Poverty is an extreme consequence of out of pocket payments in countries with
health systems that do not provide financial risk protection through mandatory health insurance
coverage for people in both the formal and informal sectors. The study assessed the determinants
of impoverishment due to out of pocket payments in Nigeria. Methods: Secondary data from the
Harmonized Nigeria Living Standard Survey (HNLSS) of 2009/10 was utilized to assess factors
associated with impoverishment in Nigeria. Household and individual characteristics associated
with impoverishment were determined using binary logistic regression. A significance level of
p<0.05 was used. Results: Results show that lack of health insurance, having a member above 65
years, large household size, household socio-economic status, type of illness suffered, type of
health facility visited, geo-political zones, education of household heads and location were major
determinants of impoverishment due to out of pocket health expenditure. Conclusion: Findings
from the study show that most households and individuals are vulnerable to financial risk due to
this regressive source of payments for health care services. This explains why the level of poverty
keeps increasing in spite of the numerous poverty alleviation programs across the country. Policy
makers and political actors need to design a new health system financing policy that will increase
financial risk protection for people in both the formal and informal sectors. Governments and
decision makers have to focus on health as a determinant of economic well-being