Abstract
BackgroundZambia is facing a double crisis of increasing malaria burden and dwindling capacity to deal with the endemic malaria burden. The pursuit of sustainable but equity mechanisms for financing malaria programmes is a subject of crucial policy discussion. This requires that comprehensive accounting of the economic impact of the various malaria programmes. Information on the economic value of programmes is essential in soliciting appropriate funding allocations for malaria control.Aims and objectivesThis paper specifically seeks to elicit a measure of the economic benefits of an improved malaria treatment programme in Zambia. The paper also studies the equity implications in malaria treatment given that demand or malaria treatment is determined by household socio-economic status.MethodsA contingent valuation survey of about 300 Zambian households was conducted in four districts. Willingness-to-pay (WTP) was elicited for an improved treatment programme for malaria in order to generate a measure of the economic benefits of the programme. The payment card method was used in eliciting WTP bids.FindingsThe study reports that malaria treatment has significant economic benefits to society. The total economic benefits of an improved treatment programme were estimated at an equivalent of US$ 77 million per annum, representing about 1.8% of Zambia's GDP. The study also reports the theoretically anticipated association between WTP and several socio-economic factors. Our income elasticity of demand is positive and similar in magnitude to estimates reported in similar studies. Finally, from an equity standpoint, the constraints imposed by income and socio-economic status are discussed.
Highlights
Malaria remains the leading cause of morbidity and mortality in Zambia
This paper reports on a methodology based on the economics of eliciting desired financial investments in malaria management interventions in Zambia
Descriptive statistics of the sample The sample gives the following summary statistics from the sample compared with population data as published in official Zambian statistics
Summary
Malaria remains the leading cause of morbidity and mortality in Zambia. The Zambian Ministry of Health estimates that the number of malaria cases has tripled in the past three decades to more than 4 million clinical cases and 50,000 deaths per year in a population of less than 11 million people [1]. Provision of adequate treatment of malaria clinical episodes remains a key challenge for Zambia. The recent change in the treatment policy from sulphadoxine-pyrimethamine (SP) to artemesinin-based combination therapy (ACT), presently Coartem® (artemether-lumefantrine) for uncomplicated malaria, has fuelled critical debate about the 'affordability' and 'sustainability' not just of ACT but of the entire malaria control strategy of a poor country like Zambia [4]. The pursuit of sustainable but equity mechanisms for financing malaria programmes is a subject of crucial policy discussion. This requires that comprehensive accounting of the economic impact of the various malaria programmes. Information on the economic value of programmes is essential in soliciting appropriate funding allocations for malaria control
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