“As I talk to you now, there is nothing at our home. We even had to sell off land to meet the financial costs of taking care of my mother. Not even the goats survived; they were all sold off for the same reason,” a patient’s caretaker said.
KAMPALA – Cancer patients in Uganda spend at least Shs200,000 and at most Shs800,000 per visit at the Uganda Cancer Institute (UCI), a Makerere University study has revealed.
The 2021 study which was disseminated on Friday, February 24, 2023, at UCI shows that much as Uganda’s policy is to provide healthcare services free of charge to all patients at public health facilities, patients pay for a large proportion of their care out of pocket due to many reasons.
Titled; “Impoverishing and Catastrophic Health Expenditure on Cancer Care among Persons affected by Cancer in Uganda”, the study sought to determine the socio-economic impact of cancer on patients and their immediate families in Uganda to inform financial protection strategies and resource allocation for cancer-related health care.
Accordingly, recent estimates in 2018 show that at least 56,238 people were living with cancer and 21,000 cancer-related deaths occurred in Uganda.
“9 out of 10 cancer patients incur out-of-pocket expenses on cancer care and treatment,” says the study, defining out-of-pocket expenditure as all health payments that patients incur at the point they receive health services, including, but not limited to, doctor’s consultation fees and purchases of medication.
“5 out of 10 patients spent at least 40% of their household income on Cancer health care,” data shows.
Speaking at the dissemination, Dr. Allen Kabagenyi, the Principal Investigator said that on average, cancer patients spend Shs300,000 whenever they visit the institute for treatment.
“And this money does not include inpatient care, this is the money that is spent on buying missing drugs, imaging services, tests, Cancer care,” she said.
Dr. Francis Kiweewa, the Director Strengthening Institutional Capacity for Research Administration (SICRA) said, “The Shs300,000 is for only one visit but remember a cancer patient who is on stage one and two has to visit every month, translating to Shs3.6 million a year.”
“As we wait for the passing and implementation of the National Health Insurance Scheme, the government needs to come up with faster measures aimed at saving cancer patients,” he called.
The data indicate that families with cancer patient(s) often have to sell household property like land in order to raise money for treatment and any other cancer-related care.
“As I talk to you now, there is nothing at our home. We even had to sell off land to meet the financial costs of taking care of my mother. Not even the goats survived; they were all sold off for the same reason,” one of the patient’s caretaker said.
Dr. Jackson Orem, the Executive Director of the UCI blamed the ever-increasing number of patients which overwhelms them, calling for the establishment of regional cancer management centres.
“Currently when you look at the statistics of the number of cancer patients we receive here, 15% are from this region and 85% from up country and what I can say is that we need to decentralize our services so that these people will access the Services in their areas at their ease.”
Prof. Yawe Bruno, Ag. Principal College of Business and Management Sciences (CoBAMS) noted that the study speaks to the objectives of goal 1 of Makerere University’s strategic planning framework for the 2020–2030 period, which seeks to enhance a research-led university.
He commended the team, saying that the study is timely especially when Uganda is registering rising mortality and morbidity related to cancer.
“Knowing the catastrophic health expenditure on cancer care is crucially important in order to design ways to provide financial protection against rising medical expenditure by households with cancer patients.”
Study recommendations
Policies that provide adequate financial protection, such as health insurance plans, especially for cancer patients should be urgently developed and implemented.
Need policies and strategies to improve the quality of services accessed by cancer patients. For instance, well-planned cost-sharing strategies to ensure a constant availability of medical supplies and drugs at the cancer care centers, and subsidize the poor.
Need for pandemic preparedness by the health care system in order to maintain health service delivery to cancer patients and others with chronic illnesses.
Principal Investigators
Dr. Allen Kabagenyi, School of Statistics and Planning, Makerere University.
Dr. Francis Kiweewa, Strengthening Institutional yon, Capacity for Research Administration (SICRA).
Co-investigators
Dr. Lydia Nakiyingi Kimuli, School of Medicine, Makerere University.
Dr. Nixon Niyonzima, Uganda Cancer Institute (UCI).
Prof. Fred Matovu, School of Economics, Makerere University.
Prof. Elizeus Rutebemberwa, School of Public Health, Makerere University.
Study coordinator: Dr. Roy Mubuuke, School of Medicine, Makerere University.
Graduate Assistants
Mr. Ronald Wasswa, School of Public Health, Makerere University
Mr. Vincent Kayemba, School of Statistics and Planning Makerere University
This study was funded by the Government of the Republic of Uganda through Makerere University Research and Innovation Fund (MAK-RiF)
