Addressing the public health challenge of birth defects in India

Abstract

Birth defects consisted of a group of diverse clinical conditions categorized on the basis of a congenital presentation and a partly or wholly genetic etiology. Although individually rare, birth defects affect 2-3% of all births in India. As India has the largest global annual births, in absolute numbers, India may harbor the largest number of affected children worldwide. There is a need of strategic research and interventions to bring down the rate of birth defects and associated economic burden and also a need to actively screen and identifythem at early stage so necessary intervention (medical or surgical) could be initiated so as to reduce lifelong disability as a result of such defects. The recent child health screening and early intervention service initiative by the Government of India, the Rashtriya Bal Swasthya Karyakram under the National Health Mission is the first attempt in the direction toward providing services for some of the more prevalent birth defects and has the potential to alleviate suffering of affected children especially from rural areas. The data collected from this program could help policy makers to allocate sufficient funds aimed at treatment of birth defects and also develop behavior change communication strategies for prevention of the same.

Cost analysis of outpatient services for major external structural birth defects: An ingredient approach in selected hospitals in Kiambu County, Kenya

“…To our knowledge, this was the first study to estimate the unit economic costs of MESBDs from health care providers' economic perspective among the under-five-year-old children in Kiambu County, Kenya. Substantial public health resources are continually allocated to the health care systems for care of children with MESBDs, however, the unit economic costs of care are barely known because they are rarely estimated mainly in the developing countries 9,29 . Sufficient access and utilization of corrective and rehabilitative health services remain an important public health intervention for improving the quality of life for birth defect-affected children globally [1][2][3][4] .…”

“…Sufficient access and utilization of corrective and rehabilitative health services remain an important public health intervention for improving the quality of life for birth defect-affected children globally [1][2][3][4] . Even though limited cost data, inadequate costing expertise, and the rarity of defects have been attributed to the lack of knowledge on their costs, it is of public health and economic interest to estimate the opportunity costs of health care services for MESBDs 9,29 . Worldwide, the results of this study could provide a baseline unit economic costs for the corrective and rehabilitative health services, inform efficient allocation of health resources, stimulate, and inform cost studies especially the costs' arms of full economic evaluation analyses 17,22,31 .…”

“…Worldwide, spina bifida has singly been observed to account for the highest-burden of disease among other types of MESBDs 11,15 19 . Low undertakings of cost studies, particularly in low-and middle-income economies have been attributed to the scarcity of data on the burden of these defects, 20,28,29 . Thus, the variations of annual direct economic costs could have been due to differences in the availability of the cost data, costing expertise, health services access, and utilization (economies of scale) 5,17,19,39 .…”

“…The advancements in medical and surgical interventions are known to reduce the severity of lifelong physical disabilities related to MESBDs; however, their costs are catastrophic and prohibitive to many households and public health care systems globally 1,2,9,15 . Even though substantial resources are usually allocated to health care systems for the provision of corrective and rehabilitative health services for MESBDs, their costs are seldom estimated due to the rarity and stochasticity of the defects, scantiness of the cost data, inaccurately profiled cost information and inadequate costing expertise in developing countries 19,20,28,29 . The scarcity of local epidemiological data and differences in the epidemiological study design (prevalence/incidence-based) also impede the accuracy of the profiled cost data in developing countries 19,20,28,29 .…”