Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Nov 21;13(11):e0205745.
doi: 10.1371/journal.pone.0205745. eCollection 2018.

The economic impact of non-communicable diseases among households in South Asia and their coping strategy: A systematic review

Anupa Rijal  1   2 , Tara Ballav Adhikari  2   3 , Jahangir A M Khan  4   5 , Gabriele Berg-Beckhoff  6
Affiliations

The economic impact of non-communicable diseases among households in South Asia and their coping strategy: A systematic review

Anupa Rijal et al. PLoS One. .

Erratum in

Abstract

Background: Out of pocket payment (OOPP), is the major health financing mechanism in South Asia region. With the rising burden of non-communicable diseases (NCDs), the region is facing a high financial burden. However, the extent and nature of economic impact caused by treatment and management of NCDs at the household level is yet unknown.

Method: We conducted a systematic review using Medline and Embase databases. Only peer-reviewed quantitative studies published between January 2000 to December 2016 assessing OOPP or catastrophic health expenditure or impoverishment or financial coping strategy due to at least one of the four major NCDs-cardiovascular diseases(CVDs), diabetes, cancer, chronic respiratory disease in South Asia region was included in the review. The review is registered in PROSPERO no: CRD42017059345.

Results: A total of 21 studies (of 2693 records identified) met the inclusion criteria. The economic impact was most frequently studied in CVDs and in terms of OOPP. The studies collectively indicated high OOPP, higher likelihood of catastrophic expenditure and impoverishment for inpatient care for these major NCDs which was visible in all income levels. Borrowing and selling off assets were the most common forms of coping strategies adopted and varied inconsistently between urban and rural households. The true extent of the economic impact, however, remains difficult to determine due to methodological heterogeneity regarding outcomes reported and measures employed for calculation of OOPP, catastrophic expenditure, and impoverishment across these four major NCDs and between nations.

Conclusion: The economic impact due to treatment and management of CVDs, diabetes, cancer and chronic respiratory diseases among households in South Asia seems dire. Given the lack of sufficient evidence the review stresses the need for further research in the region to develop evidence-informed nationally tailored prepayment mechanisms covering NCDs to reduce economic vulnerability and standardization of tools measuring the economic impact for generating comparable estimates.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flow-chart for systematic review of studies.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Global Health Estimates 2015. Deaths by Cause, Age, Sex, by Country and by Region, 2000–2015 Geneva: World Health Organization, 2016.
    1. Richards NC, Gouda HN, Durham J, Rampatige R, Rodney A, Whittaker M. Disability, noncommunicable disease and health information. Bulletin of the World Health Organization. 2016;94:230–2. 10.2471/BLT.15.156869. - DOI - PMC - PubMed
    1. Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2224–60. 10.1016/S0140-6736(12)61766-8 - DOI - PMC - PubMed
    1. Lee I-M, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT. Impact of Physical Inactivity on the World’s Major Non-Communicable Diseases. Lancet. 2012;380(9838):219–29. 10.1016/S0140-6736(12)61031-9 - DOI - PMC - PubMed
    1. The World Bank. Poverty and Equity 2017. Available from: http://povertydata.worldbank.org/poverty/region/SAS.

Publication types