33.97% at the 10% threshold of total household expenditure and 14.98% at the 40% threshold of non-food expenditure. Insured households (adjusted odds ratio = 0.02, 95% CI: 0.01-0.10) were statistically associated with CHE with total household and non-food measures. Catastrophic health expenditure was found to be decreased among insured households and increased among households had children less than 5 years of age, members with chronic illness, and poor health status. Therefore, encouraging insurance and health promotion activities to improve the health status of the community are important.