Financial Cost to Households of Hospital Care for Children Aged 0 to 59 Months, Case Study of the Kalonda West Health Zone, Kasai Province, Democratic Republic of the Congo

Introduction: Severe acute malnutrition (SAM) remains a major public health problem among children under 5 years of age in the Democratic Republic of the Congo. Hospital care can represent a significant financial burden for households, potentially leading to catastrophic healthcare expenditures. This study aimed to compare the direct and indirect financial costs of care for children with SAM and for those with normal nutritional status hospitalized for other conditions. Methods: A cross-sectional analytical study was conducted in the Kalonda West health zone, within the pediatric ward of the Kalonda West General Referral Hospital and the Ditekemena Hospital. The sample comprised 390 children aged 0 to 59 months: 130 cases of malnourished children with severe acute malnutrition (SAM) and 260 children with normal nutritional status hospitalized for other pediatric conditions. Data were collected via a structured questionnaire administered to parents or guardians. Results: The overall combined direct and indirect cost was statistically significantly higher in malnourished children (USD 13.84 [8.46 - 19.23]) compared to children with normal nutritional status (USD 10.48 [6.54 - 12.77], P = 0.001). Direct costs related to medication, nursing care, and dietary rations were significantly higher in malnourished children (P = 0.013). For indirect costs, hospital stay was more expensive for cases (P < 0.001), compared to children with normal nutritional status. Conclusion: Hospital care for severe acute malnutrition (SAM) entails higher financial costs than for other pediatric conditions. These findings highlight the need for measures to reduce the economic burden on households, particularly through financial protection mechanisms and improved access to care.