Handicap International experience in Afghanistan - CBM

Health CostsHealth expenses of persons with disability can be considerable and can weigh upon the finances of thehousehold. Results in this field indicate that a larger percentage of non-disabled persons (39.7%) state thatthey do not have any expenses for health, compared to 20.1% persons with disabilities. In addition, 39.2%of persons with disabilities report that they spend between 626 AFAs (12 USD) and 4165 AFAs (85 USD) 26on health care, compared to only 24.8% of non-disabled persons. This same type of difference is seen forthe highest category of expenses, 4166 AFAs and above: here persons with disability are 17.8% to face suchhigh expenses while non-disabled are only 3.9%.When a person with disability accesses health services, 36.2% expenses made are for medication, followedby fees or donations (25.1%), and lastly 20.0% for transportation. Medication is the most frequent expense;this is why it is also the highest average expense. As shown in Table 5, the total average expenditure isbetween 3.6 (for mental disabled) and 5.5 times (for war survivors) higher for persons with disability thanfor non-disabled. This high level of disparity is observed for all categories of disability and by major causes aswell. It is observed for all major types of expenses: transportation costs, fees, medication and medical tests.Health expensesof persons withdisability can beconsiderable andcan weigh uponthe finances ofthe householdFigure 19. Distribution of Persons with Disability andNon-Disabled According to Health Expenses During theYear Preceding the Survey45• Persons with Disability • Non-Disabled4035302520151050No ExpensesLess than200 AFAs201 to 625AFAs626 to 4165AFAs4166 to213000 AFAsDon’t KnowFor some types of expenses, the gap between persons with disability and non-disabled is particularly high.For instance, landmine or UXO survivors spend 5.5 times more money on medication than non-disabled.Persons with associated disability spent 9 times more than non-disabled on transportation expenses. Even ifthe amounts considered are less, war survivors did spent 16 times more on medical tests in 2005 than thenon-disabled.Persons with disability all together spent an average of 1728 AFAs on medication in 2005, and Landmine/UXO survivors spent up to 3000 AFAs in average for this expense. Persons with disability all together spent anaverage of 608 AFAs for transportation, 200 AFAs for fees and 268 AFAs for food. The average total amountof expenditure is of 3459 AFAs for persons with disability considered as a whole. It is higher, especially forpersons with sensorial disability.26The exchange rate during 2005 fluctuated between 45 AFAs to a USD and 52 AFAs to a USD. Here we have calculated on anaverage of 50 AFAs to a USD.The Health Picture29