title: Financial hardship in settling medical bills among households in a Semi-Urban Community in Northwest Nigeria.
abstract: BACKGROUND
  An equitable health care system that responds to the needs of its people is important to break the cycle of poverty and ill-health. However, rising health care cost, and the preponderance of user fees to finance health care have often limited access to needed health services.
  
  
  METHODS
  A cross-sectional descriptive study design was employed, using a pretested, semi-structured, interviewer-administered questionnaire.
  
  
  RESULTS
  The study was carried out among 188 respondents. Majority (88.2%) of the respondents were within the age-group 20-49 years, about two-thirds 63.8% were married and about half (42.8%) had family size between 5 and 9. The study revealed that about a quarter (26.1%) experienced hardship in settling their medical bills. While one-third (31.1%) had to sell their assets, about half (45.2%) had to secure loan while 16.6% had to resort to begging because of hardship encountered in settling the medical bills. Furthermore, of those who sold theirs asset; 46.2% sold their farmlands, 38.5% sold a piece of land, while 16.3% sold their vehicles.
  
  
  CONCLUSIONS
  This study has revealed that inhabitants of Samaru community experience hardship in settling their medical bills. Consequently, innovative strategies like deferment of payment and fee exemption, enrolling into community-based health insurance schemes as well as voluntary contributory health insurance schemes etc need to be considered, in order to alleviate the hardship in settling the medical bills.
authors.affiliation: Department of Community Medicine, Ahmadu Bello University, Zaria.
authors.forename: M N
authors.initials: MN
authors.lastname: Sambo
authors.forename: S H
authors.initials: SH
authors.lastname: Idris
authors.forename: S S
authors.initials: SS
authors.lastname: Bashir
authors.forename: J B
authors.initials: JB
authors.lastname: Muhammad
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005382:Financing, Personal / Q000191:economics*; D019538:Health Care Surveys; D005102:Health Expenditures; D006801:Humans; D008489:Medical Indigency / Q000191:economics*; D008875:Middle Aged; D009549:Nigeria; D011203:Poverty; D012959:Socioeconomic Factors; D014505:Urban Population; D055815:Young Adult