Cost of malaria treatment and health seeking behaviour of children under-five years in the Upper West Region of Ghana

Abstract

BackgroundThere is limited knowledge on cost of treating malaria in children under-five years in northern Ghana which poses a challenge in determining whether interventions such as the National Health Insurance Scheme (NHIS) and Community-based Health Planning and Services (CHPS) have reduced the economic burden of malaria to households or not. This study examined the malaria care seeking and cost of treatment in children under-five years in the Upper West Region of Ghana.MethodsThe study used a cross-sectional, quantitative design and data were collected between July and August 2016 in three districts in the Upper West Region of Ghana. A total of 574 women who had under-five children were interviewed. Socio-demographic characteristics of respondents, malaria seeking patterns for under-five children with malaria as well as direct medical and non-medical costs associated with treating under-five children with malaria were collected from the patient perspective. Analysis was performed using STATA 12.ResultsOut of 574 women visited, about 63% (360) had children who had malaria and sought treatment. Most treatment was done at formal health facilities such as the health centres (37%) and the CHPS (35%) while 3% had self-treatment at home. The main reason for choice of place of treatment outside home was nearness to home (53%). The average direct medical and non-medical costs associated with treating an under-five child with malaria were US$4.13 and US$3.04 respectively. The average cost on transportation alone was US$2.64. Overall, the average direct medical and non-medical cost associated with treating an under-five child with malaria was US$4.91(range: minimum = US$0.13 –maximum = US$46.75). Children who were enrolled into the NHIS paid an average amount of US$4.76 compared with US$5.88 for those not enrolled, though the difference was not statistically significant (p-value = 0.15).ConclusionsThe average cost to households in treating an under-five child with malaria was US$4.91. This amount is considerably high given the poverty level in the area. Children not insured paid a little over one US dollar for malaria treatment compared to those insured. Efforts to improve enrolment into the NHIS may be needed to reduce the cost of malaria treatment to households. Construction of more health facilities near to community members and at hard to reach areas will improve access to health care and reduce direct non-medical cost such as transportation costs.

Health seeking behaviour and cost of fever treatment to households in a malaria endemic setting of northern Ghana: A cross sectional study

“…The average indirect cost (GH¢25.04/US$6.59) was 1.7 times higher than the direct cost (GH¢14.87/US$3.91). This is consistent with many findings where the indirect costs of malaria treatment were higher than the direct costs of treatment [11,15,33,37,38]. Therefore, efforts to improve access to health care and reduction of financial burden to households in the treatment of malaria should not only be directed to direct medical costs but also indirect costs.…”

“…Overall, the average cost incurred in the treatment of malaria by the uninsured was greater (GH¢43.95/US$11.57) than their insured counterparts (GH¢24.75/US$6.51). Thus, the uninsured paid US$5 more than the insured, which is consistent with many findings where the uninsured paid more than the insured in treating malaria [12,15,36]. Though the insured were not supposed to incur direct medical costs, a possible reason for the cost incurred by the insured could be due to co-payments for drugs, laboratory test, ward dues and other informal payments.…”

“…This study revealed that a large proportion of malaria patients treated with ACTs (66.9%) and a little more than 50% obtained the ACTs from formal health facilities (hospitals, Health centres, clinics and CHPS). High utilization of formal health facilities for malaria treatment has been reported in a previous studies[11–15]. The high use of formal health facilities in our study could be attributed to NHIS as about 83% of patients were enrolled into the scheme.…”

<p>Economic Burden of Malaria and Associated Factors Among Rural Households in Chewaka District, Western Ethiopia</p>

“…All households that spent more than 5% of their annual income to pay for the diagnosis and treatment of malaria were classified as catastrophic payment or high economic burden and those households who paid less than this were classified as low economic burden. 10 The cost of illness approach was used to estimate the economic burden of malaria in the study area. The costs per episode of malaria to the patient and to the household were estimated by using the prevalence-based retrospective costing approach.…”

“…Particularly the poorer and vulnerable households are at increased risk of the burdens of malaria and the cost of malaria is far worse for complicated cases. [6][7][8][9][10] The environmental and socio-demographic factors predominantly affect the burden of malaria at household level. 11 Ethiopia has made notable progress in decreasing the prevalence and burden of malaria through public health measures taken during the millennium development goals (MDGs) era.…”