Household Cost of Caregiving for Children with Asthma Attending Princess Marie Louis Hospital in Accra

Abstract

Introduction: Asthma is a chronic respiratory disease which has substantial financial and non-financial burden on sufferers, their families and the society. Family caregivers continue to be the primary source of care for children with asthma in Ghana which may have financial and psycho-social implications. Aim: The objective of the study was to determine the household cost of caregiving for children with asthma at Princess Marie Louis Hospital in Accra. Methods: A retrospective cross-sectional cost-of-care study was conducted among family caregivers at Princess Marie Louis Hospital. Ninety respondents completed an interviewer-administered questionnaire. Direct cost consisted of consultation, medication, diagnosis, treatment, travel cost and other medicals. Indirect cost was estimated using the human capital approach-i.e. the time value of days lost and waiting time due to caregiving. All costs were estimated using a recall period of one month or the last monthly visit. Intangible costs were assessed using the 12-item Zarit burden interview scale. Results: The total average cost of caregiving for children with asthma in the sample was estimated at GHS5889.9 (USD 1277.1). This constituted of 93% (GHS 5472; USD 1140) being direct cost of caregiving and 7% (GHS 417.9; USD 87.1 ) being indirect cost. The major cost drivers of asthma cost were cost of medication (43.9%), treatment (17.8%) and absence from work (6.8%). Household was higher for male children (GHS 5586/ USD1163.8) than female children with asthma (GHS4749.8/USD 989.5 ). Cost also increased with age of children between 6 and 9 years bearing the highest cost (GHS 6274.8/USD1307.3) and those 1 year or less bearing the least cost (GHS 2004 / USD 417.5). Additionally, the cost was highest for children from poorest households (GHS 3217/ USD 670.3) whilst admission cases also led to high cost (GHS 7210.8/ USD 1502.3). About 45.6% had little or no burden whiles 46.7% had mild to moderate burden due to providing care. Conclusion: The study showed the family caregivers for children with asthma are faced with financial challenges. There is therefore the need for an intervention from policy makers, for instance to make asthma treatment free or at a reduced cost to enable caregivers to continue to support and give care to children with asthma.