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Catastrophic health expenditure (CHE) with a 40% capacity to pay (CTP) households in the study area was 22.5%. Female household head (AOR = 2.92; 95% CI 1.44, 5.93) and household with chronic illnesses (AOR = 3.93; 95% CI 1.78, 9.14) were positively associated with CHE and, while households who had adult household members (AOR = 0.32; 95% CI 0.16, 0.63) were negatively associated. The overall CHE, with a 40% CTP threshold, was high. Prevention of chronic illness might help to reduce the burden of the expenditure. Strengthening financial