Abstract
BackgroundMalaria is one of the main health problems in the sub-Saharan Africa accounting for approximately 198 million morbidity and close to 600,000 mortality cases. Households incur out-of-pocket expenditure for treatment and lose income as a result of not being able to work or care for family members. The main objective of this survey was to assess the economic cost of treating malaria and/or fever with the new ACT to households in the Kintampo districts of Ghana where a health and demographic surveillance systems (KHDSS) are set up to document population dynamics.MethodsThe study was a cross-sectional survey conducted from October 2009 to July 2011 using community members’ accessed using KHDSS population in the Kintampo area. An estimated sample size of 4226 was randomly selected from the active members of the KHDSS. A structured questionnaire was administered to the selected populates who reported of fever within the last 2 weeks prior to the visit. Data was collected on treatment-seeking behaviour, direct and indirect costs of malaria from the patient perspective.ResultsOf the 4226 households selected, 947 households with 1222 household members had fever out of which 92 % sought treatment outside home; 55 % of these were females. 31.6 % of these patients sought care from chemical shops. A mean amount of GHS 4.2 (US$2.76) and GHS 18.0 (US$11.84) were incurred by households as direct and indirect cost respectively. On average a household incurred a total cost of GHS 22.2 (US$14.61) per patient per episode. Total economic cost was lowest for those in the highest quintile and highest for those in the middle quintile.ConclusionThe total cost of treating fever/malaria episode is relatively high in the study area considering the poverty levels in Ghana. The NHIS has positively influenced health-seeking behaviours and reduced the financial burden of seeking care for those that are insured.
Highlights
Malaria is one of the main health problems in the sub-Saharan Africa accounting for approximately 198 million morbidity and close to 600,000 mortality cases
Kintampo Health Research Center (KHRC) located in the Kintampo districts maintains the Kintampo Health and Demographic Surveillance System (KHDSS), which was used for sampling households for this study
At the time of this study about 50 % [21] of inhabitants in the study area had valid National Health Insurance cards to access health care in public and private accredited by the National Health Insurance Authority (NHIA)
Summary
Malaria is one of the main health problems in the sub-Saharan Africa accounting for approximately 198 million morbidity and close to 600,000 mortality cases. The annual reported confirmed malaria cases in Ghana in 2013 were about 1.6 million out of which 2506 resulted in deaths. Malaria and its associated costs present a major socioeconomic challenge to households in Africa. It leads to considerable economic burden at the household level and the poorest households in the population are mostly affected [6, 7]. Households are affected through outof-pocket expenditure for treatment and by the loss of income as a result of not being able to work or care for family members. Cost of malaria constitutes significant shares of annual household incomes ranging from 6 to Tawiah et al Malar J (2016) 15:68
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