Challenges In Estimation Of Children’s Quality Of Life

Published Oct 8, 2013
Harare, Zimbabwe – Whereas a number of studies have assessed the effectiveness and value of HIV/AIDS interventions for adults in low income countries, particularly in sub-Saharan Africa, there are relatively few that have done likewise for HIV/AIDS interventions for children. Researchers from the University of Zimbabwe and the University of York sought to examine how children’s Quality of Life (QoL) could be assessed in low income countries, particularly in sub-Saharan Africa, when undergoing treatment for HIV/AIDS.  By exploring the challenges and highlighting considerations in developing instruments to measure children’s QoL in these low income countries, the researchers found that there is no consensus as to what truly constitutes children’s QoL or to what breadth or depth it should be measured. As a result, the researchers recommend that QoL estimation in children should take account of various context specific factors such as age group sensitivity and developmental stage, cultural variation and local economic conditions. Existing tools for QoL estimation in children need to examine a broader range of experiential domains, and demonstrate flexibility across varying age-groups if they are to assess pediatric QoL for effectiveness research.  QoL domains identified include  ‘physical functioning’, ‘emotional and cognitive functioning’, ‘general behavior (social, school, home)’, ‘health perception’, ‘coping and adaptation’, ‘pain and discomfort’, ‘extended effects’, ‘life perspective’, and ‘autonomy’. Informing which investments in child health interventions are effective and represent good value for money requires assessing the impact of these interventions on both mortality and quality of life (QoL). As stated by Travor Mabugu, University of Zimbabwe and lead author in the study: “The uniqueness of children in low income countries needs consideration. These children may face a different growth trajectory, they are exposed to various forms of economic hardships & poverty levels at different stages of growth, and some take a parental role at an early age due to HIV/AIDS. Further work is required to develop appropriate tools to measure quality of life of children in order to allow fair and accurate comparisons of the effectiveness and cost-effectiveness of child health care interventions.” The full study, “The Methodological Challenges for the Estimation of Quality of Life in Children for Use in Economic Evaluation in Low Income Countries,” is published in Value in Health Regional Issues.
Value in Health Regional Issues  (ISSN 2212-1099) is a scientific journal that encourages and enhances the science of pharmacoeconomic/health economic and health outcomes research and its use in health care decisions. The journal is published up to three times a year with one issue focusing on the Asia region, one issue focusing on the Latin America region, and one issue focusing on the Central & Eastern Europe, Western Asia and Africa regions. The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) is a nonprofit, international, educational and scientific organization that strives to increase the efficiency, effectiveness, and fairness of health care resource use to improve health.

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