Economic burden of family caregiving for elderly population in southern Ghana: the case of a peri-urban district

Abstract

BackgroundHealth systems in low and lower-middle income countries, particularly in sub-Sahara Africa, often lack the specialized personnel and infrastructure to provide comprehensive care for elderly/ageing populations. Close-to-client community-based approaches are a low-cost way of providing basic care and social support for elderly populations in such resource-constrained settings and family caregivers play a crucial role in that regard. However, family caregiving duties are often unremunerated and their care-related economic burden is often overlooked though this knowledge is important in designing or scaling up effective interventions. The objective of this study, therefore, was to estimate the economic burden of family caregiving for the elderly in southern Ghana.MethodsThe study was a retrospective cross-sectional cost-of-care study conducted in 2015 among family caregivers for elderly registered for a support group in a peri-urban district in southern Ghana. A simple random sample of 98 respondents representative of the support group members completed an interviewer-administered questionnaire. Costs were assessed over a 1-month period. Direct costs of caregiving (including out-of-pocket costs incurred on health care) as well as productivity losses (i.e. indirect cost) to caregivers were analysed. Intangible costs were assessed using the 12-item Zarit burden interview (ZBI) tool and the financial cost dimension of the cost of care index.ResultsThe estimated average cost of caregiving per month was US$186.18, 66% of which was direct cost. About 78% of the family caregivers in the study reported a high level of caregiving burden (as measured with the ZBI) with females reporting a relatively higher level than males. Further, about 87% of the family caregivers reported a high level of financial stress as a result of caregiving for their elderly relative.ConclusionThe study shows that support/caregiving for elderly populations imposes economic burden on families, potentially influencing the economic position of families with attendant implications for equity and future family support for such vulnerable populations.

Economic burden of caregiving for persons with severe mental illness in sub-Saharan Africa: A systematic review

“…It is evident that the direct and indirect costs incurred by caregivers is substantial, given the economic context of the study area. For instance, Addo et al [ 12 ] report that about 71% of caregivers in Ghana reported monthly income of less than $223, consistent with recent estimate that about 94% of caregivers (of elderly persons) in Ghana reported monthly incomes of less than $224 [ 40 ]. Therefore, failure to identify, measure and quantify these costs leads to an underestimation of the economic burden experienced by informal caregivers of persons with severe mental illness.…”

Economic cost and quality of life of family caregivers of schizophrenic patients attending psychiatric hospitals in Ghana

“…Similarly, Papastavrou et al [ 29 ] found that females were more burdened than males and experienced chronic stress because of caregiving responsibilities for schizophrenics in Cyprus. Sex differences in the burden of care have also been reported in studies examining elderly care [ 30 ]. Such findings reflect broader societal realities and require more in-depth investigation.…”

Gender Differences in the Associations Between Informal Caregiving and Wellbeing in Low- and Middle-Income Countries

“…In other contexts (e.g., Ghana, Russia), economic burden of caregiving and the benefits of home-based versus institutional care are emerging social policy issues. 6 Caregiving among migrant households in many countries is associated with a clash of cultures or values around balancing different caregiving beliefs. 7 In both high-income countries (HICs) and LMICs, data are showing that the informal caregiver workforce predominantly comprises of women.…”