Costs of treating childhood malaria, diarrhoea and pneumonia in rural Mozambique and Uganda.

Autor: Batura N; Institute for Global Health, University College London, 30 Guilford Street, London, WC1 1EH, UK. n.batura@ucl.ac.uk., Kasteng F; Department of Global Public Health, Karolinska Institutet, K9, 171 77, Stockholm, Sweden.; Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.; Department of Health, SINTEF Digital, Oslo, Norway., Condoane J; Malaria Consortium, Rua Joseph Ki-Zerbo, 191 Sommerschield, Maputo, Mozambique., Bagorogosa B; Malaria Consortium, Plot 25 Upper Naguru East Road, P.O.Box 8045, Kampala, Uganda., Castel-Branco AC; Malaria Consortium, Rua Joseph Ki-Zerbo, 191 Sommerschield, Maputo, Mozambique., Kertho E; Malaria Consortium, Plot 25 Upper Naguru East Road, P.O.Box 8045, Kampala, Uganda., Källander K; Department of Global Public Health, Karolinska Institutet, K9, 171 77, Stockholm, Sweden.; Malaria Consortium UK, 244-254 Cambridge Heath Rd, Cambridge Heath, London, E2 9DA, UK., Soremekun S; Department of Clinical Research London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK., Lingam R; Department of Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.; Department of Medicine & Health, University of New South Wales Rm 814, Level 8 The Bright Alliance, High St & Avoca Street, Randwick, NSW, 2031, Australia., Vassall A; Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
Jazyk: angličtina
Zdroj: Malaria journal [Malar J] 2022 Aug 20; Vol. 21 (1), pp. 239. Date of Electronic Publication: 2022 Aug 20.
DOI: 10.1186/s12936-022-04254-y
Abstrakt: Background: Globally, nearly half of all deaths among children under the age of 5 years can be attributed to malaria, diarrhoea, and pneumonia. A significant proportion of these deaths occur in sub-Saharan Africa. Despite several programmes implemented in sub-Saharan Africa, the burden of these illnesses remains persistently high. To mobilise resources for such programmes it is necessary to evaluate their costs, costs-effectiveness, and affordability. This study aimed to estimate the provider costs of treating malaria, diarrhoea, and pneumonia among children under the age of 5 years in routine settings at the health facility level in rural Uganda and Mozambique.
Methods: Service and cost data was collected from health facilities in midwestern Uganda and Inhambane province, Mozambique from private and public health facilities. Financial and economic costs of providing care for childhood illnesses were investigated from the provider perspective by combining a top-down and bottom-up approach to estimate unit costs and annual total costs for different types of visits for these illnesses. All costs were collected in Ugandan shillings and Mozambican meticais. Costs are presented in 2021 US dollars.
Results: In Uganda, the highest number of outpatient visits were for children with uncomplicated malaria and of inpatient admissions were for respiratory infections, including pneumonia. The highest unit cost for outpatient visits was for pneumonia (and other respiratory infections) and ranged from $0.5 to 2.3, while the highest unit cost for inpatient admissions was for malaria ($19.6). In Mozambique, the highest numbers of outpatient and inpatient admissions visits were for malaria. The highest unit costs were for malaria too, ranging from $2.5 to 4.2 for outpatient visits and $3.8 for inpatient admissions. The greatest contributors to costs in both countries were drugs and diagnostics, followed by staff.
Conclusions: The findings highlighted the intensive resource use in the treatment of malaria and pneumonia for outpatient and inpatient cases, particularly at higher level health facilities. Timely treatment to prevent severe complications associated with these illnesses can also avoid high costs to health providers, and households.
Trial Registration: ClinicalTrials.gov, identifier: NCT01972321.
(© 2022. The Author(s).)
Databáze: MEDLINE
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