Childhood Cancer in Ethiopia: Treatment Abandonment Rate and the Cost and Cost-Effectiveness of Service Delivery

The overall survival of children with cancer is eight out of ten in high-income countries, while only two to three of ten survive in LMICs. This drastic difference in survival rates can be explained by the unavailability of quality pediatric cancer services, late presentation, and high treatment abandonment rates in LMICs. In his research, Mizan Kiros Mirutse found that many healthcare professionals who work with children diagnosed with cancer in Ethiopia believe that a lot of children either do not start or do not complete their treatment (around 34%, ranging from 29% to 39%). The main reasons for this are the high cost of health care, families not having much money, long travel distances to treatment centers, long wait times for care, the belief that cancer can't be cured, and a lack of awareness about childhood cancer. The annual cost of running a dedicated pediatric cancer unit per treated child in 2019 was roughly US$ 600 (ranging from 500 to 1,100), which could be affordable considering the small number of patients in need of care, around 4,000 per year It is also highly likely that it is cost-effective, with a cost-effectiveness ratio at around US$360 per healthy life year gained, which is considered cost-effective taking Ethiopia's willingness to pay threshold (50% of GDP/ capita, US$ 477). These research results may have implications for policymakers in Ethiopia and make the diagnosis and treatment of cancer in children a higher priority in Ethiopia. In addition, knowledge of reasons for non-completion of treatment can help to improve the quality of the treatment programme.

Policy briefs:

- Childhood Cancer Treatment Abandonment in Ethiopia (August 2023)
- Cost-Effectiveness of Running a Pediatric Oncology Unit in Ethiopia (August 2023)

The thesis is available for download here:
Bergen Open Research Archive: Childhood Cancer in Ethiopia: Treatment Abandonment Rate and the Cost and Cost-Effectiveness of Service Delivery (uib.no)

Personal information:

Mizan Kiros Mirutse is a medical doctor who graduated from Addis Ababa University Medical Faculty in 2012 and holds a Masters in Global Health from the University of Bergen. Through his extensive academic training, ten years of professional experience in the Ethiopian health sector (including as director for resource mobilization, Director General of the Ethiopia Health Insurance Agency, Senior Health Financing Advisor to the minister, and National COVID-19 response Coordinator), and active participation in global health platforms, Dr. Mirutse has acquired extensive experience and expertise in global health, health systems, and health economics and financing. His PhD supervisors were Professor Ole F. Norheim from the Bergen Centre for Ethics and Priority Setting (BCEPS), University of Bergen, and Dr. Solomon Tessema Memirie and Dr. Mieraf Taddesse Tolla from the Addis Centre for Ethics and Priority Setting (ACEPS), Addis Ababa University.

Photo:

Foto/ill.: Lydia photography, Addis Ababa, Ethiopia . +251939252525

Photo:

UiB