Economic costs to caregivers of diarrhoea treatment among children below 5 in rural Gujarat India: Findings from an external evaluation of the DAZT programme

Samuel D. Shillcutt, Amnesty E Lefevre, Christa L. FischerWalker, Sunita Taneja, Robert E Black, Sarmila Mazumder

Research output: Contribution to journalArticle

Abstract

Introduction: Diarrhoea is a leading cause of mortality among young children in India although few receive the recommended treatment. The diarrhoea alleviation through zinc and oral rehydration salts (ORS) therapy (DAZT) team initiated a programme in Gujarat from 2011 to 2013 to increase coverage of these interventions through public and private providers at scale. This study evaluates the economic impact of diarrhoea to caregivers before and after the introduction of zinc and ORS at scale through the DAZT programme. Methods: The DAZT programme evaluation took a before-and-after study design using a two-stage clustered cross-sectional survey. Factors associated with the odds of caregivers incurring economic costs and their amounts were evaluated in a two-part modelling approach. Results: The DAZT programme lowered unadjusted economic costs to caregivers of treating a diarrhoeal episode from 4.04 to 2.49 in 2 years. Controlling for covariates, analysis showed no association between the programme and a change in odds of incurring an economic cost but did show an association with a reduction in economic cost of 2.15 (95% confidence interval (CI) 1.20- 3.11) per diarrhoea episode. A more than 4-fold increase in care-seeking from public community health workers, reduction in care-seeking from higher levels of the health system and reduced spending on drugs besides ORS and zinc may explain these results. Discussion: This study found an association between zinc introduction and a reduction in economic burden of diarrhoea treatment to caregivers in underserved rural areas of Gujarat through more efficient patterns of care-seeking and content of care.

Original languageEnglish (US)
Pages (from-to)1411-1422
Number of pages12
JournalHealth Policy and Planning
Volume31
Issue number10
DOIs
StatePublished - Dec 1 2016

Fingerprint

Program Evaluation
Caregivers
India
Diarrhea
Economics
Costs and Cost Analysis
Zinc
Fluid Therapy
Salts
Therapeutics
Health Status
Public Health
Cross-Sectional Studies
Confidence Intervals
Mortality
Pharmaceutical Preparations

Keywords

  • Cost
  • Developing countries
  • Diarrhoea
  • Implementation science
  • India
  • Oral rehydration therapy
  • Zinc

ASJC Scopus subject areas

  • Health Policy

Cite this

Economic costs to caregivers of diarrhoea treatment among children below 5 in rural Gujarat India : Findings from an external evaluation of the DAZT programme. / Shillcutt, Samuel D.; Lefevre, Amnesty E; FischerWalker, Christa L.; Taneja, Sunita; Black, Robert E; Mazumder, Sarmila.

In: Health Policy and Planning, Vol. 31, No. 10, 01.12.2016, p. 1411-1422.

Research output: Contribution to journalArticle

Shillcutt, Samuel D. ; Lefevre, Amnesty E ; FischerWalker, Christa L. ; Taneja, Sunita ; Black, Robert E ; Mazumder, Sarmila. / Economic costs to caregivers of diarrhoea treatment among children below 5 in rural Gujarat India : Findings from an external evaluation of the DAZT programme. In: Health Policy and Planning. 2016 ; Vol. 31, No. 10. pp. 1411-1422.
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AU - Mazumder, Sarmila

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