Abstract

The Government of Malawi (GoM) is promoting expanded and improved quality and equity in access to health care including for those that are infected with Human Immune Virus (HIV). As one way of ensuring such equity in access, the GoM has a policy that supports people living with HIV to be accessing free antiretroviral therapy(ART) from different ART clinics across the country. However, despite a free HIV healthcare service policy, there are systematic reported and unreported cases of out of pocket healthcare expenditure incurred by People living with HIV (PLWHIV) that are retrogressive and may lead to catastrophic conditions. There is need therefore to understand the determinants of Out of Pocket healthcare expenditure for people living with HIV in Malawi. The study has estimated a Double Hurdle model using the Survey data on People Living with HIV and AIDS collected by the Ministry of Health in Malawi in 2011. The empirical analysis is underpinned by a basic theoretical framework of demand for health and a further analysis of health as a durable commodity that depreciates over time and requires investment to replenish. The study shows that an expenditure decision of an individual has two levels namely the participation stage and the expenditure stage each of which having a vector f variables. The study revealed that individual characteristics like Age, Education level and being a Household head significantly determine the participation decision to spend through out of pocket by the PLWHIV. On the other hand the study revealed that both geographic and individual level factors statistically determine the magnitude(how much one spends) of Out of Pocket expenditure for PLWHIV. The results of the study offer reinforcement to the targeting policies and interventions for PLWHIV to minimize their chances of graduating from poor to ultra-poor as a result of episode of People living with HIV. The study concludes that there may be many more variables that are potential determinants for OOP for PLWHIV but were not pursued in this study due to data limitations. This study focused on two components namely individual level and geographic characteristics as determinants of OOP for PLWHIV.

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School	: School of Law, Economics and Government
Issued Date	: 2017

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