RESUMO
Background: Comparative costs of public health interventions provide valuable data for decision making. However, the availability of comprehensive and context-specific costs is often limited. The Enterics for Global Health (EFGH) Shigella surveillance study-a facility-based diarrhea surveillance study across 7 countries-aims to generate evidence on health system and household costs associated with medically attended Shigella diarrhea in children. Methods: EFGH working groups comprising representatives from each country (Bangladesh, Kenya, Malawi, Mali, Pakistan, Peru, and The Gambia) developed the study methods. Over a 24-month surveillance period, facility-based surveys will collect data on resource use for the medical treatment of an estimated 9800 children aged 6-35 months with diarrhea. Through these surveys, we will describe and quantify medical resources used in the treatment of diarrhea (eg, medication, supplies, and provider salaries), nonmedical resources (eg, travel costs to the facility), and the amount of caregiver time lost from work to care for their sick child. To assign costs to each identified resource, we will use a combination of caregiver interviews, national medical price lists, and databases from the World Health Organization and the International Labor Organization. Our primary outcome will be the estimated cost per inpatient and outpatient episode of medically attended Shigella diarrhea treatment across countries, levels of care, and illness severity. We will conduct sensitivity and scenario analysis to determine how unit costs vary across scenarios. Conclusions: Results from this study will contribute to the existing body of literature on diarrhea costing and inform future policy decisions related to investments in preventive strategies for Shigella.
RESUMO
Agricultural technological development is a crucial strategy for agricultural commercialization and socio-economic transformation in Africa. However, a key challenge to technology use in agriculture remains the limited farmer acceptance of unfamiliar technologies. This paper uses a sample of 245 okra farmers drawn from northern Uganda to assess the drivers of the farmer acceptance of solar drying technology. On the basis of drying performance, farmers perceive the solar dryer to perform better than the open sun-drying method. Structural equation modelling results show that the drying rate and perceived product quality are the main determinants of farmer perceptions on product marketability. Further, product marketability drives acceptance of solar dryers among farmers. We conclude that acceptance of solar dryers is dependent on: i) the drying rate, ii) favorable perceptions towards product quality, and iii) perceived marketability of the solar-dried product. We call for policy action on intensification of efforts that promote solar drying technology, including supporting local artisans to fabricate dryers, to enable increased value addition and consumption of nutritious foods.
