Affected parties | Benefit | Burden |
Child (28 weeks) | High chance of survival (90%) Significant chance (69%) of no disability | 31% risk of disability Vulnerable for other diseases later in life Risk of life with disability in a poor family Risk of life with disability in a society without adequate welfare system |
Parents and extended family | Blessing of a child and future productive member of the family For some parents their last/only chance to have a baby | Economic burden due to hospital expenses and reduced income for the family member(-s) that are staying in the hospital. Risk of future (catastrophic) health expenditures if the child is disabled Risk of falling into poverty Risk of income loss due to home-based care of disabled child (often women) Risk for mother of eviction from extended family If a girl: future economic burden of a higher dowry in case the girl has disability Stigma of having a disabled child |
Other patients in the unit, the hospital or the community | No direct benefit Indirect benefit: The doctors get experience with the most difficult patients and improve their skills | Other patients with unmet needs (opportunity costs) Less resources for treatment of others (equipment, personnel, money) Higher co-payment for others in the unit |
Doctors, nurses and other providers | Satisfaction of providing significant medical benefit for the patient | Responsibility for the family's overall welfare |
Hospital (private, non-profit) | Goal fulfilment: being able to treat poor patients for free or small co-payment | Costly treatment that reduces the fund set aside for other poor patients. The hospital could have used these resources in more efficient, cost-effective or equity-facilitating ways |
Society | A new citizen, one more survivor | One more person in need of scarce resources |