This study is concerned with the economic burden of HIV/AIDS in Nepal. It focuses on the direct costs of seeking treatment, productivity costs (before and after adjustment for coping strategies), catastrophic and impoverishing impacts, the coping strategies used by households and the socio-economic impacts of stigma and discrimination. The study was cross-sectional and employed a mixed-methods approach. The survey questionnaire (quantitative study) with 415 respondents and in-depth interviews (qualitative study) with 30 participants were conducted in six treatment centres in six different districts. Total costs due to HIV/AIDS (the sum of direct costs and productivity costs before adjustment for coping strategies) were an average of Nepalese Rupees (NRs) 2,233 per month (US$ 30.2/month), 28.5% of the household income. The main determinants of direct costs were found to be cluster of differentiation 4 (CD4) level, household income, occupation, whether the people living with HIV/AIDS (PLHA) was accompanied, and district. The main determinants of productivity costs were found to be self-reported health status, ethnicity, sexual orientation, and district. The most frequently used coping strategies were the use of savings or income, taking a loan and sale of assets. Nearly 75% of households faced catastrophic impacts due to direct and productivity costs. The study concluded that HIV/AIDS has caused a significant economic burden for (PLHA) and their families in Nepal. The study has helped fill the knowledge gap about the extent, nature and determinants of this economic burden. It has also involved methodological innovation, particularly in the measurement of productivity costs. The major limitations were a concentration on respondents attending treatment centres, the lack of a control group, the possibility of recall bias and restrictions on the type of analysis conducted because of time constraints. The study has a number of policy implications for different stakeholders and sets a further research agenda.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:641479 |
| Date | January 2015 |
| Creators | Poudel, Ak Narayan |
| Publisher | University of Aberdeen |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=225678 |
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