Table 3

Affected parties' perceived benefits and burdens of treating children at 28 GAW

Affected partiesBenefitBurden
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-paymentCostly 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
SocietyA new citizen, one more survivorOne more person in need of scarce resources