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Ofori Boateng M, Asuman D, Kugbey N, Amoah PA, Agyei-Baffour P, Enemark U. Health literacy and household financial loss on malaria treatment for children under five in Ghana: a patients' perspective. Int Health 2024:ihae022. [PMID: 38563469 DOI: 10.1093/inthealth/ihae022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 01/17/2024] [Accepted: 02/21/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Inadequate health literacy increases medical costs and leads to poor health outcomes. However, there is a paucity of empirical evidence of such associations in sub-Saharan Africa. This study investigates how the household cost of malaria in children under five in Ghana varies based on different levels of health literacy. METHODS A cross-sectional survey involving 1270 caregivers of children under five was conducted. The survey included health literacy questionnaire and several pieces of sociodemographic and behavioural variables. RESULTS We created seven caregiver health literacy profiles by scoring nine dimensions. The mean total cost for managing malaria among respondents was US$20.29 per episode. The total household cost for caregivers with high health literacy (Profile 1) (US$24.77) was higher than all other profiles, with the lowest cost (US$17.93) among the low health literacy profile (Profile 6). Compared with Profile 4, caregivers with high health literacy (Profile 1) spent more on managing malaria in children, while those with the lowest health literacy (Profile 7) spent less. CONCLUSION The current study presents a snapshot of malaria treatment costs, and argues that low health literacy may lead to increased costs due to possible reinfections from delayed healthcare use. There is a need for longitudinal studies to understand causal relationship between health literacy and household expenses on malaria treatment to inform policy development and interventions. LAY SUMMARY This study explores the impact of caregiver health literacy levels on the cost of managing malaria incidents in children under five in Ghana. High health-literate caregivers incurred the highest total household cost at US$24.77, with US$17.93 incurred by lower health-literate caregivers per malaria episode.
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Affiliation(s)
- Millicent Ofori Boateng
- Faculty of Health, Department of Public Health, Aarhus University, Bartholins Alle 2, Building 1260, DK 8000 Aarhus C, Aarhus, Denmark
- School of Public Health, Department of Community Health, Ensign Global College, P.O. Box AK 136, Akosombo, Eastern Region, Ghana
| | - Derek Asuman
- Health Economics Unit, Lund University, Medicon Village 301:5, Scheelevagen 2, 223 81, Box 117, 221 00 Lund, Sweden
| | - Nuworza Kugbey
- School of Public Health, Department of Community Health, Ensign Global College, P.O. Box AK 136, Akosombo, Eastern Region, Ghana
- Department of General Studies, School of Natural and Environmental Sciences, University of Environment and Sustainable Development, PMB, Somanya, Ghana
| | - Padmore Adusei Amoah
- Department of Psychology, Institute of Policy Studies, School of Graduate Studies, Lingnan University, 8 Castle Peak Road, Lingnan, Tuen Mun, Hong Kong
| | - Peter Agyei-Baffour
- Department of Occupational Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Private Mail Bage, University Post Office, Kumasi, Ghana
| | - Ulrika Enemark
- Faculty of Health, Department of Public Health, Aarhus University, Bartholins Alle 2, Building 1260, DK 8000 Aarhus C, Aarhus, Denmark
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Blankson PK, Amanor EM, Dai-Kosi AD, Amoako E, Konadu AB, Boamah MO, Amoah GK, Parkins GE. Paediatric maxillofacial fractures in Ghana: Pattern, household cost, and distress. Int J Paediatr Dent 2021; 31:613-618. [PMID: 33002267 DOI: 10.1111/ipd.12734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/08/2020] [Accepted: 09/23/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Maxillofacial fractures in the paediatric population are peculiar in risks, management, and potential complications. AIM To determine the pattern, psychological distress to parents, and economic cost of paediatric maxillofacial fractures in Ghana. DESIGN This study combined a retrospective evaluation with a cross-sectional cost-of-illness (COI) analysis to describe the pattern and economic cost of paediatric maxillofacial fractures in Ghana. The DASS 21 was used to assess psychological distress to parents. Descriptive summaries were generated, and cross-tabulations done, with consequent tests of associations. RESULTS In all, 253 patients were included in the study, with 68 households responding to the COI evaluation. Consisting of 179 (70.8%) males and 74 (29.2%) females, the ages ranged from 10 months to 17 years (mean age of 9.0 ± 5.0 years). Maxillofacial fractures frequently resulted from falls (56.5%), while traffic injuries accounted for 27.3%. The average household cost for paediatric maxillofacial fractures in Ghana was US$ 148.77, with the direct cost component accounting for 76% of this amount. At least half of the parents had some degree of psychological distress from the injury sustained. CONCLUSION Knowledge of the pattern and disease burden of maxillofacial fractures in children is vital in informing preventive strategies, especially for evolving health systems in sub-Saharan Africa.
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Affiliation(s)
- Paa Kwesi Blankson
- Oral and Maxillofacial Surgery Unit, Korle-Bu Teaching Hospital, Accra, Ghana.,University of Ghana Dental School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Efua M Amanor
- University of Ghana Dental School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Alfred D Dai-Kosi
- University of Ghana Dental School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Emmanuella Amoako
- Department of Child Health, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Akua B Konadu
- Oral and Maxillofacial Surgery Unit, Korle-Bu Teaching Hospital, Accra, Ghana.,University of Ghana Dental School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Matthew Owusu Boamah
- Oral and Maxillofacial Surgery Unit, Korle-Bu Teaching Hospital, Accra, Ghana.,University of Ghana Dental School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Gyaami K Amoah
- University of Ghana Dental School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Grace E Parkins
- Oral and Maxillofacial Surgery Unit, Korle-Bu Teaching Hospital, Accra, Ghana.,University of Ghana Dental School, College of Health Sciences, University of Ghana, Accra, Ghana
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Amarasinghe H, Jayasinghe RD, Dharmagunawardene D, Attygalla M, Kumara DR, Kularatna S, Johnson NW. Economic cost of managing patients with oral potentially malignant disorders in Sri Lanka. Community Dent Oral Epidemiol 2021; 50:124-129. [PMID: 33899256 DOI: 10.1111/cdoe.12639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 02/27/2021] [Accepted: 03/07/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Cancer of the oral cavity is the leading malignancy amongst males in Sri Lanka, and eighth amongst women. Almost all malignancies are developed from a clinically visible precursor stage called an oral potentially malignant disorder (OPMD). The objective of this study was to estimate costs of managing patients with OPMD in Sri Lanka for a 12-month period from diagnosis. METHODS A hospital-based costing study was conducted in Sri Lanka in the years 2016-2017. Three selected treatment centres participated. For societal perspectives, healthcare, household and indirect costs were used. Costs to the healthcare system included clinic visits, diagnostic biopsy, consumables and drug costs. Capital costs included apportioned value of land, buildings, equipment and furniture. Household costs consisted of out-of-pocket expenditure and indirect costs of lost income. RESULTS Sixty-two patients were recruited (39 male and 23 female). The majority had awareness of oral potentially malignant disorders (OPMDs). Total average cost of managing a single patient with an OPMD for 1 year was SLR 19 547 (US$ 140) which includes a health system cost of SLR 7320 (US$ 52) and household cost of SLR 12 227 (US$ 87). Travel loss and income loss were a substantial burden to patients and their families. CONCLUSIONS Managing patients with an OPMD, even with annual monitoring, is less costly than managing patients with oral cancer. Out-of-pocket costs are very high, and these could be reduced by revising the National Management Guidelines to allow care closer to home.
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Affiliation(s)
- Hemantha Amarasinghe
- Family Health Bureau, Ministry of Health, Colombo, Sri Lanka.,Menzies Health Institute Queensland, and School of Dentistry and Oral Health, Griffith University, Gold Coast, QLD, Australia
| | - Ruwan D Jayasinghe
- Department of Oral Medicine and Periodontology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | | | - Manjula Attygalla
- Department of OMF Surgery, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | | | - Sanjeewa Kularatna
- Australian Centre for Health Services Innovation, School of Public Health and Social Work, Queensland University of Technology, Gold Coast, QLD, Australia
| | - Newell W Johnson
- Menzies Health Institute Queensland, and School of Dentistry and Oral Health, Griffith University, Gold Coast, QLD, Australia.,Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
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Amarasinghe H, Jayasinghe RD, Dharmagunawardene D, Attygalla M, Scuffham PA, Johnson N, Kularatna S. Economic burden of managing oral cancer patients in Sri Lanka: a cross-sectional hospital -based costing study. BMJ Open 2019; 9:e027661. [PMID: 31326930 PMCID: PMC6661677 DOI: 10.1136/bmjopen-2018-027661] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Cancer of the oral cavity is the leading malignancy among males in Sri Lanka, and sixth among women. This study aimed to estimate costs of managing patients with oral cancer (OCA) in Sri Lanka for a 12 month period from diagnosis. DESIGN Hospital based costing study. SETTINGS Four selected cancer treatment centres in Sri Lanka. PARTICIPANTS Sixty-nine OCA patients: 60 were males and 12 had recurrent tumours. OUTCOME Societal perspectives (healthcare, household and indirect costs) were itemised. Costs to the healthcare system included surgery, Intensive Care Unit (ICU) care, chemotherapy and radiotherapy. Capital costs including apportioned value of land, buildings, equipment and furniture. Household costs consisted of out of pocket expenditure for healthcare and indirect costs of lost income. Costs were estimated from the stage of presentation for treatment to 1 year of follow-up. RESULTS Mean cost of managing a single stage II OCA patient for 1 year was Sri Lankan rupees (SLR) 58 979 (US$394, at the midyear exchange rate in 2016) to the health system. Mean household cost was SLR 77 649 (US$518). The annual cost of managing a stage III or IV patient was SLR 303 620 (US$2027), with household costs of SLR 71 932 (US$480). CONCLUSIONS Owing to the high incidence of OCA in Sri Lanka, the economic costs associated with these diseases are enormous, resulting in negative impacts on both the healthcare system and individual families, seriously impacting the country's economy. Policy-makers should take note of this burden and increase steps for prevention and control of this devastating disease.
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Affiliation(s)
- Hemantha Amarasinghe
- Institute of Oral health, Maharagama, Sri Lanka
- Menzies Health Institute Queensland, and School of Dentistry and Oral Health, Griffith University, Queensland, Australia
| | - Ruwan Duminda Jayasinghe
- Department of Oral Medicine and Periodontology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | | | - Manjula Attygalla
- Department of OMF Surgery, Faculty of Dental Sciences, University of Peradeniya, Kandy, Central, Sri Lanka
| | - Paul A Scuffham
- Menzies Health Institute Queensland, and School of Dentistry and Oral Health, Griffith University, Queensland, Australia
| | - Newell Johnson
- Menzies Health Institute Queensland, and School of Dentistry and Oral Health, Griffith University, Queensland, Australia
- Oral Health Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College, London, United Kingdom
| | - Sanjeewa Kularatna
- Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
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