Economic assessment of diagnostic systems against neglected infectious diseases in african children under five years of age

Abstract

Poverty has made access to basic health care a nightmare for most people living in countries endemic with infectious diseases. Most of the infectious diseases that affect the most vulnerable in the en-demic societies are neglected and relegated by many world health bodies to the “other diseases” category which makes it difficult to secure grants for researching those diseases. Unfortunately child-ren are more affected. Clinical researchers are only interested in clinical efficacy of their trials or projects with very limited or no interest on the value for money of their projects. Children younger than five years of age who were taken to the Pramso or Agogo hospitals were the main target of this research as they fall within the category of “most proned” to diseases. Pramso and Agogo hospitals are both located in the Bosomtwe district and Asante Akim North both in the Ashanti Region of Ghana Lack of adequate diagnostic facilities in most local hospitals in most African countries, for instance Ghana, makes it difficult to sometime trust laboratory test results hence the establishment of a state of the art microbiological diagnostic center in the Ashanti Region of Ghana by the Bernhard-Nocht Institute for Tropical Medicine (BNITM) based in Hamburg, Germany to help all surrounding health facilities analyze specimen or samples for precise diagnostic results. This study aimed at assessing whether the intervention by the BNITM has a real value for money or the standard diagnostics system. A questionnaire was used to collect data from study participants and data on cost as well as their utility for the diagnostic facility in two hospitals in the Ashanti region of Ghana, Pramso and Agogo. Care-givers (parents or guardians) were made to trade perfect health with ill-health using the time trade off (TTO) method and the cost of treatment was collated right on discharge from the children wards. The net benefit of each of the diagnostic systems, the standard and the conventional, was calculated for each of the hospitals under study. The results showed that both diagnostic systems are beyond the affordability of the care-giver to some extent. I finally found out that both the diagnostic systems of Pramso and Agogo were very expensive for care-givers who take their children there for treatment yet those at Agogo offered to pay some rea-listic amount of money to get medical care since most of them were very satisfied with the overall service of the hospital. Though care-givers at Pramso Hospital (stanbdard diagnostics) were “satisfied with the service” yet what they are willing to pay for the treatment of their children is far less than the actual cost of treatment. I finally discussed how health policy makers could fix realistic price, based on the average willingness to pay so that all care-givers could access basic health and medical care. The need to collate health economic data alongside clinical and epidemiological from onset as part of the hospital database was also discussed.