Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 6 2025 06 02 1291 1299 Zainab Mhmood Abdulhasan Department of Health Care Management, SR.C., Islamic Azad University, Tehran, Iran Ghobad Moradi 1. Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran 2. Center for Comonoidal Disease Control, Ministry of Health and Medical Education, Tehran, Iran Hayedeh Hoorsan Department of Nursing-Midwifery, Sa.C., Islamic Azad University, Sanandaj, Iran Yousef Moradi Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran Amjad Mohamadi Bolbanabad Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran 2024 10 09 2025 01 14 Background: Catastrophic health expenditures can lead to severe household financial burdens, exacerbating poverty and limiting access to necessary health services. This study examined the prevalence and determinants of catastrophic health expenditures among households in six provinces of Iraq. Methods: A cross-sectional design was employed, gathering data from 2,400 households in Baghdad, Wasit, Karbala, An-Najaf, Babil, and Maysan in 2023. A two-stage cluster sampling method was utilized, selecting 400 households from each province. Data were collected using WHO "World Health Survey" questionnaire, focusing on health expenditures and household income. Catastrophic health expenditures as defined as out-of-pocket costs exceeding 40% of a household’s capacity to pay. Statistical analyses, including logistic regression with calculating adjusted odds ratio, were performed using STATA14 software. Results: Overall, 246 households (12.6%) faced Catastrophic health expenditures, with a higher prevalence among female heads of households (13.1%) compared to males (12.6%). The multivariate logistic regression analysis indicated that households with 4 to 6 members had 1.52 times higher odds of facing catastrophic health expenditures (AOR=1.52, CI: 1.06 to 2.20). Furthermore, the poorest households had an AOR of 95.28 for experiencing catastrophic health expenditures (OR=95.28, CI: 13.12 to 691.49). Conclusion: This study underscores the urgent need for tailored policies to reduce the impact of CHE on Iraqi households. By improving access to healthcare and promoting equitable health insurance enrollment, policymakers can alleviate financial strain and support the health and well-being of vulnerable communities. https://ijph.tums.ac.ir/index.php/ijph/article/view/36867 https://ijph.tums.ac.ir/index.php/ijph/article/download/36867/8581