Abstract:
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Non-communicable diseases have become a major threat to Sri Lanka as well
as all developing and developed countries. Though the government provides all health
facilities free of charge at public hospitals, people have to bear the out-of-pocket
expenditure. The expenditure compared to other diseases is double the burden from
non-communicable diseases
Based on a literature review, it was found that there is a lack of studies on the
economic burden on households with individuals with non-communicable diseases,
with specific reference to cancer in Sri Lanka. This study has focused on assessing the
economic burden on households. In addition it has tried to identify the determinants
effect of the economic burden on households. This study focuses on the demographic,
economic, and disease characteristics of patients. Identifying the major effects of
cancer is helpful for prioritizing policy options in order to reduce the burden on
households. Furthermore, the analysis is concerned with the challenges faced by
patients in order to provide better policy options. Finally, based on the findings it
prioritizes policy options.
Primary data were collected from a semi-structured questionnaire. After the
pilot study, 400 respondents were selected using the stratified sampling method. The
mixed method mainly, focused on the quantitative method, was adopted for the study.
Qualitative analysis was used to triangulate the quantitative findings.
Both bivariate and multivariate analyses confirmed the same findings; some
null hypotheses were rejected and some were not. Gender, distance, income, types of
cancer, severity of disease, and period of suffering are significant effects in terms of
the economic burden on households with cancer patients. Further, sources of
financing are significant regarding the economic burden and in terms of direct cost
and indirect costs as well.
It was found that there are many challenges faced by the respondents, and high
opportunity costs in obtaining government allowances led the respondents not to
apply or use the allowance. Some people have lack of information about sources of
financing and health issues. The findings of the study provide priorities that can
helpful for decision-makers in creating policy options to reduce the economic burden
on households. Since direct costs have become higher compared to other types of
costs, and it is necessary to focus on direct medical costs, travel costs, and the cost of
special foods in order to reduce the burden. Both direct medical costs and travel costs
can be reduced by a more fair distribution of resources to the nearest hospital and by
facilitating easy accessibility for patients. One option is to reform the present system
of allowing medical or sick leaves for patients. The introduction of special insurance
schemes for the self-employed sector would be useful for self-employed patients that
would suffer from non-communicable diseases. Beginning the treatment process at
the earliest possible stage could reduce a huge burden at later stages for both affected
households and the government. Therefore, it is necessary to have continuous
awareness campaigns in all corners of Sri Lanka, reaching all the people. In addition,
free periodical cancer screening tests could help early detection and treatment, which
could either eliminate or reduce the burden on households in the country as a whole
This study contributes both theoretically and practically, and as well as shows
some of the unchartered areas for future research. The study shows the relationship
between the determinants and economic burden on households. The practical
contribution is comprised of suggestions regarding policy options to the government,
highlighting priorities to be considered and the selection of cost-effective policy
options amongst them. There are some other aspects that have not come under the
scope of the study. The social costs for the households could affect them, and this is a
very important area for future research. Proper qualitative analysis also can be carried
out in future research.
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