Background: Healthcare associated infections (HAI) remain a global health challenge and have elevated rates in Sub-Saharan Africa. HAIs impact patients and their families by causing illness, prolonged hospital stay, potential disability, excess costs and sometimes death. The costs of HAI are increasing due to spreading antimicrobial resistance. A major risk factor for HAIs is lack of water, sanitation, and hygiene (WASH), environmental cleaning and healthcare waste management. In Sub-Saharan Africa these services are lacking in at least 50% of healthcare facilities.
Aim: This study estimated the costs associated with HAIs at national level in fourteen countries in Sub-Saharan Africa.
Methods: Economic methodologies were employed to estimate the medical costs, productivity losses and value of premature death from HAIs, drawing on national statistics and published studies to populate the economic model.
Results: In 2022, the number of HAIs was estimated at 4.8 million, resulting in 500,000 deaths. Health-related economic losses amounted to US$13 billion per year, equivalent to 1.14% of combined GDP and US$15.7 per capita. Healthcare costs were US$500 per HAI and represented 5.6% of total health expenditure. The costs of providing basic WASH were US$0.91 per capita, which, if they reduced HAIs by 50%, resulted in benefit-cost ratios of 1.6 (financial health care savings only) and 8.6 (including all economic benefits).
Conclusion: HAIs have a major health and economic burden on African societies, and a significant share can be prevented. It is critical that health policy makers and practitioners dedicate policy space, resources, and training to address HAIs.
Keywords: Antimicrobial resistance; Economic cost; Financial cost; Healthcare associated infection; Medical cost; Nosocomial infection; Social cost.
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