A 2020 baseline assessment for the monitoring of the End TB indicator of catastrophic costs in Burkina Faso

Abstract

BACKGROUND Prior assessment of the economic burden of TB showed high risk of catastrophic costs in Burkina Faso. A decade later, the National TB Programme conducted the first national patient cost survey, establishing a baseline for future policymaking.METHODS A national TB patient cost survey was conducted early 2020. Following WHO methods, a structured questionnaire was administered to 465 patients (20 clusters) to report on the direct and indirect costs of TB, household income and coping strategies adopted by the TB-affected families. The share of households facing catastrophic costs was assessed. Multiple logistic regression was performed to identify factors associated with catastrophic costs due to TB.RESULTS One in two (54.4%) TB-affected households in Burkina Faso faced catastrophic costs, resulting in major improvements over the past decade. On average, households incurred in US$962.64 per episode of care (respectively US$741.7, US$122.3 and US$98.6 for indirect, direct medical and non-medical costs), leaving substantial costs requiring mitigation strategies (39.8%). Major risk factors were associated with hospitalisation and wealth-related variables. Job loss, food insecurity and other social consequences were also experienced.CONCLUSION Despite progress, reducing the End TB indicator of catastrophic costs remains central to policymaking to ensure effective financial protection in Burkina Faso.