During Valid Evaluations’ 4 year study of multiyear humanitarian financing (MYHF), ill-health repeatedly emerged as a factor maintaining people in poverty and vulnerability. However, there is currently insufficient information about the economic cost of ill-health for households to inform policy, either for health or livelihoods.
In the Democratic Republic of Congo (DRC), a national-level survey has established the level of direct expenditure on healthcare, often known as ‘out-of-pocket’ (OOP) health expenditure, but the scope of this information is restricted in 2 significant ways.
The report only addresses direct costs, leaving out two potentially critical costs of ill-health: the indirect costs needed to access healthcare (transport, food, accommodation, etc. for patients and carers) and the cost of lost income due to ill-health, either as a patient or as a carer.
Figures are only broken down to provincial level averages.
To develop informed policies, some understanding is needed of how and why costs differ across a province, and about the differences between the average figures and the likely costs faced by most households. As part of the overall evaluation programme into MYHF and resilience, Valid Evaluations has undertaken a stand-alone study to assess the full economic cost of ill-health in North Kivu, DRC. (A parallel study in Darfur, Sudan is covered in a separately published paper.)
This report is part of ‘Building resilience and responding to crises in fragile and conflict-affected states: A thematic evaluation of DFID’s multi-year approaches to chronic/protracted humanitarian crises in the Democratic Republic of Congo, Ethiopia, Sudan and Pakistan’ programme.
Levine, S. and Kusnierek, A. (2019); Can’t afford to be sick: assessing the full economic cost of ill-health in North Kivu, Eastern DRC. London: ODI; pp 24
Can’t afford to be sick: assessing the full economic cost of ill-health in North Kivu, Eastern DRC