Economic Burden of Childhood Pneumonia in Abbottabad, Pakistan

Abstract

Objective: To estimate the cost per episode of childhood pneumonia in under-five children as well as both direct and indirect costs associated with the treatment of these infections.

Study Design: Cross sectional study

Place and Duration of Study: This study was conducted at the Department of Pathology, Shahina Jamil teaching hospital of Frontier Medical College, Abbottabad, Pakistan from  July, 2014 and June, 2015.

Materials and Methods: Under-five children who were suffering from childhood pneumonia or suffered and treated for it in the past one month were included in the study. Their mothers/caretakers were the respondents. Data was obtained using a structured and pre-tested questionnaire.

Results: There were 229 respondents. Total median cost, direct non-medical cost and median direct medical cost associated with each episode of pneumonia was 300 PKR, 100 and 150 PKR, respectively. Non-medical expenses associated with treatment were low, 105 PKR. Direct medical expenses were 250 and 100 PKR in terms of medications and user fee at private health facility while at a public health facility, they were 100 and 03 PKR, respectively. It is evident that the expenses incurred in terms of fee and medicines were noticeably higher in private sector than in public sector. Indirect expenses were considerably higher amongst those patients who had visited a public health center as an out-patient. It was attributed to increased waiting time for medical consultation, 120 minutes, as compared to half hour at a private center. The indirect costs associated with hospitalized patients were non-significant. Many different methods were used to meet the health expenses related to treatment of ARIs in under-five children so as to produce extra funds. These methods included borrowing, allocation of fixed funds and selling personal goods or animals. Majority of the study participants (68.6%) had their monthly earnings amid 10,000-20,000 PKR.

Conclusion: The childhood pneumonia is associated with substantial economic burden. This must be considered while making health plans and strategies. This burden of disease could be attenuated by enhancing public sector medical services, curtailing treatment costs and introducing preventive strategies. The most significant preventive strategy will be to initiate influenza and pneumococcal immunization.