BACKGROUND
This study evaluated the cost of the vaccine-preventable diseases (VPD) surveillance system in Ethiopia to inform budgeting for disease detection, prevention, and control, and planning for transitions from donor funding.
METHODS
This cross-sectional retrospective, bottom-up micro-costing study collected data on resource utilization to conduct VPD surveillance during one fiscal year (2018-2019) in Ethiopia. The study covered 16 VPDs and costs from the government and partners perspective.
RESULTS
The estimated economic costs of VPD surveillance in Ethiopia were US$69.11 million or US$0.70 per capita, while financial costs were US$26.83 million or US$0.27 per capita. The largest economic cost was for labor (41.0%) and the largest financial cost was for supplies (36.9%). Resources were mostly allocated to integrated, general disease surveillance (economic: 54.6%; financial: 50.7%), followed by surveillance for measles and rubella (economic: 15.9%; financial: 22.5%) and polio (economic: 12.4%; financial: 15.7%). The main funder was the Ethiopian Ministry of Health (economic: 78.8%; financial 62.6%), including donor resources channeled through the ministry.
CONCLUSIONS
Human resources were primary drivers of economic costs. Although the Ethiopian VPD surveillance system uses shared resources across multiple VPDs, resulting in scale efficiencies, and the Ethiopian government covers most of its economic costs, a substantial portion relies on direct external donor support.
Nelly Mejia, Aschalew Abayneh Workineh, Eden Dagnachew Zeleke et al.· Journal of public health· 0 citations
INTRODUCTION
Diarrheal disease is a significant public health concern, especially among children under the age of five. Its burden is particularly high in low-income countries, including Ethiopia. However, there is a lack of recent, nationally representative studies that adequately identify individual and community-level factors to inform effective interventions. Hence, this study aimed to fill this gap.
METHODS
This study utilized data from the national representative Health Equity Survey, conducted in all regional states and two city administrations of Ethiopia. A total of 8,747 mothers with children under five were selected using a two-stage stratified cluster sampling. Data were collected through face-to-face interviews. Descriptive statistics were computed, and mixed- effect multilevel logistic regression identified factors associated with diarrheal disease. Significance was set at p-value of < 0.05, with results reported as AORs and 95% CI. Four models were fitted, and the best-fit model was selected based on the lowest value of Deviance Information Criterion (DIC), Akaike's Information Criterion (AIC), and Bayesian Information Criterion (BIC).
RESULTS
The prevalence of diarrheal disease among children under five years old was 7.8% and varied across different regions of the country, ranging from 21% (Afar region) to 1.9% (Southwest region). In the multilevel logistic regression analysis, children aged 6-12 months (AOR = 4.5; 95% CI: 2.86, 6.97), children aged over 12 months (AOR = 3.5; 95% CI: 2.31, 5.45), no formal maternal education (AOR = 1.8; 95% CI: 0.99, 3.13), unimproved water sources (AOR = 1.6; 95% CI: 1.07, 2.52), and unimproved sanitation facilities (AOR = 1.7; 95% CI: 1.34, 2.09) had higher odds of developing diarrheal disease, while mothers aged 30 years and older (AOR = 0.8; 95% CI: 0.59, 1.02), living at altitude of 2501-3500 m and 3501-5500 m (AOR: 0.6, 95%CI: 0.43-0.77) and (AOR: 0.5, 95%CI: 0.42-0.60), had lower odds of diarrheal disease.
CONCLUSION
The prevalence of diarrheal disease among children under five in Ethiopia remains high with regional variations. Contributing factors include younger age particularly aged < 12 months, maternal lack of formal education, limited access to improved water sources and sanitation facilities. To effectively decrease this burden, targeted public health strategies are needed focusing on interventions that will address educational disparities and expanding access to clean water and adequate sanitation.
H. Achamyeleh, A. Zeru, G. Taye et al.· BMC Public Health· 0 citations