Estimating the cost of referral and willingness to pay for referral to higher-level health facilities: a case series study from an integrated community case management programme in Uganda

BMC Health Services Research
Agnes NanyonjoinSCALE Study Group

Abstract

Integrated community case management (iCCM) relies on community health workers (CHWs) managing children with malaria, pneumonia, diarrhoea, and referring children when management is not possible. This study sought to establish the cost per sick child referred to seek care from a higher-level health facility by a CHW and to estimate caregivers' willingness to pay (WTP) for referral. Caregivers of 203 randomly selected children referred to higher-level health facilities by CHWs were interviewed in four Midwestern Uganda districts. Questionnaires and document reviews were used to capture direct, indirect and opportunity costs incurred by caregivers, CHWs and health facilities managing referred children. WTP for referral was assessed through the 'bidding game' approach followed by an open-ended question on maximum WTP. Descriptive analysis was conducted for factors associated with referral completion and WTP using logistic and linear regression methods, respectively. The cost per case referred to higher-level health facilities was computed from a societal perspective. Reasons for referral included having fever with a negative malaria test (46.8%), danger signs (29.6%) and drug shortage (37.4%). Among the referred, less than half co...Continue Reading

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Citations

Jul 7, 2015·The Lancet Global Health·Maureen M Black, Pamela J Surkan
Oct 27, 2017·Healthcare·Padmore Adusei Amoah, David R Phillips
Mar 4, 2017·International Journal of Environmental Research and Public Health·David E V OlivaresFabio J Pacheco
Aug 15, 2017·Health Expectations : an International Journal of Public Participation in Health Care and Health Policy·Chinyere MbachuFabian Enabulele
Feb 18, 2021·Journal of the Chinese Medical Association : JCMA·Mao-Hsuan HuangJong-Ling Fuh
Jul 1, 2021·Health SA = SA Gesondheid·Hillary MukuduJude Igumbor
Sep 4, 2021·Archives of public health = Archives belges de santé publique·Habtamu BeyeneDella Berhanu

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STATA
CORE Plus )

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