ABSTRACT:
Severe anaemia and malaria are among the leading causes of childhood hospital admissions in Africa south of the Sahara. This represents substantial resource and budget implications that should be considered to provide adequate care. This study aims to estimate healthcare provider costs for children under-five diagnosed with severe anaemia and severe malaria at Zomba and Kamuzu Central Hospitals in Malawi, Kisumu Referral Hospital in Kenya and Jinja Children’s Referral Hospital in Uganda. This is a sub study of the clinical trial “Dihydroartemisinin-piperaquine and azithromycin for the post-discharge management of children with severe anaemia in Malawi, Kenya and Uganda”. Cost data were collected from January 2024 to July 2024. We used both top-down and bottom-up costing methods to estimate annual personnel, supplies and overhead economic costs required for a paediatric medical admission, referral and blood transfusion processes. All costs were collected in local currency and converted to 2024 United States Dollar. The cost to healthcare providers for one bed-day for a general paediatric medical admission was $17 at Zomba Central Hospital, $46 at Kisumu County Referral Hospital, and $15 at Jinja Children’s Referral Hospital. When accounting for laboratory services, blood transfusions, malaria medication and other costs for the duration of the entire hospital stay, the total costs of care were: $111 in Zomba, $446 in Kisumu and $132 in Jinja. At Kamuzu Central Hospital, a bed-day costs $9 in the main children’s medical ward, and $23 in the High Dependency Unit, totaling $70 and $273 for an entire admission, respectively. Personnel and utility costs were the main cost drivers for admissions costs, while laboratory supplies were the main cost component when providing laboratory services for blood transfusions. These estimates can provide evidence to advocate for greater commitment to health financing from respective country health care providers