Costs, burden and quality of life associated with informal caregiving for children with Lymphoma attending a tertiary hospital in Ghana

Dawson, C.P.; Aryeetey, Genevieve Cecilia; Agyemang, Samuel Agyei; Mensah, Kofi Boamah; Addo, Rebecca; Nonvignon, Justice

doi:10.1177/2053434520981357

Cited by 8 publications

(21 citation statements)

References 30 publications

(25 reference statements)

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“…A study in Ghana assessing medicines for treating childhood cancer estimated that it would cost on average $900 to treat a 30 kg child (4). In a cost-of-illness study, Dawson et al estimated an average cost of $440 for treating lymphoma in children (12). Similar to our nding, the average costs of treating Burkitt's Lymphoma in Uganda were estimated to be $1,350 (8).…”

Section: Discussionsupporting

confidence: 75%

Cost-effectiveness and budget impact of covering Burkitt’s Lymphoma in children under Ghana’s National Health Insurance Scheme

Owusu,

Pritchard,

Heupink

et al. 2023

Preprint

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Background Many children in sub-Saharan Africa die from preventable deaths due to Burkitt’s lymphoma (BL), an aggressive but highly curable form of non-Hodgkin’s lymphoma. Delayed care seeking and treatment abandonment are common reasons for a relatively low overall survival (OS) in low-and middle-income countries when compared to OS in high income settings. The financial burden of care seeking to families is often the main reason for the high treatment abandonment. Yet childhood cancer is not a high priority in health care financing for many countries, including in Ghana, where at the time of this study, treatment was not covered by the National Health Insurance Scheme (NHIS). In this study, we analyze the cost-effectiveness of extending health insurance coverage to children with BL in Ghana. Methods We developed a Markov model in Microsoft Excel to estimate the costs and effects of BL treatment when NHIS was provided compared to the status quo where NHIS does not cover care for childhood cancer. The analysis was undertaken from the societal perspective. Both costs (measured in $) and effects, measured using disability adjusted life years (DALYs), were discounted at a rate of 3%. The time horizon was a lifetime. Probabilistic sensitivity analysis was done to assess uncertainty in the measurement of the incremental cost-effectiveness ratio (ICER). A budget impact analysis was undertaken from the perspective of the NHIS. Results In the base-case analysis, the intervention (NHIS reimbursed treatment) was less costly than current practice ($8,302 vs $9,558). The intervention was also more effective with less DALYs per patient than the standard of care (17.6 vs 23.33). The ICER was $219 and indicates that intervention is still cost-effective when taking a narrower, health system only perspective. The probabilistic sensitivity analysis showed that the intervention is likely to be both less costly and more effective than current practice in 100% of the 1,000 simulations undertaken. Conclusion Providing health insurance coverage to children with BL is potentially highly cost-effective. The effectiveness and cost-savings relating to this strategy is driven by its positive impact on treatment initiation and retention. Based on this evidence, there has been a policy change where Ghana’s NHIS has prioritized financing for cancer treatment in children.

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Section: Discussionsupporting

confidence: 75%

Cost-effectiveness and budget impact of covering Burkitt’s Lymphoma in children under Ghana’s National Health Insurance Scheme

Owusu,

Pritchard,

Heupink

et al. 2023

Preprint

Self Cite

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“…Six studies from Southern Africa, Zimbabwe ( 29 ), Madagascar ( 19 ), Malawi ( 17 , 18 , 30 ) and South Africa ( 31 ). Five of the articles came, respectively, from Central Africa, DR Congo ( 15 , 16 ) and Cameroon ( 17 – 19 ); and West Africa, Cote d’Ivoire ( 16 , 19 ), Ghana ( 17 , 18 , 20 , 21 ), Burkina Faso, Mali, Senegal ( 19 ) and Nigeria ( 22 , 23 , 29 ) ( Figure 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…Only 2 out of 17 articles included ( 15 , 20 ) reported both the average total cost, the direct cost and the indirect cost. Childhood cancer treatment costs were reported for lymphoma ( n = 9), multiple cancers ( n = 8), Wilms tumors ( n = 5), leukemia ( n = 4), retinoblastoma ( n = 3), nephroblastoma ( n = 1) and rhabdomyosarcoma ( n = 1).…”

Section: Resultsmentioning

confidence: 99%

Financial costs of pediatric cancer management in Africa: systematic review

Mjumbe,

Kulimba,

Numbi

et al. 2023

Front. Public Health

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The high costs of cancer treatment and the lack of investment in health care are significant barriers to public health on the African continent. The objective of this study was to investigate the financial cost of children cancer treating in sub-Saharan Africa. We systematically searched PubMed, Cochrane, and Google Scholar to identify relevant studies between March 2000 and December 2022. We selected articles that specifically addressed the US dollar financial costs of childhood cancer in African countries. Medians and interquartile ranges (IQR) were calculated. We also calculated the economic burden of childhood cancer at the individual level, by dividing the direct costs of cancer per patient by the GDP per capita, PPP of the country studied. The quality of economic studies was assessed using the CHEERS (2022) 28-point checklist. A total of 17 studies met our eligibility criteria. The median (IQR) of total childhood cancer costs by region was $909.5 ($455.3–$1,765) and ranged from $88803.10 for neuroblastoma to $163.80 for lymphoma. No significant differences (p < 0.05) were observed for comparisons of the direct cost of childhood cancer between the geopolitical zone of sub-Saharan Africa. Differences in the direct costs of childhood cancer were significant for different cancer types (p < 0.05). In the majority of 17 out of 54 countries on Africa the continent, the economic burden of childhood cancer exceeds 80% of GDP per capita, PPP, up to 345.38% of Nigeria’s GDP for Rhabdomyosarcoma. The cost of treating childhood cancers is high in Africa is catastrophic, if not downright prohibitive for households in Sub-Saharan Africa. We believe that the data from our study will be able to help make different objective advocacy allowing it to be provided with funds based of the evidence that can strengthen this program in order to install cancerology structures in the countries and by following the system plan. Cost reduction in the treatment of childhood cancer in particular and in general all types of cancer.Systematic review registrationApproval of the study was given by the ethics committee of the Faculty of Medicine of the University of Lubumbashi (UNILU/CEM/135/2018) and (UNILU/CEM/096/2019).

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“…Despite the high prevalence of caregiver burden in SSA including Ghana, not much is known regarding the association between caregiver burden and health-related quality of life among informal caregivers of older adults. The existing research has focused on family caregivers with schizophrenic patients [ 29 ], informal caregiving for children with lymphoma [ 30 ] and caregivers of stroke survivors [ 31 ]. For instance, Opoku-Boateng et al [ 29 ] wrote on economic cost and quality of life among family caregivers of schizophrenic patients attending psychiatric hospitals in Ghana.…”

Section: Introductionmentioning

confidence: 99%

“…Their study reports that caregivers with higher severity of depression, anxiety and stress experience higher caregiver burden and lower quality of life. Another independent study by Dawson et al [ 30 ] focused on costs, burden and quality of life associated with informal caregiving for children with lymphoma attending a tertiary hospital in Ghana. They found that lymphoma is linked to increased cost and higher burden impacting on quality of life among caregivers.…”

Section: Introductionmentioning

confidence: 99%

Caregiver burden and health-related quality of life: A study of informal caregivers of older adults in Ghana

Agyemang-Duah,

Abdullah,

Rosenberg

2024

J Health Popul Nutr

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Background Similar to many developing countries, caregiver burden remains high in Ghana which may affect informal caregivers of older adults’ health-related quality of life (HRQoL). However, no study has examined the association between caregiver burden and HRQoL among informal caregivers of older adults in Ghana to date. Understanding this association may well help to inform health and social policy measures to improve HRQoL among informal caregivers of older adults in Ghana. Situated within a conceptual model of HRQoL, the purpose of this study was to examine the relationship between caregiver burden and HRQoL among informal caregivers of older adults in Ghana. Methods We obtained cross-sectional data from informal caregiving, health, and healthcare (N = 1853) survey conducted between July and September 2022 among caregivers (≥ 18 years) of older adults (≥ 50 years) in the Ashanti Region of Ghana. The World Health Organization Impact of Caregiving Scale was used to measure caregiver burden. An 8-item short form Health Survey scale developed by the RAND Corporation and the Medical Outcomes Study was used to measure HRQoL. Generalized Linear Models were employed to estimate the association between caregiver burden and HRQoL. Beta values and standard errors were reported with a significance level of 0.05 or less. Results The mean age of the informal caregivers was 39.15 years and that of the care recipients was 75.08 years. In our final model, the results showed that caregiver burden was negatively associated with HRQoL (β = − .286, SE = .0123, p value = 0.001). In line with the conceptual model of HRQoL, we also found that socio-economic, cultural, demographic and healthcare factors were significantly associated with HRQoL. For instance, participants with no formal education (β = −1.204, SE= .4085, p value = 0.01), those with primary level of education (β = −2.390, SE= .5099, p value = 0.001) or junior high school education (β = −1.113, SE= .3903, p value= 0.01) had a significantly decreased HRQoL compared to those with tertiary level of education. Participants who were between the ages of 18–24 (β = 2.960, SE= .6306, p value=0.001), 25–34 (β = 1.728, SE= .5794, p value = 0.01) or 35–44 (β = 1.604, SE= .5764, p value= 0.01) years significantly had increased HRQoL compared to those who were 65 years or above. Also, participants who did not utilize healthcare services in the past year before the survey significantly had increased HRQoL compared to those who utilized healthcare services five or more times in the past year (β = 4.786, SE=. 4610, p value= 0.001). Conclusion Consistent with our hypothesis, this study reported a significant negative association between caregiver burden and HRQoL. Our findings partially support the conceptual model of HRQoL used in this study. We recommend that health and social policy measures to improve HRQoL among informal caregivers of older adults should consider caregiver burden as well as other significant socio-economic, cultural, demographic, and healthcare factors.

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Costs, burden and quality of life associated with informal caregiving for children with Lymphoma attending a tertiary hospital in Ghana

Cited by 8 publications

References 30 publications

Cost-effectiveness and budget impact of covering Burkitt’s Lymphoma in children under Ghana’s National Health Insurance Scheme

Cost-effectiveness and budget impact of covering Burkitt’s Lymphoma in children under Ghana’s National Health Insurance Scheme

Financial costs of pediatric cancer management in Africa: systematic review

Caregiver burden and health-related quality of life: A study of informal caregivers of older adults in Ghana

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