Household Expenditure on Prevention and Treatment of Malaria in Khartoum State during a Transmission Season September 2003.
Household Expenditure on Prevention and Treatment of Malaria in Khartoum State during a Transmission Season September 2003.
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Date
2015-04-01
Authors
Hassan, Muna
Journal Title
Journal ISSN
Volume Title
Publisher
UOFK
Abstract
Malaria represents a major public health problem in Khartoum State. It is
responsible for 24% of disease episodes seen at outpatient departments.,13.4%
of inpatients admittance and 10% of hospital deaths. Combating malaria needs
mutual efforts from both the government and the community. For the successful
implementation of control measures, the economic impact of malaria on
households as a whole, and in different subgroups of the population need to be
known. This is needed first to target the population by equitable and efficient
interventions. And second to promote the uptake of preventive measures by the
households and guide them in their care seeking practices.
This study was conducted to estimate the out-of-pocket expenditure related to
malaria prevention and treatment by households, and the effects of care seeking
behaviour, socioeconomic status, health insurance coverage and residential area
on these expenditures, during the transmission season in Khartoum State during
the year 2003.
A total of 904 households, selected by the stratified, cluster sampling
techniques, were included in the study. Two pre-tested questionnaires were used
to collect retrospective data about prevention practices and prevention
expenditure. Data about care seeking behaviour during simple malaria episodes
and expenditure on malaria treatment during September 2003 were also
collected.
The results revealed a low use of preventive measures in all sectors of the
population and especially among those of low socioeconomic status and
residents of rural areas and camps. There was no significant difference in the
incidence of malaria among the different income groups. On the other hand rural
areas and camps had a significantly higher incidence than urban areas. There
was a high rate of health facility use and low rate of self treatment for malaria
management. Use of governmental health facilities was higher than use of
private facilities. The mean annual expenditure on malaria prevention was 2944
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Sudanese Dinars (SD) (5517) per household, and the median was 1400 SD. This
depleted 0.6% of the annual income of the population. The mean monthly
expenditure on malaria treatment per household was 2710 SD (2191) and the
median was 1100SD, depleting 5.9% of the monthly income of the population.
In both instances, and in absolute terms, the expenditures were low for low
income groups and for those residing in rural areas and camps. However, on
relative terms households from low income groups and rural areas and camps
suffer a greater burden. The expenditure on treatment per fully cured patient was
1391 SD (1334) and the median was1070SD. It was lower for those with Health
Insurance Corporation coverage. It was higher for those who used health
facilities, especially those of the private sector. Expenditure on drugs comprised
the greatest proportion of all treatment expenditure (45.1%), and this proportion
is anticipated to increase even more after the adoption of new combination
therapy.
It was concluded that malaria places a tremendous economic burden on
households of Khartoum state especially those of low socioeconomic status and
those residing in rural areas and camps. The relatively high treatment
expenditure compared to preventive expenditure can be due to the high
accessibility to health services in the Khartoum and low coverage by health
insurance in one hand and low preventive measures uptake by the population on
the other hand.
It is thus recommended that this economic burden should be reduced through:
• Increasing coverage by preventive measures to reduce treatment costs in long
run.
• Expanding coverage by health insurance.
• Educating the population on how to channel their expenditure rationally and
insuring rational use of drug at facility level.
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• Studies to quantify the indirect cost of malaria including cost of treating
malaria on an inpatient bases, should be conducted to reflect the whole
burden that falls on households.
Description
Keywords
Household Expenditure,Direct Medical Cost),Prevention Practices