Abstract
Economic analyses of patients’ costs are pertinent to improve effective healthcare services including the prevention of mother-to-child HIV/AIDS transmission (PMTCT). This study assessed the direct and non-direct medical costs borne by pregnant women attending PMTCT services in urban (high-HIV prevalence) and rural (low-HIV prevalence) settings, in Ethiopia. Patient-level direct medical costs and direct non-medical data were collected from HIV-positive pregnant women in six regions. The cost estimation was classified as direct medical (service fee, drugs and laboratory) and direct non-medical (food, transportation and accommodation). The mean direct medical expense per patient per year was Ethiopian birr (ETB) 746 (US$ 38) in the urban settings, as compared to ETB 368 (US$ 19) in the rural settings. On average, a pregnant woman from urban and rural catchments incurred direct non-medical costs of ETB 6,435 (US$ 327) and ETB 2,154 (US$ 110) per year, respectively. On average, non-medical costs of friend/relative/guardian were ETB 2,595 (US$ 132) and ETB 2,919 (US$ 148.39) in the urban and rural settings, respectively. Although the PMTCT service is provided free of charge, HIV-positive pregnant women and infant pairs still face a substantial amount of out-of-pocket spending due to direct medical and non-medical costs.
Highlights
HIV/AIDS continues to challenge socio-economic progress across the globe
Patient cost data were collected from 85 HIV-positive pregnant women attending their antiretroviral treatment, 17 Mother Support Groups (MSGs) and 12 healthcare professionals who were closely working with the patients
As a way of exhausting all costs information from women attending prevention of mother-to-child HIV/AIDS transmission (PMTCT) services, additional costing inputs to be included in the costing sheets were solicited from 17 MSGs and 12 healthcare professionals who were closely working with the patients
Summary
HIV/AIDS continues to challenge socio-economic progress across the globe. In particular, the disease has been affecting the socio-economic development of most sub-Saharan African (SSA) countries. Vol 12, no 4, 2016 generations (UNAIDS, 2013) It eroded the productive labor force in lowincome countries. Almost 90% of mother-to-child transmission of HIV/AIDS was reported in African countries (Vitoria et al, 2009). The vertical transmissions of HIV/AIDS from mother-to-infant accounts for a significant proportion of the total number of new HIV infection reported in SSA countries. It is documented that 15-30% of these vertical transmissions of HIV infections from mother-to-child occur during labor, delivery, pregnancy and breastfeeding (De Cock et al, 2000; World Health Organization [WHO], 2004, 2007b). Prevailing numbers of infant infections and low antiretroviral treatment coverage for pregnant women and infants, coupled with low domestic financial resources in these countries have made it difficult to achieve zero mother-to-child HIV infections by 2015 (Joint United Nations Programme on HIV and AIDS [UNAIDS], 2013)
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