@article{fdi:010081336,
  title = {{F}ree access to antiretroviral treatment and protection against the risk of catastrophic health expenditure in people living with {HIV} : evidence from {C}ameroon},
  author = {{B}ousmah, {M}arwan-al-{Q}ays and {N}ishimwe, {M}. {L}. and {K}uaban, {C}. and {B}oyer, {S}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground{T}o foster access to care and reduce the burden of health expenditures on people living with {HIV} ({PLHIV}), several sub-{S}aharan {A}frican countries, including {C}ameroon, have adopted a policy of removing {HIV}-related fees, especially for antiretroviral treatment ({ART}). {W}e investigate the impact of {C}ameroon's free antiretroviral treatment ({ART}) policy, enacted in {M}ay 2007, on catastrophic health expenditure ({CHE}) risk according to socioeconomic status, in {PLHIV} enrolled in the country's treatment access program.{M}ethods{B}ased on primary data from two cross-sectional surveys of {PLHIV} outpatients in 2006-2007 and 2014 (i.e., before and after the policy's implementation, respectively), we used inverse propensity score weighting to reduce covariate imbalances between participants in both surveys, combined with probit regressions of {CHE} incidence. {T}he analysis included participants treated with {ART} in one of the 11 {HIV} services common to both surveys (n=1275).{R}esults{T}he free {ART} policy was associated with a significantly lower risk of {CHE} only in the poorest {PLHIV} while no significant effect was found in lower-middle or upper socioeconomic status {PLHIV}. {U}nexpectedly, the risk of {CHE} was higher in those with middle socioeconomic status after the policy's implementation.{C}onclusions{O}ur findings suggest that {C}ameroon's free {ART} policy is pro-poor. {A}s it only benefitted {PLHIV} with the lowest socioeconomic status, increased comprehensive {HIV} care coverage is needed to substantially reduce the risk of {CHE} and the associated risk of impoverishment for all {PLHIV}.},
  keywords = {{HIV} ; {C}atastrophic health expenditure ; {C}osts ; {T}reatment ; {F}ree antiretroviral treatment ; {P}olicy evaluation ; {P}overty ; {C}ameroon ; {CAMEROUN}},
  booktitle = {},
  journal = {{BMC} {H}ealth {S}ervices {R}esearch},
  volume = {21},
  numero = {1},
  pages = {313 [7 ]},
  year = {2021},
  DOI = {10.1186/s12913-021-06331-5},
  URL = {https://www.documentation.ird.fr/hor/fdi:010081336},
}