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[Family expenses caused by pediatric hospitalization in Niamey (Niger)]
1Centre Muraz, Bobo-Dioulasso, Burkina Faso.
Insights
Hospitalization in Niger is costly for families, representing 8-10 times annual health expenditure. Medical expenses form the largest portion, highlighting the need for cost-reduction strategies for pediatric care.
Area of Science:
- Public Health
- Health Economics
- Pediatric Care
Background:
- Niger faces significant poverty, with over 54% of the population living below the poverty line.
- The Nigerien government is implementing policies to reduce healthcare costs, including hospital expenses.
- Childhood hospitalization presents a substantial financial burden on families in low-income settings.
Purpose of the Study:
- To analyze the total financial expenditure incurred by families of children admitted to Niamey National Hospital.
- To determine the proportion of medical versus non-medical expenses during pediatric hospitalization.
- To assess the overall cost of pediatric hospitalization in relation to average annual health expenditure in Niger.
Main Methods:
- A study was conducted during the 1994-1995 rainy and dry seasons.
- Eighty children admitted to the pediatric ward of Niamey National Hospital were randomly selected.
- Family expenditures related to hospitalization, including medical and non-medical costs, were recorded and analyzed.
Main Results:
- Total family expenses ranged from 151.8 to 185.5 FF, with medical costs comprising 60-64.5%.
- Non-medical expenses (transport, food, gifts) accounted for 35.4-39.9% of total family expenditure.
- The total cost of a pediatric hospital stay (family + hospital expenditure) was 316.5-350.4 FF, equivalent to 8-10 times mean annual urban health expenditure.
Conclusions:
- Pediatric hospitalization in Niger imposes a severe financial strain on families, exceeding typical annual health spending.
- Current government measures, such as promoting generic drugs, are steps towards cost reduction.
- Further strategies are needed to lower costs for families and improve the cost-effectiveness of healthcare services.
Abstract:
In Niger, 54.4% of the population live below the poverty level (less than 750 FF per year per person). The government is currently implementing a policy to reduce medical costs, including those of hospitals. We carried out a study during the rainy and dry seasons of 1994-1995, of 80 children, randomly selected, who had been admitted to the pediatric ward of Niamey National Hospital. The total expenditure of their families, due to their hospitalization, was recorded and analyzed. The total expenses of the family were 151.8 (+/- 100.0) to 185.5 (+/- 118.9) FF depending on where the drugs were purchased (wholesale or private). Medical expenses accounted for 98.0 (+/- 48.3) to 119.8 (+/- 57.2) FF, that is 60.0 to 64.5% of total expenses. Non-medical expenses (transport, food, presents) accounted for 61.7 to 65.7 FF, 35.4 to 39.9%. Total daily expenses were 23 to 41.7 FF for the five main diseases. In 66 cases, the costs were paid by the father (82.5%), with the mother or another person paying in 7 cases (8.8%). Only 24 families (30%) paid the hospital fee (10.5 FF). Twenty-seven families were exempted and 22 avoided payment. The cost of medical analysis was 32.6 (+/- 31.3) FF and this was paid by the hospital. The total cost (total family expenditure + hospital expenditure) of a stay in a pediatric unit was 316.5 to 350.4 FF, which is equivalent to 8 to 10 times the mean annual individual expenditure on health in urban areas of Niger. Measures have already been introduced to encourage the prescription of generic drugs and a number of measures are currently under discussion for lowering the cost to families of hospital and health center care and for improving the cost effectiveness of treatment.