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

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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.

Keywords: catastrophic costs; cost of illness; evidence-based decision making; health financing for Universal Health Coverage; informed policy making; public policy

Document Type: Research Article

Affiliations: 1: National Tuberculosis Control Programme, Ministry of Health, Ouagadougou, Burkina Faso 2: Institut national de Sante publique, Observatoire national de la santé, Ouagadougou, Burkina Faso 3: Institut National de la Statistique et de la Démographie, Ouagadougou, Burkina Faso 4: WHO Global TB Programme, Geneva, Switzerland 5: WHO Country Office, Ouagadougou, Burkina Faso 6: Centre Muraz, INSP, Bobo Dioulasso, Burkina Faso 7: Institut de Recherche en Sciences de la Santé, Centre National de recherche scientifique et Technologique, Ouagadougou, Burkina Faso 8: WHO Global TB Programme–Country Support, Geneva, Switzerland, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA

Publication date: October 1, 2022

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