Fiscal Burden and Health Access: Indirect Taxation and Healthcare Utilisation Among Rural Households in Cameroon

Abstract

Abstract In many developing economies, the subtle yet pervasive influence of indirect taxation on household welfare remains insufficiently understood, particularly in the domain of health. This study investigates the impact of indirect taxation on healthcare utilisation among rural households in Cameroon using nationally representative secondary data. Specifically, the study seeks to examine how consumption-based taxes shape healthcare-seeking behaviour, assess their distributional implications across rural populations, and determine their role in influencing out-of-pocket health expenditure. The analysis relies on micro-level data from the Cameroon Household Consumption Survey, employs a quantitative research design, and estimates a probit and instrumental variables model to address potential endogeneity. The findings reveal that a higher indirect tax burden significantly reduces the likelihood of healthcare utilisation in rural areas, while increasing reliance on informal and delayed treatment options. The results further indicate that the tax burden disproportionately affects poorer households, thereby exacerbating rural health inequalities. Based on these findings, the study recommends targeted tax relief on essential consumption goods and the strengthening of rural health financing mechanisms through coordinated action by the Ministry of Finance and the Ministry of Public Health. Keywords Indirect taxationhealthcare utilisationrural householdsCameroonhealth economicsfiscal policy