The economic burden of measles in children under five in Bangladesh

Abstract

Background This study estimated the economic cost of treating measles in children under-5 in Bangladesh from the caregiver, government, and societal perspectives. Method We conducted an incidence-based study using an ingredient-based approach. We surveyed the administrative staff and the healthcare professionals at the facilities, recording their estimates supported by administrative data from the healthcare perspective. We conducted 100 face-to-face caregiver interviews at discharge and phone interviews 7 to 14 days post-discharge to capture all expenses, including time costs related to measles. All costs are in 2018 USD ($). Results From a societal perspective, a hospitalized and ambulatory case of measles cost $159 and $18, respectively. On average, the government spent $22 per hospitalized case of measles. At the same time, caregivers incurred $131 and $182 in economic costs, including $48 and $83 in out-of-pocket expenses in public and private not-for-profit facilities, respectively. Seventy-eight percent of the poorest caregivers faced catastrophic health expenditures compared to 21% of the richest. In 2018, 2263 cases of measles were confirmed, totaling $348,073 in economic costs to Bangladeshi society, with $121,842 in out-of-pocket payments for households. Conclusion The resurgence of measles outbreaks is a substantial cost for society, requiring significant short-term public expenditures, putting households into a precarious financial situation. Improving vaccination coverage in areas where it is deficient (Sylhet division in our study) would likely alleviate most of this burden.

Second-dose measles vaccination and associated factors among under-five children in urban areas of North Shoa Zone, Central Ethiopia, 2022

“…At the same time, caregivers incurred $131 and $182 in economic costs, including $48 and $83 in out-ofpocket expenses in public and private not-for-profit facilities, respectively. Seventy-eight percent of the poorest caregivers faced catastrophic health expenditures compared to 21% of the richest (14).…”

Methods used to account for caregivers’ sex and gender within studies examining the financial burden of caregivers of children and adolescents : Results from a scoping review

“…First, sex-stratified analyses were used to report how total costs differed (or did not) in function of respondents’ sex; differences or lack of were not generally discussed within the studies that examined these relations. 104 , 109 , 111 , 115 , 139 , 204 , 207 , 210 Second, stratification on the respondents’ sex was used to account for and/or illustrate sex-based differences in indirect costs incurred by caregivers. 139 , 204 , 207 , 220 , 221 …”

Analysis of the different interventions scenario for programmatic measles control in Bangladesh: A modelling study

“…Therefore, due to paying less attention to the spread of measles, Bangladesh has been suffering from measles for many years even though measles is a vaccine-preventable disease with adequate and timely vaccination [ 37 ]. Indeed, ensuring vaccines for all people is a high burden and expensive for Bangladesh, as in other South Asian countries, but still the collected vaccines are not administered properly and therefore a considerable number of vaccines are wasted [ 38 ]. Even at the beginning of the last decade, more than half (about 69.7%) of measles vaccines distributed at both ward and village levels almost in all districts were wasted due to improper distribution planning or supply process and lack of proper maintenance [ 39 ].…”