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[Correspondence] Out-of-pocket payments in Nigeria

“You have to make a deposit before we can treat the patient” is what many patients and their relatives are greeted with when they enter health-care facilities in Nigeria. Hospitals, public or private, demand upfront payments. There is an over-reliance on out-of-pocket payments in Nigeria. About 70% of Nigerians are living in poverty.1 Out-of-pocket payments can make households and individuals incur catastrophic health expenditure and this can exacerbate the level of poverty. Studies in Enugu and Anambra States in Nigeria showed that the incidence of catastrophic health expenditure among households (at a 40% threshold of non-food expenditure) were 14·8% and 27%, respectively.