Levison S Chiwaula1, Paul Revill2, Deborah Ford3, Misheck Nkhata4, Travor Mabugu5, James Hakim5, Cissy Kityo6, Adrienne K Chan7, Fabian Cataldo4, Diana Gibb3, Bernard van den Berg8. 1. Dignitas International, Zomba, Malawi; Department of Economics, University of Malawi, Zomba, Malawi. Electronic address: lschiwaula@cc.ac.mw. 2. Centre for Health Economics, University of York, York, UK. 3. MRC Clinical Trials Unit at UCL, London, UK. 4. Dignitas International, Zomba, Malawi. 5. University of Zimbabwe Clinical Research Centre, Harare, Zimbabwe. 6. Joint Clinical Research Centre, Kampala, Uganda. 7. Dignitas International, Zomba, Malawi; Division of Infectious Diseases, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada. 8. Faculty of Economics and Business, University of Groningen, Groningen, The Netherlands.
Abstract
BACKGROUND: Economic evaluation studies often neglect the impact of disease and ill health on the social network of people living with HIV (PLHIV) and the wider community. An important concern relates to informal care requirements which, for some diseases such as HIV/AIDS, can be substantial. OBJECTIVES: To measure and value informal care provided to PLHIV in Malawi. METHODS: A modified diary that divided a day into natural calendar changes was used to measure informal care time. The monetary valuation was undertaken by using four approaches: opportunity cost (official minimum wage used to value caregiving time), modified opportunity cost (caregiver's reservation wage), willingness to pay (amount of money caregiver would pay for care), and willingness to accept (amount of money caregiver would accept for providing care to someone else) approaches. Data were collected from 130 caregivers of PLHIV who were accessing antiretroviral therapy from six facilities in Phalombe district in southeast Malawi. RESULTS: Of the 130 caregivers, 62 (48%) provided informal care in the survey week. On average, caregivers provided care of 8 h/wk. The estimated monetary values of informal care provided per week were US $1.40 (opportunity cost), US $2.41 (modified opportunity cost), US $0.40 (willingness to pay), and US $2.07 (willingness to accept). CONCLUSIONS: Exclusion of informal care commitments may be a notable limitation of many applied economic evaluations. This work demonstrates that inclusion of informal care in economic evaluations in a low-income context is feasible. Copyright Â
BACKGROUND: Economic evaluation studies often neglect the impact of disease and ill health on the social network of people living with HIV (PLHIV) and the wider community. An important concern relates to informal care requirements which, for some diseases such as HIV/AIDS, can be substantial. OBJECTIVES: To measure and value informal care provided to PLHIV in Malawi. METHODS: A modified diary that divided a day into natural calendar changes was used to measure informal care time. The monetary valuation was undertaken by using four approaches: opportunity cost (official minimum wage used to value caregiving time), modified opportunity cost (caregiver's reservation wage), willingness to pay (amount of money caregiver would pay for care), and willingness to accept (amount of money caregiver would accept for providing care to someone else) approaches. Data were collected from 130 caregivers of PLHIV who were accessing antiretroviral therapy from six facilities in Phalombe district in southeast Malawi. RESULTS: Of the 130 caregivers, 62 (48%) provided informal care in the survey week. On average, caregivers provided care of 8 h/wk. The estimated monetary values of informal care provided per week were US $1.40 (opportunity cost), US $2.41 (modified opportunity cost), US $0.40 (willingness to pay), and US $2.07 (willingness to accept). CONCLUSIONS: Exclusion of informal care commitments may be a notable limitation of many applied economic evaluations. This work demonstrates that inclusion of informal care in economic evaluations in a low-income context is feasible. Copyright Â
Authors: Bernard van den Berg; Werner Brouwer; Job van Exel; Marc Koopmanschap; Geertrudis A M van den Bos; Frans Rutten Journal: Soc Sci Med Date: 2005-08-30 Impact factor: 4.634
Authors: Levison Stanely Chiwaula; Gowokani Chijere Chirwa; Fabian Cataldo; Atupele Kapito-Tembo; Mina C Hosseinipour; Monique van Lettow; Hannock Tweya; Virginia Kayoyo; Blessings Khangamwa-Kaunda; Florence Kasende; Clement Trapence; Salem Gugsa; Nora E Rosenberg; Michael Eliya; Sam Phiri Journal: BMC Health Serv Res Date: 2016-04-19 Impact factor: 2.655