Health Service Utilization Pattern and Costs Incurred by People Living with HIV/AIDS at the Nkambe District Hospital, Cameroon
DOI:
https://doi.org/10.47672/ejhs.946Keywords:
Health, Utilization, outpatient, inpatient Costs and HIV/AIDS, CameroonAbstract
Purpose: Even though ART services in Cameroon are highly subsidized, people living with HIV/AIDS still incur a non-ART drug cost. This piece of paper is aimed at investigating the health service utilization pattern and the outpatient and inpatient costs incurred by people living with HIV/AIDS in the Nkambe District Hospital.
Methodology: A single facility-based cross-sectional survey was conducted between February and June 2018 at Nkambe District Hospital. A micro-costing analysis was used to determine the direct and indirect cost of treatment and access. Data were collected using an administered questionnaire and secondary data from patients' files, analyzed using a one-way analysis of variance (ANOVA). A convenient and purposive sample of 346 participants were enrolled (281 outpatients and 65 inpatients).
Results: Result shows that, majority of participants (97.5%) were in their follow up visit. 83.3% had been on ART for more than 1year, while more than half (59.5%) visited the hospital every after 3months for ART refilled. 80% of admitted cases were admitted for the first time. An average direct cost of treatment access was 2108.89FCFA ($3.47) for outpatient and 30414.31FCFA ($54.12) for inpatient, giving an annual average cost of 8435.56FCFA ($15) and 121657.24 FCFA ($216.5), respectively.
Conclusion: This work concluded that the of ART services is not sufficient to eliminate the economic burden of treatment on HIV patients.
Recommendations: Implementing effective community dispensation of ARVs and other differentiated care models like multi-month scripting and home dispensations well as creating more HIV treatment centers is vital. Also, implementation of a user fee policy for other HIV services. Finally, accelerating the process of universal health coverage in Cameroon will go a long way to help HIV patients and their households.
Downloads
References
Baier, E. (1997). The impact of HIV/AIDS on rural households/communities and the need for multisectoral prevention and mitigation strategies to combat the epidemic in rural areas. In p. d. United Nations, The Impact of AIDS (p. 81). New York.
Beegle, K., Ainsworth M., Koda G. (2005). The impact of Adult mortality and parental death on primary schooling in North-Western Tanzania. Journal of D studies development, 412-439.
Boysen, F., le, R., Bachmann, M., Matebesi, Z., Meyer, J. (2004). The socioeconomic impact of HIV/AIDS on households in South Africa: a pilot study in Welkom and Qwaqwa. free state province. AIDS.
CAMPHIA. (2018). Cameroon Population-based HIV impact assessment preliminary findings. Yaounde: MINSANTE.
Collins, D., Liedbrandt M. (2007). The financial impact of HIV/AIDS on house holds in SouthAfrica. AIDS, 21(7), 75-81.
Dhaliwal, M., Ellman, T. (2003). Improving access to antiretroviral treatment in Cambodia. Cambodia: Eldis.
DHS. (2011). Cameroon demographic health survey report. Yaounde: Natitonal institute of statistics.
Duraisamy, P., Ganesh, A., Homan, R., Kumarasamy, N., Castle, C., Sripriya, P., Mahendra, V., Solomon, S. (2006). Cost and financial burden of care and support services for PLHA households of South India. AIDS Care, 18(2), 121-7.
Etiaba, E., Onwujekwe O., Torpey K., Uzuchukwu B., Chiegil R. (2016). what is the economic burden of HIV/AIDS on patients in Nigeria and is this burden catastrophic to the households? PLoS ONE, 12(11).
Kumarasamy, N., Safren S., Raminani S., Pickard R., James R., Krishnan A., Solomon S., Mayer K. (2005, Aug). Barriers and facilitators to antiretroviral medication adherence among patients with HIV in Chennai, India: a qualitative study. AIDS patient vare STDS, 19(8), 526-37.
Kharsany, B.M., Karim, A.,Q. (2016, April 8). HIV infection in Sub-Saharan Africa: Current Status, Challenges, and Opportunities. Open AIDS Journal, 10:34-48.
Leive A., Xu k. (2008). coping with out-of-pocket health payments: empirical evidence from 15 countries. bulletin of World Health Organisation, 86:849-856.
Lopera, M.,Thomas R., Bula J. (2011). Out-of-Pocket expenditures and coping strategies for people living with HIV: Bogota, Columbia. AIDS, 1602-1608.
MINSANTE. (2018). Population cible de sante. Yaounde: Ministry of Public Health.
Moon S., Van Leemput L., Durier N., Jambert E., Dahamane A., Jie Y., Wu G., Phillips N.,Hu Y., Sanranchu P.,. (2008, Sep). The out-of-pocket cost of AIDS in China. are free antiretroviral drugs enough? AIDS Care, 984-94.
Mudzengi, D., Sweeney S., Hippner P., Kufa T., Fielding K., Grant A., Churchyard D., Vassal A. (2017). The patient cost of care for those with Tuberculosis and HIV: A cross-sectional study from South Africa. Health Policy and Planning, 1-9.
National AIDS Control Committee (2017). Annual Report of 2016 activities for the fight against HIV/AIDS and STIs in Cameroon. Yaounde: National AIDS control committee.
Omer, E., Mirriam D. (2008, April). Impact of HIV/AIDS on labor productivity in Akaki fiber products factory, Ethiopia. Ethiopian Med Journal, 46(2), 123-31.
ONUSIDA. (2014). 90-90-90, une cible ambiteuse de traitment pour aider a mettre fin a l'epidemie du SIDA . . Geneve: ONUSIDA.
Poudel, A., Newland D.,Simkhada P. (2015). Economic Burden of HIV/AIDS upon households in Nepal: A critical review. Nepal Journal of Epidemiology, 5(3), 502-10.
Rosen, S., Ketlhapile, M., Sanne I., Bachman M. (2007). Cost to the patient of obtaining Treatment for HIV/AIDS in South Africa. South African medical journal, 97(7).
Russell, S. (1996). Ability to pay for health care: concepts and evidence. Health Policy Plan., 11:219-237.
Russell, S. (2004, August). The Economic Burden of Illness for Households in Developing: A Review of studies Focusing on Malaria, Tuberculosis, and Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome. American Journal of Tropical Medicine and Hygiene, 71(2).
UNAIDS. (2012). Global Report; global AIDS epidemic. UNAIDS.
UNAIDS. (2016). Prevention Gap Report. UNAIDS
UNAIDS. (2017). UNAIDS factsheet world AIDS day. UNAIDS.
UNAIDS. (2018). Global HIV and AIDS statistics factsheet. UNAIDS.
Wasti, S., Simkhada P., Van Teijlingen E. (2009). Antiretroviral treatment program in Nepal: problems and barriers. Kathmandu University Medical Journal, 7(3), 290-298.
WHO. (2015). World health organization, test and treatment recommendations. Geneva: World Health Organisation.
WHO. (2016). Consolidated guidelines on the use of Antiretroviral drugs for treating and preventing HIV infection: Recommendation for a Public Health approach. Geneva: World Health Organisation.
Zachariah, R., Harries AD. Mnazi M. Gomani P. Teck R. Phillips M. Firmenich P. (2006). Acceptance of anti-retroviral therapy among patients infected with HIV and tuberculosis in rural Malawi is low and associated with the cost of transport. PLoS One, 121
Downloads
Published
How to Cite
Issue
Section
License
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.