title: Methodological Issues to Consider When Collecting Data to Estimate Poverty Impact in Economic Evaluations in Low-income and Middle-income Countries.
abstract: Out-of-pocket spending is increasingly recognized as an important barrier to accessing health care, particularly in low-income and middle-income countries (LMICs) where a large portion of health expenditure comes from out-of-pocket payments. Emerging universal healthcare policies prioritize reduction of poverty impact such as catastrophic and impoverishing healthcare expenditure. Poverty impact is therefore increasingly evaluated alongside and within economic evaluations to estimate the impact of specific health interventions on poverty. However, data collection for these metrics can be challenging in intervention-based contexts in LMICs because of study design and practical limitations. Using a set of case studies, this letter identifies methodological challenges in collecting patient cost data in LMIC contexts. These components are presented in a framework to encourage researchers to consider the implications of differing approaches in data collection and to report their approach in a standardized and transparent way.
authors.affiliation: London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Sedona
authors.initials: S
authors.lastname: Sweeney
authors.affiliation: London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Anna
authors.initials: A
authors.lastname: Vassall
authors.affiliation: University of Cape Town, Cape Town, South Africa.
authors.forename: Nicola
authors.initials: N
authors.lastname: Foster
authors.affiliation: London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Victoria
authors.initials: V
authors.lastname: Simms
authors.affiliation: Centre Muraz, Bobo-Dioulasso, Burkina Faso.
authors.forename: Patrick
authors.initials: P
authors.lastname: Ilboudo
authors.affiliation: National Institute for Medical Research, Dar es Salaam, Tanzania.
authors.forename: Godfather
authors.initials: G
authors.lastname: Kimaro
authors.affiliation: Aurum Institute, Johannesburg, South Africa.
authors.forename: Don
authors.initials: D
authors.lastname: Mudzengi
authors.affiliation: London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Lorna
authors.initials: L
authors.lastname: Guinness
mesh_terms: D003362:Cost-Benefit Analysis / Q000379:methods*; D003625:Data Collection / Q000191:economics / Q000379:methods*; D003906:Developing Countries / Q000191:economics*; D004470:Economics, Medical; D017048:Health Care Costs; D005102:Health Expenditures; D006302:Health Services Research; D006801:Humans; D011203:Poverty / Q000191:economics*; D012107:Research Design
keywords: catastrophic expenditures; data collection methods; economic evaluation; out-of-pocket payments; poverty