Severe anaemia and malaria are among the leading causes of childhood hospital admissions in Africa south of the Sahara. The researchers note that children discharged from hospital often require readmission, which raises the costs of inpatient care. The work was carried out as a sub-study of a clinical trial registered in March 2023 examining dihydroartemisinin-piperaquine and azithromycin for the post-discharge management of children with severe anaemia in the three countries.
Cost data were collected between January 2024 and October 2024. The team used a bottom-up costing approach, estimating annual economic costs for personnel, supplies and overheads from individual cost components. They identified, measured and valued the resources required for paediatric medical admissions, referral processes and blood transfusions, covering inpatient and outpatient care, laboratory processing and ambulance referrals.
The resulting estimates show considerable variation both between and within countries. A bed-day for a general paediatric medical admission cost $18 at Zomba Central Hospital, $50 at Kisumu County Referral Hospital and $15 at Jinja Children’s Referral Hospital. At Kamuzu Central Hospital, a bed-day cost $9 in the main children's medical ward and $24 in the High Dependency Unit.
Bed-days alone do not capture the full cost of an admission. When the researchers accounted for laboratory services, blood transfusions and malaria medication over the duration of the entire hospital stay, the total costs of care were $118 in Zomba, $427 in Kisumu and $167 in Jinja. At Kamuzu Central Hospital, the cost of providing an entire hospital admission was $79 in the main medical ward and $310 in the High Dependency Unit.
The analysis also identified what drives these costs. Personnel and operational costs were the main cost drivers for admission costs, while laboratory supplies were the main cost component when providing blood testing services.
In their conclusion, the authors write that the study demonstrates how the costs of providing health care are influenced by fixed and variable cost components, health service utilization, and country-specific investments in health care. The differences between the four hospitals illustrate how the costs of providing health care are influenced by fixed and variable cost components, health service utilization, and country-specific investments in health care.
The findings are intended to contribute to an evidence base for resource allocation and for cost-effectiveness analyses of interventions targeting severe anaemia and malaria in children in Malawi, Kenya and Uganda. Because the study measured provider costs at four specific hospitals during a defined ten-month window in 2024, the estimates describe those settings and that period rather than national averages, and the authors present them as inputs for future economic evaluations of post-discharge care strategies.
The underlying clinical trial, registered with the South African clinical trials registry on 8 March 2023 under number PACTR202303630742194, is testing whether post-discharge medication can improve outcomes for children treated for severe anaemia. The costing sub-study provides the economic foundation needed to judge whether such interventions represent good value for the health systems of the three countries.
Subject of Research: Healthcare provider costs of hospital care for children with severe anaemia and malaria in Malawi, Kenya and Uganda
Article Title: Health care provider costs of child health services for severe anaemia and malaria in Malawi, Kenya, and Uganda
Article References: Mzumara, G. W., Kühl, M.-J., Chinkhumba, J., Kaarboe, O. M., Phiri, K., & Robberstad, B. (2026). Health care provider costs of child health services for severe anaemia and malaria in Malawi, Kenya, and Uganda. Cost Effectiveness and Resource Allocation. https://doi.org/10.1186/s12962-026-00860-8
Image Credits: AI Generated
DOI: 10.1186/s12962-026-00860-8
Keywords: severe anaemia, malaria, paediatric hospital costs, Malawi, Kenya, Uganda, bottom-up costing, bed-day costs, blood transfusion, cost-effectiveness, health economics, resource allocation
News Source: Harold Sullivan. (November 5, 2026). Research report: Health care provider costs of child health services for severe anaemia and malaria in Malawi, Kenya, and Uganda. Scienmag.
