Managing Diabetes in Urban Ghana: Is it Affordable?

Abstract

<p>Background: In recent decades there has been an escalating epidemic of diabetes in Ghana. However, there has been little research on the economic burdens associated with diabetes in Ghana, despite diabetes's costly nature. This study investigated economic burdens and financial protections of households with diabetes patient(s) in urban Ghana.</p><p>Methods: Questionnaire-based interviews were conducted with 40 diabetes patients and their household heads in two urban communities in the city of Accra, Ghana. Information was obtained regarding participants' demographic and socioeconomic characteristics, patterns of healthcare utilization, direct and indirect costs, and financial protections pertaining to diabetes treatment and management. Cost-­of-­illness analysis and catastrophic health expenditure computation were conducted to investigate the costs associated with diabetes and households' affordability. Statistical tests were also conducted to analyze the effect of the National Health Insurance Scheme (NHIS) on the costs associated with diabetes.</p><p>Results: The total cost of diabetes for 40 households was estimated to be 14,989 cedis/month, of which 66.5% was direct cost and 30.2% was indirect cost. 52.9% of the households occurred catastrophic health expenditure. The means of outpatient and inpatient expenditure were 136 and 418 Cedi/month, respectively. NHIS had a positive financial protection effect on the economic burden of diabetes, while this effect was diminished by deficiencies in NHIS. Extended family was the main resource of financial support for diabetes treatment and management.</p><p>Conclusion: The economic burden of diabetes is high in urban Ghana, with a catastrophic effect on households. Except for NHIS, patients' financial support mainly comes from personal resources rather than public resources. Social supports and improvements in NHIS are needed to protect households with diabetes patient(s) against financial risks.</p>