Dataset Information

Economic burden of malaria and predictors of cost variability to rural households in south-central Ethiopia.

ABSTRACT: While recognizing the recent remarkable achievement in the global malaria reduction, the disease remains a challenge to the malaria endemic countries in Africa. Beyond the huge health consequence of malaria, policymakers need to be informed about the economic burden of the disease to the households. However, evidence on the economic burden of malaria in Ethiopia is scanty. The aims of this study were to estimate the economic burden of malaria episode and to identify predictors of cost variability to the rural households.A prospective costing approach from a household perspective was employed. A total of 190 malaria patients were enrolled to the study from three health centers and nine health posts in Adami Tullu district in south-central Ethiopia, in 2015. Primary data were collected on expenditures due to malaria, forgone working days because of illness, socioeconomic and demographic situation, and households' assets. Quantile regression was applied to predict factors associated with the cost variation. Socioeconomic related inequality was measured using concentration index and concentration curve.The median cost of malaria per episode to the household was USD 5.06 (IQR: 2.98-8.10). The direct cost accounted for 39%, while the indirect counterpart accounted for 61%. The history of malaria in the last six months and the level of the facility visited in the health system predominantly influenced the direct cost. The indirect cost was mainly influenced by the availability of antimalarial drugs in the health facility. The concentration curve and the concentration index for direct cost indicate significant pro-rich inequality. Plasmodium falciparum is significantly more costly for households compared to Plasmodium vivax.The economic burden of malaria to the rural households in Ethiopia was substantial-mainly to the poor-indicating that reducing malaria burden could contribute to the poverty reduction as well.

SUBMITTER: Hailu A

PROVIDER: S-EPMC5636083 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Economic burden of malaria and predictors of cost variability to rural households in south-central Ethiopia.

Hailu Alemayehu A Lindtjørn Bernt B Deressa Wakgari W Gari Taye T Loha Eskindir E Robberstad Bjarne B

PloS one 20171011 10

<h4>Background</h4>While recognizing the recent remarkable achievement in the global malaria reduction, the disease remains a challenge to the malaria endemic countries in Africa. Beyond the huge health consequence of malaria, policymakers need to be informed about the economic burden of the disease to the households. However, evidence on the economic burden of malaria in Ethiopia is scanty. The aims of this study were to estimate the economic burden of malaria episode and to identify predictors ...[more]

PMID: 29020063

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Project description:BackgroundThis study explores the consequences of a maternal death to households in rural Western Kenya focusing particularly on the immediate financial and economic impacts.MethodsBetween September 2011 and March 2013 all households in the study area with a maternal death were surveyed. Data were collected on the demographic characteristics of the deceased woman; household socio-economic status; a history of the pregnancy and health care access and utilization; and disruption to household functioning due to the maternal death. These data were supplemented by in-depth and focus group discussions.ResultsThe health service utilization costs associated with maternal deaths were significantly higher, due to more frequent service utilization as well as due to the higher cost of each visit suggesting more involved treatments and interventions were sought with these women. The already high costs incurred by cases during pregnancy were further increased during delivery and postpartum mainly a result of higher facility-based fees and expenses. Households who experienced a maternal death spent about one-third of their annual per capita consumption expenditure on healthcare access and use as opposed to at most 12% among households who had a health pregnancy and delivery. Funeral costs were often higher than the healthcare costs and altogether forced households to dis-save, liquidate assets and borrow money. What is more, the surviving members of the households had significant redistribution of labor and responsibilities to make up for the lost contributions of the deceased women.ConclusionKenya is in the process of instituting free maternity services in all public facilities. Effectively implemented, this policy can lift a major economic burden experienced by a very large number of household who seek maternal health services which can be catastrophic in complicated cases that result in maternal death. There needs to be further emphasis on insurance schemes that can support households through catastrophic health spending.

Project description:Apart from its direct impact on public health and well-being, malaria had placed significant socioeconomic burden on both individuals and whole health systems. This study was conducted to investigate the hospitalization cost of malaria and explore the inter-province variation during the National Malaria Elimination Programme in China.Information on medical expenditure for malaria treatment was extracted from inpatient medical records in Henan, Hainan and Guangxi Province. The costs were adjusted to the price in 2014 and converted to USD (United States Dollars). Non-parametric and parametric methods were employed to estimate hospitalization costs and non-parametric bootstrap method was used for the comparison of hospitalization costs among sample provinces and to estimate the uncertainty of differences in inter-province hospitalization costs.The hospitalization cost and daily cost of 426 malaria inpatients were 929.8 USD and 143.12 USD respectively. The average length of stay was 11.95 days. The highest cost of hospitalization services occurred in tertiary hospitals (956 USD per episode). Whereas the lowest ones occurred in internal departments (424 USD). Medications, laboratory tests and supportive resources for treatment were the most important components of hospitalization costs, respectively responsible for 45.31, 24.70, and 20.09% of the total hospitalization costs. The hospitalization cost per episode in Henan Province was significantly higher than that in Hainan an in Guangxi Province, with incremental costs of 713 USD (95% confidence interval 419.70, 942.50) and of 735.58 USD (95% CI 606.50, 878.00), respectively. The differences in the daily costs between Henan and Hainan along with Guangxi provinces were 75.33 USD (95% CI 40.33, 96.67) and 93.56 USD (95% CI 83.58, 105.28), respectively.Although the prevalence of malaria cases has considerably declined, the direct hospitalization costs of malaria in the household remain high and the inter-province variations need to be seriously considered in the formulation the further interventions regarding hospitalization cost control. This study suggests that economic risk protection mechanisms targeting at malaria inpatients should be redesigned. The drug price addition policy in public hospitals should be gradually reformed or abolished coupling with increasing government subsidies along with the charges for treatment services to reduce the hospitalization cost. The policy for cost control in the provincial hospitals should be implemented in comparison with the policy in other provinces, where the status of economic and geography are similar.

Project description:BackgroundMalaria remains a leading cause of morbidity and mortality in Mozambique. Increased investments in malaria control have reduced the burden, but few studies have estimated the costs of malaria in the country. This paper estimates the economic costs associated with malaria care to households and to the health system in the high burden district of Mopeia in central Mozambique.MethodsMalaria care-seeking and morbidity costs were routinely collected among 1373 households with at least one child enrolled in an active case detection (ACD) cohort in Mopeia, and through cross-sectional surveys with 824 families in 2017 and 805 families in 2018. Household costs included direct medical expenses, transportation and opportunity costs of the time lost due to illness. Structured questionnaires were used to estimate the health system costs associated with malaria care in all 13 district health facilities. Cost estimations followed an ingredient-based approach with a top-down allocation approach for health system expenses.ResultsAmong participants in cross-sectional studies, households sought care for nine severe malaria cases requiring hospital admission and for 679 uncomplicated malaria cases. Median household costs associated with uncomplicated malaria among individuals of all ages were US$ 3.46 (IQR US$ 0.07-22.41) and US$ 81.08 (IQR US$ 39.34-88.38) per severe case. Median household costs were lower among children under five (ACD cohort): US$ 1.63 (IQR US$ 0.00-7.79) per uncomplicated case and US$ 64.90 (IQR US$ 49.76-80.96) per severe case. Opportunity costs were the main source of household costs. Median health system costs associated with malaria among patients of all ages were US$ 4.34 (IQR US$ 4.32-4.35) per uncomplicated case and US$ 26.56 (IQR US$ 18.03-44.09) per severe case. Considering household and health system costs, the overall cost of malaria care to society was US$ 7.80 per uncomplicated case and US$ 107.64 per severe case, representing an economic malaria burden of US$ 332,286.24 (IQR US$ 186,355.84-1,091,212.90) per year only in Mopeia.ConclusionsDespite the provision of free malaria services, households in Mopeia incur significant direct and indirect costs associated with the disease. Furthermore, the high malaria cost on the Mozambican health system underscores the need to strengthen malaria prevention to reduce the high burden and improve productivity in the region.

Project description:BACKGROUND:In Ethiopia malaria is one of the top ten leading causes of morbidity and mortality. Community knowledge of prevention and control methods had been proven to play an important role in the implementation of effective and sustainable interventions against malaria. This information is limited in the study area. This study aimed to assess knowledge of malaria prevention and control methods and its associated factors among households in West Belessa district, 2019. METHODS:Community-based cross-sectional mixed quantitative and qualitative study was conducted from April to June 2019 in West Belessa district, North West Ethiopia. Multistage sampling was used to select an estimated 770 sample size. A structured questionnaire was used for the quantitative component and semi-structured questionnaire for the qualitative component. Quantitative data were collected by interviewing and qualitative data using focus group discussion (FGD). Quantitative data was coded and entered using Epi info software version 7 then exported to SPSS version 20 for analysis. The binary logistic regression model was fitted to identify the associated factors. Odds Ratio (OR) with 95% Confidence Interval (CI) was used to assess the strength of association. The qualitative data was transcribed manually using the thematic approach. RESULT:A total of 770 subjects were included in this study with a 99.5% response rate. Of the total respondents, 75.6% had good knowledge of malaria prevention methods. LLINs and IRS were mentioned by 84.7 and 83.7% respectively. Poorest wealth quintiles [AOR?=?0.40, 95% CI: 0.23, 0.73], poor wealth quintiles [AOR?=?0.38, 95% CI: 0.21, 0.70], and medium wealth quintiles [AOR?=?0.41, 95% CI: 0.22, 0.76], living in Menti Kebele [AOR?=?3.07, 95% CI 1.85, 5.08], living in Abay tera kebele [AOR?=?2.00, 95% CI 1.21, 3.29] were significantly associated with good knowledge. About all of the focused group discussion (FGD) participants agreed that malaria is a preventable disease and mentioned some of the preventive methods. CONCLUSION:Overall there was relatively high knowledge of malaria prevention and control methods. LLINs and IRS were known malaria prevention methods in West Belessa. Wealth index and respondents living kebele are predictors for knowledge of malaria prevention.

Dataset Information

Economic burden of malaria and predictors of cost variability to rural households in south-central Ethiopia.

Publications

Economic burden of malaria and predictors of cost variability to rural households in south-central Ethiopia.

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