Financial protection failure among urban poor populations in Karachi, Pakistan: a cross-sectional household survey of catastrophic health expenditure prevalence, determinants and insurance effectiveness

Description

Ahsanullah Khan and four co-authors published a 2026 household survey of catastrophic health costs among Karachi's urban poor. Pakistan's out-of-pocket health burden is among South Asia's highest, and slum households are nearly invisible in national data. Surveying 1,211 households across six districts in 2023, the team measured health spending against income at three catastrophe thresholds. The picture was bleak at every line.

At the lowest threshold, about 92 percent of households faced catastrophic costs; even at the strictest, two-thirds did. The burden hit all income groups almost evenly, defying the usual pro-poor pattern. Health costs pushed 28 percent of households below the poverty line. Hospital stays and chronic illness drove the risk. The few insured households, under 6 percent, gained no measurable protection. The authors call the financial protection system failed.

Catalog record

Source: https://europepmc.org/articles/PMC13536158