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

Abstract

Background This study examined the health seeking behaviours and cost of treatment of malaria to households in the Kassena-Nankana district of Ghana. Methods A cross-sectional household survey was conducted between July and September 2015. Individuals who had an episode of fever or malaria in the past two weeks identified during routine Health and Demographic Surveillance System data collection were selected for the study. Socio-demographic characteristics, treatment seeking behaviours and cost of treatment of malaria were obtained from the patient perspective. Results Out of the 1,845 households visited, 21.3% (393/1,845) reported to have had an episode of fever or malaria in the past two weeks. Of the 393 people with malaria, 66.9% (263/393) reported taking an antimalarial. About 53.6% (141/263) of the antimalarials were obtained from formal healthy facilities. About 36.1% (95/263) reported to have taken Dihydroartemisinin-piperaquine, 35.4% (93/263) took Artesunate–Amodiaquine and 21.7% (57/263) took Artemether-Lumefantrine. Only 49.6%% (195/393) of the study participants had their blood sample taken for illness (microscopic or Rapid Diagnostic Test). Only 23.6% (62/263) took antimalarial within 24 hours of the onset of illness. The overall average costs (direct and indirect cost) incurred by households per malaria treatment was GH¢27.82/US$7.32 (range: GH¢0.2/ US$0.05 - GH¢200/ US$52.63). The average cost incurred in the treatment of malaria by those who were enrolled into the National Health Insurance Scheme (NHIS) was GH¢24.75/US$6.51 and those not enrolled was GH¢43.95/US$11.57. Conclusions Prompt treatment such as treatment within 24 hours of onset of malaria was low. The average costs to households per malaria treatment was GH¢27.82/US$7.32 and the preferred antimalarial was Dihydroartemisinin-piperaquine. There was a positive effect of NHIS enrolment on cost of treatment as the insured incurred less cost (US$5 less) in treatment than the uninsured.