Investigating parents/caregivers financial burden of care for children with non-communicable diseases in Ghana

Abstract

BackgroundThe introduction of the Ghana national health insurance scheme (NHIS) has led to progressive and significant increase in utilization of health services. However, the financial burden of caring for children with non-communicable diseases (NCDs) under the dispensation of the NHIS, especially during hospitalization, is less researched. This paper therefore sought to assess the financial burden parents/caregivers face in caring for children hospitalized with NCDs in Ghana, in the era of the Ghana NHIS.MethodsWe conducted a cross-sectional survey of 225 parents or caregivers of children with NCDS hospitalized in three hospitals. Convenience sampling was used to select those whose children were discharged from hospital after hospitalization. Descriptive statistics such as frequencies and chi-square and logistic regression were used in data analysis. The main outcome variable was financial burden of care, proxied by cost of hospitalization. The independent variable included socio-economic and other indicators such as age, sex, income levels and financial difficulties faced by parents/caregivers.ResultsThe study found that over 30 % of parents/caregivers spend more than Gh¢50 (25$) as cost of treatment of children hospitalized with NCDs; and over 40 % of parents/caregivers also face financial difficulties in providing health care to their wards. It was also found that even though many children hospitalized with NCDs have been covered by the NHIS, and that the NHIS indeed, provides significant financial relief to parents in the care of children with NCDs, children who are insured still pay out-of-pocket for health care, in spite of their insurance status. It was also found that there is less support from relatives and friends in the care of children hospitalized with NCDs, thus exacerbating parents/caregivers financial burden of caring for the children.ConclusionsEven though health insurance has proven to be of significant relief to the financial burden of caring for children with NCDs, parents/caregivers still face significant financial burden in the care of their wards. Stakeholders in health care delivery should therefore ensure that all children with NCDs including those excluded from the NHIS should be covered by NHIS. A special effort focusing on identifying children with NCDs within the lower income groups, especially from rural areas, in order to exempt them from any form of payment for their health care is recommended.

Non-communicable diseases among children in Ghana: health and social concerns of parent/caregivers

“…The analysis showed most caregivers believed NCDs had negatively affected child's physical growth and school attendance and had caused caregivers/ parents to spend so much money. This finding conforms to earlier research on the social and economic burden of NCDs on families in Ghana 20,24 . Diabetes, especially, type 2 diabetes in the young, is also an increasing problem with potentially serious outcomes 25 .The increasing prevalence of pediatric type 2 diabetes coincides with increasing obesity in children 26 .…”

“…The opportunity cost of taking caregivers away from their trading and work activities to care for the sick child in health facilities have implications for the wellbeing of other members of the family 23 . The cost of health care, cost of transportation and daily living cost, as well as the opportunity cost to caregivers increases the economic and social burden on the household and family 20,23 .…”

“…Sickle cell disease has long been identified to afflict children in Ghana and has severe educational and developmental challenges as well as economic and social challenges for the family 20,24 . The analysis showed most caregivers believed NCDs had negatively affected child's physical growth and school attendance and had caused caregivers/ parents to spend so much money.…”

“…The financial and social burden of most parents/caregivers are exacerbated by these out-of-pocket payments. In addition, financial support from relatives and friends for the health care of children with NCDs have been shown to be minimal 20 . The absence of comprehensive coverage for NCDs in the general population and especially among children (e.g childhood cancers) by the national health insurance scheme in Ghana 21 imposes huge financial burden on families in accessing health care for their chronically sick children.…”

“…A recent publication in Ghana demonstrated that the national health insurance provides significant financial relief to parents/caregivers in the care of their children with NCDs. However, parents/caregivers still face considerable financial burden of caring for their children with NCDs during hospitalization 20 . The financial and social burden of most parents/caregivers are exacerbated by these out-of-pocket payments.…”