The economic impact of Visceral Leishmaniasis in Baringo, Kenya

Abstract

The main objective of the study was to examine the economic impact of Visceral Leishmaniasis (VL) on households (HHs) in Baringo. VL is a deadly parasitic disease transmitted by the bite of a sand fly. The study population comprised all the 108 VL patients in Baringo who had been diagnosed and treated for VL in the past one year at the two District Hospitals. Out of this a representative random sample of 84 was calculated using the Creative Research Online sample calculator. Questionnaires were used to collect data from 30 HHs. Data collected from the survey was analyzed using mainly descriptive methods such as percentages and frequencies. Findings indicate that a single VL episode costs about Kshs. 31,200 (USD.390, at exchange rate of 80) which is triple the average household monthly income for the affected HHs or 1.6 times their annual per capita income. These costs are beyond the reach of majority poor households, 70% living in the first two poorest quintiles, and they are forced to employ a combination of coping strategies including asset sales, reliance on community support, spending family savings or borrowing. In most cases, patients could still not meet the cost of VL treatment even after exhausting available coping strategies. Comparisons of cost lines indicate that short-term direct costs outweigh short-term indirect costs. However, in the long-run, there are chances that the indirect costs may be much higher than direct costs especially where the patient is incapacitated and is not able to work again. The cost of drugs was the main cost driver, accounting for about 70-80 % of the entire cost. It is concluded that the economic burden of caring for VL and the subsequent stripping and compromise of coping mechanisms can institute a vicious cycle of poverty in a household and may undermine sustainable development of endemic communities. It is recommended that VL disease control programs need to adopt novel mechanisms to fast track VL patients reach competent diagnostic facilities more rapidly and receive medical attention without compromising livelihood and food security of their HH. The National Hospital insurance Fund (NHIF) should also enhance customer enrollment as the current health insurance uptake is almost nil among the communities residing in this part of the country. These support systems are necessary if the country has to sustain long-term health, welfare and sustainable development of the endemic community and indeed achieve the economic and health aspirations in our economic blue print, the Vision 2030.