TB-related catastrophic costs in Ethiopia.

Autor:	Deribew AA; United States Agency for International Development (USAID) Eliminate TB Project, Management Sciences for Health (MSH), Addis Ababa., Dememew ZG; United States Agency for International Development (USAID) Eliminate TB Project, Management Sciences for Health (MSH), Addis Ababa., Alemu KM; United States Agency for International Development (USAID) Eliminate TB Project, Management Sciences for Health (MSH), Addis Ababa., Tefera G; United States Agency for International Development (USAID) Eliminate TB Project, Management Sciences for Health (MSH), Addis Ababa., Negash SG; United States Agency for International Development (USAID) Eliminate TB Project, Management Sciences for Health (MSH), Addis Ababa., Molla YA; United States Agency for International Development (USAID) Eliminate TB Project, Management Sciences for Health (MSH), Addis Ababa., Woldegiorgis AG; USAID Eliminate TB Project, KNCV Tuberculosis Foundation, Addis Ababa, Ethiopia., Datiko DG; United States Agency for International Development (USAID) Eliminate TB Project, Management Sciences for Health (MSH), Addis Ababa., Suarez PG; MSH, Arlington, VA, USA.
Jazyk:	angličtina
Zdroj:	Public health action [Public Health Action] 2024 Jun 01; Vol. 14 (2), pp. 71-75. Date of Electronic Publication: 2024 Jun 01 (Print Publication: 2024).
DOI:	10.5588/pha.24.0006
Abstrakt:	Objectives: To measure the progress towards reducing TB-related catastrophic costs in 19 zones of Amhara, Oromia, SNNP (Southern Nations and Nationalities, and Peoples) and Sidama Regions of Ethiopia. Methods: A baseline survey was conducted in randomly selected health facilities from all districts within the 19 zones from November 2020 to February 2021. Interventions targeting the major drivers of catastrophic costs identified in the baseline survey, such as installation of 126 GeneXpert and 13 Truenat machines, securing connectivity of 372 GeneXpert, establishing alternative specimen referral systems, and capacity-building of health workers, were implemented. A follow-up survey was conducted from October to December 2022. The WHO generic tool was used to collect data based on probability proportional to size. Data were entered into STATA software, and the proportion of catastrophic costs was calculated and compared between the two surveys. Results: A total of 433 and 397 patients participated in the baseline and follow-up surveys, respectively. The proportion of catastrophic costs reduced from 64.7% to 43.8% ( P < 0.0001). The share of direct non-medical costs decreased from 76.2% to 19.2%, while medical and indirect costs increased from 11.6% and 12.3% to 30.4% and 52.4 %. Conclusion: The proportion of households facing TB-related catastrophic costs has significantly reduced over the 2-year period. However, it remains unacceptably high and varies among regions. Further reducing the catastrophic costs requires multisectoral response, reviewing the TB service exemption policy, further decentralisation and improving the quality of TB services. Competing Interests: Conflicts of interest: none declared. (© 2024 The Authors.)
Databáze:	MEDLINE
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