Health Care Financing and Financial Hardship among Rural and Urban Households in Ekiti State, Nigeria

Background: Individuals and families suffer financial hardship in seeking health care. The study aimed to assess health care financing and experience of financial hardship in seeking health care among urban and rural households in Ekiti State, Nigeria. 
Methods: This was a comparative, cross-sectional study. A multi-stage sampling technique was used to select 420 households each in the rural and urban areas. Data was collected using pre-tested, structured interviewer-administered questionnaire, and analysed using SPSS v20. Level of statistically significance was set at p-value of <0.05. 
Results: One hundred and seventy-nine respondents (42.6%) in the rural area, and 156 (37.1%) in the urban area had experienced difficulty in paying for health bills (p=0.105). Respondents who have had to borrow recently for seeking healthcare were 129 (30.7%) in the rural area, and 131 (31.2%) in the urban area (p=0.881), while 47 (11.2%) in the rural area, and 43 (10.2%) in the urban area have had to sell household assets (p=0.655). Out-of-Pocket was the main method of healthcare financing for the majority, 410 (97.6%) in the rural areas, and 400 (95.2%) in the urban areas. Only 10 (2.4%) of the ruralrespondents and 20 (4.8%) of the urban respondents were on health insurance. 
Conclusion: A high proportion of the study population experienced financial hardship and there is high dependence on out-of-pocket financing. This calls for increased community mobilization and acceleration of the progression of health insurance towards universal coverage in Ekiti State.