Several barriers hinder households from access to and use of health services in low-and middle-income countries (LMICs).

Cost of access to and use is one of the barriers:

• Direct (money) costs of transport and service use
• Indirect costs of labour productivity loss

Both direct and indirect costs contribute to welfare loss and catastrophic spending especially among the poor.

Although direct costs have been documented in literature, little is known about the burden of direct and direct costs, and how these costs are distributed across patients' subgroups, especially in settings with poor health systems.