Household Integrated Economic Survey Research Articles

Out-of-pocket expenditures associated with double disease burden in Pakistan: a quantile regression analysis

BackgroundPakistan is currently experiencing a double burden of disease. Families with members having both communicable and noncommunicable diseases are at a greater risk of impoverishment due to enormous out-of-pocket payments. This study examines the percentile distribution of the determinants of the out-of-pocket expenditure on the double disease burden.MethodThe study extracted a sample of 6,775 households with at least one member experiencing both communicable and noncommunicable diseases from the Household Integrated Economic Survey 2018-19. The dataset is cross-sectional and nationally representative. Quantile regression was used to analyze the association of various socioeconomic factors with the OOP expenditure associated with double disease burden.ResultsOverall, 28.5% of households had double disease in 2018-19. The households with uneducated heads, male heads, outpatient healthcare, patients availing public sector healthcare services, and rural and older members showed a significant association with the prevalence of double disease. The out-of-pocket expenditure was higher for depression, liver and kidney disease, hepatitis, and pneumonia in the upper percentiles. The quantile regression results showed that an increased number of communicable and noncommunicable diseases was associated with higher monthly OOP expenditure in the lower percentiles (10th percentile, coefficient 312, 95% CI: 92–532), and OOP expenditure was less pronounced among the higher percentiles (75th percentile, coefficient 155, 95% CI: 30–270). The households with older members were associated with higher OOP expenditure at higher tails (50th and 75th percentiles) compared to lower (10th and 25th percentiles). Family size was associated with higher OOPE at lower percentiles than higher ones.ConclusionThe coexistence of communicable and noncommunicable diseases is associated with excessive private healthcare costs in Pakistan. The results call for addressing the variations in financial costs associated with double diseases.

The Nutritional Implications of High Wheat Prices on Agriculture Households in Pakistan

This study analyzes the potential repercussions of high wheat prices on agriculture household economic and nutritional well-being in Pakistan. This task was accomplished by formulating a theoretical model to capture the economic behavior of agricultural households that produce marketable surpluses of wheat. For empirical verification, eight modules of nationally representative Household Integrated Economic Survey (HIES) were combined with approximate price levels to create a pooled cross-sectional sample of annual price-indices for household expenditure from 2000-01 to 2018-19. The study uses the Linear Approximate of Almost Ideal Demand System (LA-AIDS) model to derive demand elasticities and conduct a comparative static analysis. Finally, the model is extended to assess household nutritional well-being by linking price effects to calorie intake. The empirical findings demonstrated that high wheat prices resulted in high farm revenues for agricultural households. Although wheat consumption has declined, these households have used excess profits to diversify the food basket, which in turn led to an improvement in calorie intake. An indirect spillover effect from changes in wheat prices has also been observed, leading to an increase in demand for domestically produced commodities. Since the overall impact of wheat price increase on agricultural and non-agricultural households is mixed, it is proposed to pursue a careful food security policy to ensure the economic and nutritional well-being of the entire society. This study adopts a two-pronged approach of social to integrating social safety nets that does not hinder agricultural growth to achieve a mutually rewarding outcome.

Informality, Food Insecurity and Intra-Household Resource Allocation: Evidence from Pakistan

The significance of employment in alleviating household poverty and enhancing overall well-being is widely acknowledged. In Pakistan, even with the notable growth in agricultural production, the country struggles with significant levels of food insecurity, affecting approximately 20.3 percent of the population, as indicated by a 2019 global report. This research investigates the impact of informal employment on the Food Insecurity Experience Scale (FIES) and the distribution of resources within households, including categories such as food, non-food items, education, and health. Utilizing data from the Household Integrated Economic Survey (HIES) conducted in 2018-19, fractional response and ordered logit models were employed to analyze the influence of informal employment on resource allocation across various categories and household food insecurity. The findings indicated that households headed by individuals in informal employment typically allocate a more significant portion of their budget to food and health than those in formal employment. Moreover, the impact of informal employment on non-food expenses appears limited, and households with informal workers demonstrate reduced spending on education compared to their formal counterparts. Additionally, the study highlights a higher probability of severe or moderate food insecurity levels in households headed by individuals in informal employment. Comprehending employment and household welfare dynamics necessitates a thorough understanding of intra-household dynamics. This research contributes valuable insights for policymakers, aiding in identifying critical areas for expanding social protection measures for informal workers.

Examining Fruit Demand Elasticities In Pakistan

Abstract Research background Income and prices are important factors that determine and decide households consumption decisions and behavior. Purpose and research methodology This paper aims to examine fruits’ demand elasticities in Pakistan by using the Linear Approximate Almost Ideal Demand System (LA/AIDS). For this purpose, data from the Household Integrated Economic Survey (HIES) 2018–2019 part of Pakistan Living Standard and Measurement is used for the selected fruits. Results Marshallian, Hicksian, and expenditures elasticities were calculated through the estimated parameter from the Linear Approximate Almost Ideal demand system. The results show that all the estimated expenditure elasticities of the selected fruits for Pakistan are positive. The magnitude of expenditure elasticities for bananas, malta, apple, grapes, watermelon, plum, and almonds, is less than unity, and are thus categorized as normal food items. The estimated uncompensated own price demand elasticities for all fruits are less than unity (inelastic) for Pakistan and thus categorized as necessities. Based on the cross-price uncompensated demand elasticities eighteen fruits are reported as gross complements and three fruits are gross substitutes. Most of the fruits are categorized as neutral fruits having no cross-price effect on each other’s demand as their estimated elasticities are closer to zero. Only apples with grapes and almonds are found to be notable substitutes. As most of the price elasticities of fruits are inelastic, any change in their price would result in a massive increase in expenditure on these fruits. As a result, the government may adopt policies for the stabilization of fruit prices to meet the minimal daily food requirements of the lower segments of society. Novelty This study is an attempt to estimate demand elasticities for individual fruit as very little research is available in the study area for individual commodities.

The Role of Local Governments in the Effective Implementation of SDGs in Pakistan

To hasten the implementation of SDGs at the local level, policymakers are stressing the role of local governments. This study investigates the local government’s capacity and role in the effective implementation of SDGs in Pakistan. The data is gathered from the Household Integrated Economic Survey of Pakistan from 2004 to 2019, from which indicators were created using key variables. Based on these indicators, regression analysis shows that there is less chance that the individual will use government healthcare facilities when the local government is suspended (SDG-3, Good Health Being). Similarly, suspension of local governments leads to a small reduction in the average number of years of schooling (SDG-4, Quality Education). Moreover, there is less chance that the individual will have toilet facilities when the local government is suspended (SDG-6, Clean Water and Sanitation). To expedite the localisation of the SDGs in Pakistan, the study recommends that the state should empower their local bodies to a greater extent which would allow the local bodies to work independently of external pressures for the betterment of their communities.

Households food consumption pattern in Pakistan: Evidence from recent household integrated economic survey

The analysis of food consumption pattern is a primary concern of any developing country because it is related with food security. Pakistan is one of the emerging nations of the developing world.Due to the similarities and differences in households' food consumption behavior, income distribution, the effects of alternative tax structures, cost-benefit analyses, and the choice of cost of living index, the study of households' food consumption pattern is crucial for a developing nation like Pakistan. Furthermore, for Pakistan's food security in the present and the future, an analysis of food consumption pattern is crucial. The main objective of this study is to analyze the households' food consumption pattern. Linear Approximation Almost Ideal Demand System (LA/AIDS) is applied using data from Household Integrated Economic Survey (HIES) for the year 2018–19. This study makes a significant contribution by estimating household age composition elasticities, which were absent from earlier studies. Results from the income elasticities reveal that milk, meat, and fruits are luxuries food items. Similarly, on the basis of inelastic income elasticities we declared cereals, pulses, vegetables, sugar, and ghee as necessity food items. Results from the compensated own price elasticities show that the eight food commodity groups have inelastic own-price elasticities. This implies that these food commodities are integral food items of household diet. Results from the compensated cross-price elasticities shows that cereals and pulses, cereals and vegetables, pulses and vegetables, milk and fruits, meat and fruits, and milk and ghee are gross substitutes. On the other hand, pulses and meat, pulses and fruits, and ghee and meat are gross complements. According to the findings of the household age composition elasticities, adding children to a household significantly increases its sugar consumption while significantly reducing its fruit consumption. Any increase in the size of the household by an adolescent, adult, or a person in their middle age results in a significant increase in the consumption of cereals and a significant drop in the consumption of fruits. Finally, any increase in the size of the households brought about by an elder resulted in a significant rise in the consumption of cereals and a significant drop in the consumption of vegetables.

WOMEN DECISION MAKING POWER AND ENTREPRENEURSHIP: EFFECT ON CHILDREN’S WELLBEING IN PAKISTAN

Globally, growing economic needs, increasing dependency ratio, poverty, and unemployment with gender differences enforcing females to participate in economic activities. Female entrepreneurs are recognized as an economic driver for the growth as well economy generating income for their own, families and creating employment for other females. However being a woman, that usually becomes hard to manage work-life balance and hence they shift the workload on their children. This study aims to explore the links among female entrepreneurs (own household enterprises) on child education and employment. The Probit model is used to estimate the model for that purpose cross-sectional data of HIES (Household Integrated Economic Survey) is employed for the period 2018-2019. The finding of the results reveals that female having enterprises positively influence girls' employment while the effect on education it remained insignificant. Meanwhile, empowerment influences education with a negative sign that shows the presence of daughters in the labor force. While for boys only empowerment shows significant results. Keywords: Entrepreneurship, Employment, Time allocation, Children, Well-being

Multidimensional Poverty Assessment in Pakistan: Does Household Dependency Escalate Poverty?

The household dependency ratio on young or old family members is considered a major determinant in poverty when human capital cannot support the family income. Since the elderly suffer a significant risk of poverty and make up an increasing percentage of the population, the country’s economic inequality is quite sensitive to population ageing. Family size adversely affects household well-being when focusing on children under 15 and adults over 65. The dependency increases the burden on bread earners and reduces consumption expenditure. The current study uses family reliance and the multidimensional poverty concept to analyse how poverty is distributed throughout different provinces. The current study intends to provide poverty analysis across all four provinces of Pakistan using the Alkire and Foster method of multidimensional poverty indexes from Household Integrated Economic Survey data. The study found that increasing child dependence significantly reduces consumption and exacerbates poverty. The Seniors Dependency Indicator demonstrates that as the elderly population in Sindh, Punjab, and Khyber Pakhtoon Khwa (KPK) declines, poverty decreases. All provinces saw an increase in the prevalence of child poverty, with the highest KPK rates in Punjab (6%) and Sindh (4%), respectively. Since the functional sector does not have to shoulder the full load, the government should set up safety support mechanisms for these segments to lessen the burden on wage workers. According to the survey, access to clean water and literacy rates are the other leading indicators of poverty alleviation.

Understanding multidimensional poverty in pakistan: implications for regional and demographic-specific policies.

This study enriches the limited literature on multidimensional poverty by focusing on household demographic characteristics as determinants of household-specific living arrangements in Pakistan. The study employs the Alkire and Foster methodology to measure the multidimensional poverty index (MPI) using data drawn from the latest available nationally representative Household Integrated Economic Survey (HIES 2018-19). The analysis investigates multidimensional poverty levels among households in Pakistan according to various criteria (such as access to education and healthcare, basic living standards, and monetary status) and how they differ across Pakistan's regions and provinces. The results indicate that 22% of Pakistanis are multidimensionally poor in terms of health, education, basic living standards, and monetary status; and that multidimensional poverty is more common in rural areas and Balochistan. Furthermore, the logistic regression results show that households with more working-age people, employed women, and employed young people are less likely to be poor, whereas households with more dependents and children are more likely to be poor. This study recommends policies for addressing poverty that consider the needs of multidimensionally poor Pakistani households in various regions and with various demographic characteristics.

Collateral damage? Welfare effects of the Ukraine war on Pakistan

The 2022 Ukraine conflict has contributed to a major spike in international commodity prices. In this study, we conduct a top-down, macro-micro simulation analysis by combining Computable General Equilibrium simulations with data from the 2018–19 Pakistan Household Integrated Economic Survey to analyze the impact of global price shock to four major commodities, namely wheat, vegetable oil, petroleum, and fertilizers. We come up with evidence for a significant, non-negligible negative impact of the price shock, both at the aggregate and the household level: Real GDP shrinks and real household consumption and income decrease. The drop in consumption and income is more visible among farm households, with the two falling by 5% and 3.48% respectively. The consumption and income of the above-median income households fall more steeply, and income inequality decreases. The USD3.2 headcount poverty rate at the 2018 purchasing power parity increases by 1.15%. Urban households show the worst decline in food security, both in incidence and intensity. The role of petrol prices in driving poverty among rural farm households and that of food stuff (wheat and vegetable oil prices) in aggravating urban food security is particularly evident. These findings highlight the poverty and food security-worsening dimension of the Russo-Ukrainian conflict.

Informal employment and catastrophic health expenditures: Evidence from Pakistan.

Workers in informal employment suffered significant out-of-pocket healthcare expenditures (OOPHEs) due to their low earnings and a lack of a social safety net or health insurance. There is little or no evidence of impoverishment caused by OOPHEs in the context of labor market categorization. Therefore, this study examines the economic burden of OOPHEs and its associated consequences on households, whose members are in informal employment. This study estimates the incidence of catastrophic health expenditures (CHEs) and impoverishment across the households in formal and informal employment and their key determinants in Pakistan by employing the data from the two rounds of the Household Integrated Economic Survey (2015-16, 2018-19). For measuring CHEs and impoverishment, the budget share and capacity-to-pay approaches are applied. Various thresholds are used to demonstrate the sensitivity of catastrophic measures. We found a higher incidence of catastrophic healthcare payments among the informal workers, that is, 4.03% and 7.11% for 2015-16 and 2018-19, respectively, at a 10% threshold, while at a 40% threshold, the incidence of CHEs is found to be 0.40% and 2.34% for 2015-16 and 2018-19, respectively. These OOPHEs caused 1.53% and 3.66% of households who are in informal employment to become impoverished, compared with their formal counterparts. The study demonstrates that the probability of incurring CHEs and becoming impoverished is high among informal workers, compared with their formal counterparts. This result has clear policy implications, in which to protect the informal workers, it is necessary to expand the insurance coverage, particularly during the COVID-19 response and recovery efforts.

Potential impact of food inflation on households’ welfare: Evidence from Pakistan

The global food price crises of 2007–2008 and the recent resurgence of food inflation have gained attention of the researchers about the causes and consequences of this volatility in food prices around the globe. This paper aims to examine the potential impact of food inflation on households’ welfare in Pakistan. For this purpose, the authors used a flexible Linear Approximate Almost Ideal demand System (LA/AIDS) to estimate the food demand pattern using the recently available Household Integrated Economic Survey of Pakistan for the year 2018–2019. Food products were categorized into thirteen food groups including milk, meat, fruits, vegetables, sugar, beverages, cereals, wheat, rice, oil & fats, tea, condiments and baked products. The estimated model was used to simulate different price increase scenarios in each of the currently own price. We found out that the estimated loss in the consumption was consistently high for milk, sugar, cereals, rice, wheat, meat and oil & fats. The issue of limited diversity in the dietary pattern and persistently food inflation will result in alarming food security in the country. The Effect of an increase in the general price level on food consumption could only be reduced by enhancing households’ purchasing power in the current scenario. The outcome of this research study will help policymakers in the agriculture sector to develop reliable and sound policy designs that will help control the implications of food inflation on household welfare loss.

Assessing the household saving behavior of urban and rural households in Pakistan: Evidence from PSLM/HIES 2018-19

The purpose of this article is to examine household saving behavior in urban and rural areas of Pakistan. The study obtained microdata from the Household Integrated Economic Survey (HIES) 2018-19 and Pakistan Social Living Standards Measurements Survey (PSLM) 2018-19 conducted by the Pakistan Bureau of Statistics (PBS). A nationally representative sample of 5499 households is selected, 3155 from rural areas and 2344 from urban areas by using systematic sampling. The impact of socioeconomic and demographic characteristics on household saving behavior is investigated by applying a multiple linear regression model through Ordinary Least Squares (OLS) estimation method. A strong relationship between household saving behavior and socioeconomic and demographic characteristics is observed. Income has a positive impact on household savings, but age, dependency ratio, and family size have a negative effect. Furthermore, it is found that as the household income rises, their savings rise as well. Although, people residing in rural areas tend to save more amount contrary to urban households. However, saving rates of household with large families exhibited a decline in saving. Government should introduce new saving schemes in banks and reduce non-development expenditures for productive plans. It will provide motivation for domestic saving and an upsurge in employment opportunities.

Is information communication technology and women empowerment helping to alleviate poverty in Pakistan?

The study investigates the role of Information Communication Technology (ICT) and women empowerment in reducing Pakistan's poverty by make use of the Household Integrated Economic Survey 2018-19. The poverty situation of a country, when defined through different poverty bands, has significant policy implications as categorizing people into different poverty bands helps in targeted policy initiatives for these groups. The five levels of the poor defined for this research are (extremely poor, deeply poor, poor, vulnerable, and marginally poor). To analyze the determinants of poverty Probit model has been used, whereas for targeted policy implication, quantile regression has been employed. The empirical results reveal that ICT has a significant role in alleviating poverty. Access to the internet plays a significant role in reducing poverty by rendering job and entrepreneurial opportunities. It helps the rural population keep abreast with the latest information and developments. Further, women empowerment has a significant impact on improving the living standard of a household, and the impact is strong for marginally poor households as compared to extremely poor households. Finally, other control variables like human capital and the experience of the household head also play a significant role in helping the households to improve their poverty state.

Disparities in economic achievement across the rural–urban divide in Pakistan: Implications for development planning

Growth, underpinned by augmented production, has been the dominant mode of development, where the focus is to influence the ability to increase the output and income of producers. In this process, differences in economic achievement are influenced collectively by geography, culture and institutions that determine effective capabilities. Yet, disparities associated with place are still widespread. In this paper, we draw some insights on the nature of economic deprivation amongst Pakistan households using Household Integrated Economic Survey (PSLM/HIES) data and treating the residential location as a key parameter of interest. In relating to the well-known discussion on rural–urban divide, we identify some commonalities in location-specific attributes in the achievement of economic-wellbeing. The analyses confirm the existing knowledge that poverty and well-being have strong place attachments, favouring urban areas as locations of greater relative well-being due to low levels of deprivation, in particular health, education and food security. In discussing how location may predispose inhabitants to deprivations or vulnerabilities, we identify some opportunities to realign development focus towards meeting local needs and raising aspirations for self-empowerment by better focusing on the nature of economic linkages that supports livelihood diversity.

Reflections of Pro-Poor Growth across Agro-Climatic Zones for Farming and Non-Farming Communities: Evidence from Punjab, Pakistan

The basic objective of the existing study was to inspect the triangular association between economic growth, poverty, and income disparity in farming and non-farming communities across agro-climatic zones in Punjab province, Pakistan. The cross-sectional Household Integrated Economic Survey (HIES) data and Poverty Equivalent Growth Rate (PEGR) methodology were applied from 2001–2002 to 2015–2016. Outcomes of the study found that in a short period, 2001–2002 to 2004–2005; 2004–2005 to 2005–2006; 2005–2006 to 2007–2008; 2007–2008 to 2010–2011; 2010–2011 to 2011–2012; 2011–2012 to 2013–2014; and 2013–2014 to 2015–2016, economic growth has presented hybrid (pro-poor and anti-poor) pattern across both communities of all agro-climatic zones of Punjab province in different periods. In the longer period of 2001–2002 to 2015–2016, economic growth has been pro-poor across both communities of all the zones apart from zone III (Cotton-Wheat Punjab); there is an anti-poor pattern of economic growth. Results for the decomposition of change in poverty further indicate that economic growth is a dominant factor in reducing poverty for all investigated zone. Moreover, a positive redistribution component reduces the beneficial impacts of economic growth for the poor more than for non-poor, that ultimately makes economic development patterns anti-poor in zone III. In the present study, we proposed two-fold policy implications. First, improve the living standard of households in each agro-climatic zone by increasing their incomes. Second, develop a precise taxation system that helps to reduce income disparities among upper-pro to lower-income groups.

Crowding Out Effect of Tobacco Usage on Household Education and Health Expenditures - An Econometric Analysis

Tobacco consumption is growing day by day everywhere in the world in countless forms such as supari, tobacco raw, chew, pan, cigarettes, bidi and naswar etc. Tobacco consumption may avert the limited family resources far away from advantageous uses between low-slung income households. The relatively underprivileged households frequently allocate an ample share of the domestic budget on tobacco expenditures. These uneconomical expenditures on tobacco could be a diversion of household monetary resources from necessary things, such as foodstuff, healthcare and education. Explicitly this paper discovers the crowding-out impact of tobacco expenditures on a household’s education and health payouts. The facts for this study has been engaged from HIES (Household Integrated Economic Survey) conducted regularly by PBS (Pakistan Bureau of Statistics) that offers evidence at household level and covered the whole nation. The estimation has been carried out by employing the Engel Curves, the quadratic terms using QUAIDS (Quadratic Almost Ideal Demand System) were found to be empirically important in describing household budget behavior. By employing data on outlays, study evaluated a user demand structure that comprises numerous main spending classifications (tobacco, education and healthcare). OLS (Ordinary Least Square) was used to estimate the effect of tobacco outlay and other covariates on share of education and health in the total budget of a household. The results found out were just alike John (2006) that a rise in the tobacco expenditure brings a reduction in the budget quota dedicated to health and education. The quantitative results aim to help the policy makers to formulate and apply such policies to restrict the consumption of tobacco products and diverting those expenses for the formation of human capital by increased spending on health and education.

Analyzing the Mediating Role of Food Insecurity between Economic Factors and Child Health in Pakistan: An Application of Haye’s Logistic Model

This study tends to assess the critical selected economic factors intervening the child health problems in Pakistan. Child health problem is of great concern and became even more important after the United Nation’s Sustainable Development Goals vision of Global Social, Economics, and Environmental sustainability. This study analyses the data of the Pakistan Household Integrated Economic Survey (HIES) 2018-19, which is the latest available data in the current year, 2022. A total frequency of 24809 households are included in the study sample and are inquired about their economic proceeding of life and their child's health problems. Child health is a derived factor that is not obviously directly affected by its socio-economic determinants. Unlike the previous studies, this study follows an indirect analysis while explaining child health determinants. Hayes' process of mediation is applied to see the role of global food insecurity in the households in the country and its implication on the child health ratio in Pakistan. This study implies a significant negative role in asset poverty. Food insecurity on the child health in Pakistan, meaning that if a household is food insecure, that will lead to a high risk of child adverse health problems and vice-versa. Moreover, there are some direct effects of asset poverty on the child's health as they assess the fiat source of finance for the household after a liquid form of monetary assets.

Cost of Access to Justice and Exclusion in Pakistan: An Empirical Analysis

This paper examines the cost of access to justice and analyses whether such a cost is affordable by the average citizen of Pakistan. It is assumed that the foundation on which the current judicial system has evolved is unfair. It facilitates the rich and wealthy, while the poor are excluded as they cannot bear the cost of access to justice. The paper tests this assumption of accessibility due to cost presumption of exclusion empirically based on primary data collected from lawyers in the District Courts of Islamabad (Pakistan), together with data on the average income of representative individuals from the Household Integrated Economic Survey 2015-16 (PBS 2017). The paper shows the cost of access to justice in different types of cases across various types of courts in Islamabad, and then compares the cost with the average income per year of an ordinary citizen. It finds that the average cost of almost all types of cases is higher than what an average Pakistani can afford. The study notes that one of the reasons for this costly access to justice is because lawyers’ earnings are linked with the disputes on commercial basis. Hence, affordable access requires that judicial disputes between people should not become sources of earning for others and should be resolved with non-commercial objectives.

Incidence and determinants of catastrophic health expenditures and impoverishment in Pakistan

ObjectivesOut-of-pocket (OOP) payment is a major health financing mechanisms across developing nations such as Pakistan. Private health expenditures are estimated to be 64.4%, of which 89% are OOP made by the households (National Health Accounts, 2015–16). These high health care expenditures cause households to face financial burden resulting in poverty. This study aims to estimate the incidence and determinants of catastrophic health expenditures and impoverishment for Pakistan. Study designHousehold-based cross-section study. MethodsWe used the data from the Household Integrated Economic Survey (2015–16 and 2018–19), carried out by the Pakistan Bureau of Statistics. The well known methodology developed by Wagstaff and Doorslaer was used in this study for estimating the incidence and impoverishment effect of catastrophic health spending. ResultsIt is found that at 10% threshold (out of total consumption expenditures), catastrophic health payments are incurred by 4.51% and 13.15% of households for 2015–16 and 2018–19, respectively. Moreover, following the 40% threshold (out of non-food expenditures), this incidence is 0.45% and 4.57%. Poverty headcount was 23.28% and 18.43% gross of health payments in both the considered years, respectively, whereas it turns out to be 24.68% and 22.02% net of healthcare payments for the respective years, representing an increase in poverty headcounts of 1.4% and 3.59%. ConclusionOOP health payments exert pressure on household's capacity to pay and push them into poverty. This article recommends that the burden of OOP expenditures borne by households should be reduced to prevent them from falling into poverty by initiating some strategies (health financing policy reforms in terms of financial protection) with political support.