The economic burden of measles in children under five in Bangladesh

Gatien de Broucker, Sayem Ahmed, Md Zahid Hasan, Gazi Golam Mehdi, Jorge Martin Del Campo, Md Wazed Ali, Md Jasim Uddin, Dagna Constenla, Bryan Patenaude

Research output: Contribution to journalArticlepeer-review


Background: This study estimated the economic cost of treating measles in children under-5 in Bangladesh from the caregiver, government, and societal perspectives. Method: We conducted an incidence-based study using an ingredient-based approach. We surveyed the administrative staff and the healthcare professionals at the facilities, recording their estimates supported by administrative data from the healthcare perspective. We conducted 100 face-to-face caregiver interviews at discharge and phone interviews 7 to 14 days post-discharge to capture all expenses, including time costs related to measles. All costs are in 2018 USD ($). Results: From a societal perspective, a hospitalized and ambulatory case of measles cost $159 and $18, respectively. On average, the government spent $22 per hospitalized case of measles. At the same time, caregivers incurred $131 and $182 in economic costs, including $48 and $83 in out-of-pocket expenses in public and private not-for-profit facilities, respectively. Seventy-eight percent of the poorest caregivers faced catastrophic health expenditures compared to 21% of the richest. In 2018, 2263 cases of measles were confirmed, totaling $348,073 in economic costs to Bangladeshi society, with $121,842 in out-of-pocket payments for households. Conclusion: The resurgence of measles outbreaks is a substantial cost for society, requiring significant short-term public expenditures, putting households into a precarious financial situation. Improving vaccination coverage in areas where it is deficient (Sylhet division in our study) would likely alleviate most of this burden.

Original languageEnglish (US)
Article number1026
JournalBMC health services research
Issue number1
StatePublished - Dec 2020


  • Bangladesh
  • Caregiver cost
  • Cost of illness
  • Economic burden
  • Measles

ASJC Scopus subject areas

  • Health Policy


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