The economic burden of measles in children under five in Bangladesh

BMC Health Serv Res. 2020 Nov 10;20(1):1026. doi: 10.1186/s12913-020-05880-5.

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.

Keywords: Bangladesh; Caregiver cost; Cost of illness; Economic burden; Measles.

MeSH terms

  • Bangladesh
  • Caregivers / psychology*
  • Child, Preschool
  • Cost of Illness*
  • Delivery of Health Care / economics*
  • Female
  • Financing, Personal*
  • Health Care Costs*
  • Humans
  • Interviews as Topic
  • Male
  • Measles / economics*
  • Poverty
  • Surveys and Questionnaires