Economic costs of fever to households in the middle belt of Ghana

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.

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.…”

“…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.…”

“…The overall average cost of treating malaria in the Kassena Nankana District was estimated at US GH¢27.83/US$7.2. Though the cost of treatment is lower than malaria treatment cost estimated in other similar studies conducted in other parts of Ghana [11,33], this amount is still relatively high given that most of the respondents were from poor households. High treatment costs can prevent the poor from seeking care when they have a fever episode as well as impoverish households who seek care when they have an episode of fever [11,34].…”

“…A cross-sectional household survey design was used, and data was collected using quantitative approach. The study was conducted within the INDEPTH-network effectiveness and safety studies (INESS) Phase IV research platform that aimed to assess the effectiveness of new malaria treatments and its determinants in real life health systems[10,11].…”

The Accuracy and Perception of Test-Based Management of Malaria at Private Licensed Chemical Shops in the Middle Belt of Ghana

“…4 Licensed chemical shops are found in almost every town or village in Ghana and are the first point of call when most community members are unwell probably because of their ease of access to services at relatively lower cost. 5,6 They, therefore, play a complementary role in the formal health system by bringing health-care services to the doorsteps of people in deprived communities. 7 The Pharmacy Council of Ghana (PCG) oversees the registration, accreditation, and operations of LCS.…”