Potential Challenges In Collecting Pneumonia, Diarrhea and Measles among children under five years-Related Costs From Different Health Facility Levels In Uganda

Presenter: Aloysius Mutebi

Twitter: '@amutebi1

Co-authors: Elisabeth Ekirapa Kiracho, Anthony Sebagereka, Racheal Apolot, Gatien de Broucker, Dagna Constenla

Poster file: [download]
Background: Guidelines to conduct cost of illness studies are not well established. This limitation is compounded by difficulties in collecting costs from different facility levels. We documented key challenges in collecting pneumonia, diarrhea, measles-specific resource use, cost and expenditure data among children attending public, private (profit, non-profit) healthcare facilities, and pharmacies. Methods: This is part of a larger cross-sectional study conducted in four regions of Uganda i.e. Northern, Western, Eastern and Central to estimate the cost of treating pneumonia, diarrhea, and measles for one year. Resource use, cost and expenditure data for this study are collected through facility records review from 48 facilities and face-to-face interviews with caretakers of 720 children under 5 years with pneumonia. A follow-up telephone survey is conducted 7-14 days after initial survey to collect additional out-of-pocket healthcare payments. Results: We found several practical challenges that impact our ability to collect resource use, cost and expenditure data. Data collection through facility records review has gaps due to missing records; pneumonia, diarrhea, and measles cases are not always identified due to nonstandard case definitions; difficulties obtaining facility expenditure data due to facility managers’ unwillingness to release data and inconsistency and wide variation of documentation practices across facilities; challenges collecting out-of-pocket expenditure data due to recall bias, loss to follow-up and caretaker illiteracy. Conclusions: Collecting resource use, cost and expenditure data is an empirical process. With a judicious mix of practical approaches, it’s possible to assemble a credible set of data for use in cost of illness of pneumonia diarrhea, and measles in Uganda. The health facility management team is very central to the success of the costing study and thus should be actively engaged throughout the study. The costing data collection tools should be well pretested and well adapted to the type of health facility from which data is to be collected, so as to generate reliable data. Key words: Pneumonia, diarrhea, measles costs, health facilities, different levels Funding source: IVAC

Additional Files:
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