Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jul 28:16:314.
doi: 10.1186/s12913-016-1573-5.

Measurement and valuation of health providers' time for the management of childhood pneumonia in rural Malawi: an empirical study

Affiliations

Measurement and valuation of health providers' time for the management of childhood pneumonia in rural Malawi: an empirical study

Fiammetta Maria Bozzani et al. BMC Health Serv Res. .

Abstract

Background: Human resources are a major cost driver in childhood pneumonia case management. Introduction of 13-valent pneumococcal conjugate vaccine (PCV-13) in Malawi can lead to savings on staff time and salaries due to reductions in pneumonia cases requiring admission. Reliable estimates of human resource costs are vital for use in economic evaluations of PCV-13 introduction.

Methods: Twenty-eight severe and twenty-four very severe pneumonia inpatients under the age of five were tracked from admission to discharge by paediatric ward staff using self-administered timesheets at Mchinji District Hospital between June and August 2012. All activities performed and the time spent on each activity were recorded. A monetary value was assigned to the time by allocating a corresponding percentage of the health workers' salary. All costs are reported in 2012 US$.

Results: A total of 1,017 entries, grouped according to 22 different activity labels, were recorded during the observation period. On average, 99 min (standard deviation, SD = 46) were spent on each admission: 93 (SD = 38) for severe and 106 (SD = 55) for very severe cases. Approximately 40 % of activities involved monitoring and stabilization, including administering non-drug therapies such as oxygen. A further 35 % of the time was spent on injecting antibiotics. Nurses provided 60 % of the total time spent on pneumonia admissions, clinicians 25 % and support staff 15 %. Human resource costs were approximately US$ 2 per bed-day and, on average, US$ 29.5 per severe pneumonia admission and US$ 37.7 per very severe admission.

Conclusions: Self-reporting was successfully used in this context to generate reliable estimates of human resource time and costs of childhood pneumonia treatment. Assuming vaccine efficacy of 41 % and 90 % coverage, PCV-13 introduction in Malawi can save over US$ 2 million per year in staff costs alone.

Keywords: Children; Malawi; PCV-13; Pneumococcal conjugate vaccine; Pneumonia; Provider costs; Time use.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Description of reported activities by type (n = 1071)

Similar articles

Cited by

References

    1. Fischer Walker CL, Rudan I, Liu L, Nair H, Theodoratou E, Bhutta ZA, et al. Global burden of childhood pneumonia and diarrhoea. Lancet. 2013;381:1405–16. doi: 10.1016/S0140-6736(13)60222-6. - DOI - PMC - PubMed
    1. Ojo LR, O’Loughlin RE, Cohen AL, Loo JD, Edmond KM, Shetty SS, et al. Global use of Haemophilus influenzae type b conjugate vaccine. Vaccine. 2010;28:7117–22. doi: 10.1016/j.vaccine.2010.07.074. - DOI - PubMed
    1. Wolfson LJ, Gasse F, Lee-Martin S, Lydon P, Magan A, Tibouti A, et al. Estimating the costs of achieving the WHO-UNICEF Global Immunization Vision and Strategy, 2006–2015. Bull World Health Organ. 2008;86(1):27–39. doi: 10.2471/BLT.07.045096. - DOI - PMC - PubMed
    1. GAVI Alliance. The GAVI Alliance policy reference book. Geneva: GAVI Alliance; 2010.
    1. Drummond M, Chevat C, Lothgren M. Do we fully understand the economic value of vaccines? Vaccine. 2007;25:5945–57. doi: 10.1016/j.vaccine.2007.04.070. - DOI - PubMed

MeSH terms

Substances