Economic Burden and distribution of Household Expenditures on Snakebites: Assessing Catastrophic Health Expenditures and Financial Hardship in Rural Uganda

Introduction : Snakebites remain a major yet long-neglected public health burden, disproportionately affecting the poor communities in rural Uganda. Households continue to unfairly spend out of pocket on snakebites and are further pushed into poverty. The study estimated household economic burdens, Catastrophic Health Expenditure (CHE), and associated socioeconomic inequalities from snakebites in Eastern Uganda. Methods This was a cross-sectional study that used an ingredient-based approach to estimate the household costs of management and productivity loss of a snakebites from the household perspective. Two districts from Eastern Uganda with the highest incidence cases were visited for household survey to elicit costs borne by the snake bite victims at community level. CHE was evaluated using expenditure thresholds of 10%, 25%, and 40%. Inequalities were assessed using concentration indices, slope index of inequality (SII), relative index of inequality (RII), Oaxaca–Blinder decomposition, and quantile regression. Results CHE related to snakebite was experienced by 31.4% of households at the 40% threshold, with the poorest quintile most affected (χ²=23.97, p < 0.001; SII = − 0.173, p = 0.011). Significant disparities in economic burden were found by occupation (hospital costs p = 0.002; productivity loss p = 0.020), socioeconomic status (hospital costs p = 0.003), and hospital visit type (p < 0.001). Outpatient care was strongly protective (p < 0.001), while hospital admissions drove up costs (p < 0.001). Quantile regression showed outpatient care significantly reduced financial burdens (p < 0.001), whereas hospitalization increased costs substantially (p < 0.001). Decomposition analysis showed structural inequities: middle-income patients faced 55.2% higher unexplained costs than the poorest. Conclusion Snakebites led to substantial financial hardship and entrenched inequities for households in Eastern Uganda. Policy responses should prioritize affordable treatment access and financial risk protection for the poorest and most vulnerable populations.