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Exploring household economic impacts of childhood diarrheal illnesses in 3 African settings
Richard Rheingans1, Matt Kukla, Richard A Adegbola
1Department of Environmental and Global Health, University of Florida, Gainesville, FL 32610, USA. rrheing@ufl.edu
Insights
Childhood diarrhea imposes substantial economic burdens on sub-Saharan African households. Poorer families and girls often face lower care costs, potentially increasing mortality risks.
Area of Science:
- Public Health
- Global Health
- Pediatrics
Background:
- Childhood diarrhea presents a significant morbidity and mortality challenge in sub-Saharan Africa.
- Beyond health impacts, childhood diarrhea incurs substantial economic costs for affected households.
Purpose of the Study:
- To estimate the direct medical, direct nonmedical, and indirect economic costs of childhood diarrhea episodes for households in sub-Saharan Africa.
- To analyze cost variations across different countries and socioeconomic groups.
Main Methods:
- Utilized survey data from three Global Enteric Multicenter Study (GEMS) sites in sub-Saharan Africa: Gambia, Kenya, and Mali.
- Calculated mean and distributed costs per diarrheal episode for young children, categorizing expenses into medical, nonmedical, and productivity losses.
Main Results:
- Mean costs per episode varied by country: $2.63 (Gambia), $6.24 (Kenya), and $4.11 (Mali).
- Direct medical costs constituted less than half of the total household expenditure per episode.
- A disproportionate cost burden was observed in 10% of cases, exceeding $6.50, $11.05, and $13.84 in Gambia, Kenya, and Mali, respectively.
- Poorer households and, in some cases, girls experienced lower reported costs, suggesting potential underinvestment in care.
Conclusions:
- Childhood diarrhea imposes significant and unevenly distributed economic burdens on households in sub-Saharan Africa.
- Lower reported costs for vulnerable groups (poor children, girls) may indicate reduced access to or investment in care, potentially exacerbating health risks.
- Understanding these economic impacts is crucial for developing targeted interventions and support systems.
Abstract:
Beyond the morbidity and mortality burden of childhood diarrhea in sub-Saharan African are significant economic costs to affected households. Using survey data from 3 of the 4 sites in sub-Saharan Africa (Gambia, Kenya, Mali) participating in the Global Enteric Multicenter Study (GEMS), we estimated the direct medical, direct nonmedical, and indirect (productivity losses) costs borne by households due to diarrhea in young children. Mean cost per episode was $2.63 in Gambia, $6.24 in Kenya, and $4.11 in Mali. Direct medical costs accounted for less than half of these costs. Mean costs understate the distribution of costs, with 10% of cases exceeding $6.50, $11.05, and $13.84 in Gambia, Kenya, and Mali. In all countries there was a trend toward lower costs among poorer households and in 2 of the countries for diarrheal illness affecting girls. For poor children and girls, this may reflect reduced household investment in care, which may result in increased risks of mortality.
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