Socio-demographic and economic profile of households with catastrophic health expenditures in Muanda, Boma and Matadi in 2022: a household cross-sectional study

Background Catastrophic health expenditures are direct healthcare expenses that exceed 10% or 25% of total household income. The present study aims to measure the proportion of households that fall into catastrophic health expenditure, their socio-demographic and economic characteristics and the factors associated with catastrophic health expenditures. Methods We conducted a secondary data analysis of 205 households from a cross-sectional study in seven health zones in 2022 in DRC. A Clustered Lot Quality Assurance Sampling (LQAS) was used through a 3-stage sampling process. Data were entered into SPSS version 26 and analyzed using the same software. Descriptive analyses included frequencies and percentages, bivariate analyses were performed to see the association between catastrophic health expenditure at 10% and 25% and the independent variables (location, household size, household head occupation, health insurance coverage, and economic well-being). Binary logistic regressions were performed respectively at the 10% and 25% thresholds of income. The association was statistically significant if the p-value was strictly less than 0.05. Results Overall, the extent of catastrophic expenditure at the 10% threshold was 72%, and 47% at the 25% threshold of the monthly household income. Poor households were 1.87 (95% confidence interval, CI=1.06-3.28) times more exposed to catastrophic expenditure than rich households. Conclusions In Kongo Central’s port area, catastrophic health expenditure prevalence is significantly higher than in Sub-Saharan Africa. This exposes the majority to further poverty, highlighting the need for a healthcare coverage system in the country. Registration: ESP/CE/118/2022 of September 12, 2022