title: Household costs for treatment of severe pneumonia in Pakistan.
abstract: Current World Health Organization (WHO) guidelines for severe pneumonia treatment of under-5 children recommend hospital referral. However, high treatment cost is a major barrier for communities. We compared household costs for referred cases with management by lady health workers (LHWs) using oral antibiotics. This study was nested within a cluster randomized trial in Haripur, Pakistan. Data on direct and indirect costs were collected through interviews and record reviews in the 14 intervention and 14 control clusters. The average household cost/case for a LHW managed case was $1.46 compared with $7.60 for referred cases. When the cost of antibiotics provided by the LHW program was excluded from the estimates, the cost/case came to $0.25 and $7.51 for the community managed and referred cases, respectively, a 30-fold difference. Expanding severe pneumonia treatment with oral amoxicillin to community level could significantly reduce household costs and improve access to the underprivileged population, preventing many child deaths.
authors.forename: Salim
authors.initials: S
authors.lastname: Sadruddin
authors.forename: Shafqat
authors.initials: S
authors.lastname: Shehzad
authors.forename: Abdul
authors.initials: A
authors.lastname: Bari
authors.forename: Attaullah
authors.initials: A
authors.lastname: Khan
authors.lastname: Ibad-Ul-Haque
authors.forename: Amanullah
authors.initials: A
authors.lastname: Khan
authors.forename: Shamim
authors.initials: S
authors.lastname: Qazi
mesh_terms: D000658:Amoxicillin / Q000191:economics* / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000191:economics* / Q000627:therapeutic use; D019090:Case Management; D002675:Child, Preschool; D016000:Cluster Analysis; D003150:Community Health Workers / Q000191:economics*; D017281:Cost of Illness; D004305:Dose-Response Relationship, Drug; D005191:Family Characteristics; D005260:Female; D005500:Follow-Up Studies; D017408:Guidelines as Topic; D017048:Health Care Costs; D006282:Health Personnel; D006801:Humans; D007223:Infant; D008297:Male; D010154:Pakistan; D011014:Pneumonia / Q000188:drug therapy / Q000191:economics*; D016896:Treatment Outcome; D014944:World Health Organization
chemical_list: D000900:Anti-Bacterial Agents; D000658:Amoxicillin