Can't afford to be sick : assessing the cost of ill-health in North Kivu, Eastern Democratic Republic of Congo

Ill-health is a factor that keeps people in poverty and vulnerability. However, there is currently insufficient information about the economic cost of ill-health for households to inform policy, either for health or livelihoods. This study, conducted by Valid Evaluations in several areas of West Darfur, Sudan and North Kivu, Eastern Democratic Republic of Congo, aims to help fill that evidence gap. It differs from other studies quantifying health costs in two ways. First, the cost of ill-health is defined more broadly than the usual definition of direct expenditure on healthcare. The costs of ill-health include these direct costs (for consultation, tests and drugs), as well as the indirect costs of accessing healthcare (e.g. transport) and the potential income lost due to ill-health, either as a patient or as a carer. Second, the data is treated in non-standard ways. Average/mean health costs are highly skewed to large amounts, and so data does not present a picture of what most households would expect to pay for health. Alongside the standard statistical treatment based on means, these papers uses the data to construct more typical pictures, using hybrid calculations often including median values. Although based entirely on quantitative data, this study aims to be easily accessible for those interested in livelihoods and health, even those without any familiarity with statistics.