Health expenditures in the families and its relation to Non communicable diseases and multi-morbidity amongst its adult members in selected wards of Kageshwori Manohara Municipality, Kathmandu, Nepal

Healthcare services, one of the basic necessities of life, are meant to provide social protection to the households but its rising cost has put financial burden on them. The rise in the prevalence of non-communicable disease as well as multi-morbidity as a result of increased life expectancy has added to this cost burden the households as the treatment is likely to be needed throughout the lifetime. As a part of National Health Insurance Program in an attempt to address the problem of high healthcare expenditures, the local government has recruited enrollment assistants from each ward to conduct home visit, explain families about the benefits of health insurance and enroll them in this national scheme. Hence it is very important that the data related to health expenditures incurred by family members in a year is available in the wards. Community based survey was carried out in ward 3 and 2 of Kageshwori Manohara Municipality of Kathmandu District, Nepal, in September 2023 and April 2024, respectively. Out of 848 households covered, annual health cost incurred by the family as a part of their annual income could only be obtained from 793 households (93.5%). Out of these households, health cost exceeded 10% of their annual income in 28.4% of the households and this was significantly associated with a household member having a non-communicable disease and multi-morbidity. Households living below the poverty line set at NRs. 200/person/day was seen to be significantly associated with having catastrophic health expenditure i.e. exceeding 10% of their annual income.