IDEAS home Printed from https://ideas.repec.org/a/plo/pntd00/0006431.html
   My bibliography  Save this article

Patients’ costs, socio-economic and health system aspects associated with malaria in pregnancy in an endemic area of Colombia

Author

Listed:
  • Elisa Sicuri
  • Azucena Bardají
  • Sergi Sanz
  • Sergi Alonso
  • Silke Fernandes
  • Kara Hanson
  • Myriam Arevalo-Herrera
  • Clara Menéndez

Abstract

Malaria in pregnancy threatens birth outcomes and the health of women and their newborns. This is also the case in low transmission areas, such as Colombia, where Plasmodium vivax is the dominant parasite species. Within the Colombian health system, which underwent major reforms in the 90s, malaria treatment is provided free of charge to patients. However, patients still incur costs, such as transportation and value of time lost due to the disease. We estimated such costs among 40 pregnant women with clinical malaria (30% Plasmodium falciparum, 70% Plasmodium vivax) in the municipality of Tierralta, Northern Colombia. In a cross-sectional study, women were interviewed after an outpatient or inpatient laboratory confirmed malaria episode. Women were asked to report all types of cost incurred before (including prevention), during and immediately after the contact with the health facility. Median total cost was over 16US$ for an outpatient visit, rising to nearly 30US$ if other treatments were sought before reaching the health facility. Median total inpatient cost was 26US$ or 54US$ depending on whether costs incurred prior to admission were excluded or included. For both outpatients and inpatients, direct costs were largely due to transportation and indirect costs constituted the largest share of total costs. Estimated costs are likely to represent only one of the constraints that women face when seeking treatment in an area characterized, at the time of the study, by armed conflict, displacement, and high vulnerability of indigenous women, the group at highest risk of malaria. Importantly, the Colombian peace process, which culminated with the cease-fire in August 2016, may have a positive impact on achieving universal access to healthcare in conflict areas. The current study can inform malaria elimination initiatives in Colombia.Author summary: Malaria in pregnancy is a harsh and undesirable illness and is the cause of adverse effects on birth outcomes and on the health of women and newborns. Despite the low transmission, the predominance of Plasmodium vivax over Plasmodium falciparum and free treatment, estimated costs incurred by pregnant women seeking malaria care in an endemic area of Northern Colombia are considerable. Importantly, these costs are likely to represent only one of the constraints that women face when seeking treatment in an area characterized, at the time of the study, by armed conflict, displacement, and high vulnerability of indigenous women, the group at highest risk of malaria in the area. Important advances may result from the current peace process, potentially able to support the efforts made since the 90s to reform the health system towards achieving universal health coverage. Within this context, the current study can inform malaria elimination initiatives in Colombia.

Suggested Citation

  • Elisa Sicuri & Azucena Bardají & Sergi Sanz & Sergi Alonso & Silke Fernandes & Kara Hanson & Myriam Arevalo-Herrera & Clara Menéndez, 2018. "Patients’ costs, socio-economic and health system aspects associated with malaria in pregnancy in an endemic area of Colombia," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 12(5), pages 1-13, May.
  • Handle: RePEc:plo:pntd00:0006431
    DOI: 10.1371/journal.pntd.0006431
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0006431
    Download Restriction: no

    File URL: https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0006431&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pntd.0006431?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Barofsky, Jeremy & Anekwe, Tobenna D. & Chase, Claire, 2015. "Malaria eradication and economic outcomes in sub-Saharan Africa: Evidence from Uganda," Journal of Health Economics, Elsevier, vol. 44(C), pages 118-136.
    2. Thomas F. Crossley & Joachim K. Winter, 2014. "Asking Households about Expenditures: What Have We Learned?," NBER Chapters, in: Improving the Measurement of Consumer Expenditures, pages 23-50, National Bureau of Economic Research, Inc.
    3. Banguero, Harold, 1984. "Socioeconomic factors associated with malaria in Colombia," Social Science & Medicine, Elsevier, vol. 19(10), pages 1099-1104, January.
    4. Grant Miller & Diana Pinto & Marcos Vera-Hernández, 2013. "Risk Protection, Service Use, and Health Outcomes under Colombia's Health Insurance Program for the Poor," American Economic Journal: Applied Economics, American Economic Association, vol. 5(4), pages 61-91, October.
    5. David Cutler & Winnie Fung & Michael Kremer & Monica Singhal & Tom Vogl, 2010. "Early-Life Malaria Exposure and Adult Outcomes: Evidence from Malaria Eradication in India," American Economic Journal: Applied Economics, American Economic Association, vol. 2(2), pages 72-94, April.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Le, Dung D. & Molina, Teresa & Ibuka, Yoko & Goto, Rei, 2024. "The Intergenerational Health Effects of Child Marriage Bans," IZA Discussion Papers 17089, Institute of Labor Economics (IZA).
    2. Luiza M Karpavicius & Ariaster Chimeli, 2023. "Forest Protection and Human Health: The Case of Malaria in the Brazilian Amazon," Working Papers, Department of Economics 2023_08, University of São Paulo (FEA-USP), revised 26 Jul 2023.
    3. Cirera, Laia & Castelló, Judit Vall & Brew, Joe & Saúte, Francisco & Sicuri, Elisa, 2022. "The impact of a malaria elimination initiative on school outcomes: Evidence from Southern Mozambique," Economics & Human Biology, Elsevier, vol. 44(C).
    4. Fink, Günther & Venkataramani, Atheendar S. & Zanolini, Arianna, 2021. "Early life adversity, biological adaptation, and human capital: evidence from an interrupted malaria control program in Zambia," Journal of Health Economics, Elsevier, vol. 80(C).
    5. Karpavicius, Luiza & Chimeli, Ariaster, 2023. "Forest Protection and Human Health: The Case of Malaria in the Brazilian Amazon," TD NEREUS 6-2023, Núcleo de Economia Regional e Urbana da Universidade de São Paulo (NEREUS).
    6. Sergi Alonso & Khátia Munguambe & Elisa Sicuri, 2017. "Market for Artemether‐Lumefantrine to treat childhood malaria in a district of southern Mozambique," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 345-360, December.
    7. Milusheva, Sveta, 2020. "Managing the spread of disease with mobile phone data," Journal of Development Economics, Elsevier, vol. 147(C).
    8. O'Donnell, Owen, 2024. "Health and health system effects on poverty: A narrative review of global evidence," Health Policy, Elsevier, vol. 142(C).
    9. Pan, Yao & Singhal, Saurabh, 2019. "Agricultural extension, intra-household allocation and malaria," Journal of Development Economics, Elsevier, vol. 139(C), pages 157-170.
    10. Shampa Bhattacharjee & Aparajita Dasgupta, 2022. "Disease Eradication, Infant Mortality, and Fertility Response: Evidence from Malaria Eradication in India," Journal of Development Studies, Taylor & Francis Journals, vol. 58(12), pages 2444-2459, December.
    11. Milusheva,Sveta, 2020. "Using Mobile Phone Data to Reduce Spread of Disease," Policy Research Working Paper Series 9198, The World Bank.
    12. Bethencourt, Carlos & Marrero, Gustavo A. & Ngoudji, Charlie Y., 2021. "The Fight against Malaria: A New Index for Quantifying and Assessing Policy Implementation Actions to Reduce Mortality in Sub-Saharan Africa," MPRA Paper 108570, University Library of Munich, Germany.
    13. Josselin Thuilliez & Hippolyte d'Albis & Hamidou Niangaly & Ogobara Doumbo, 2017. "Malaria and Education: Evidence from Mali," Journal of African Economies, Centre for the Study of African Economies (CSAE), vol. 26(4), pages 443-469.
    14. Patricio S Dalton & Victor H Gonzalez Jimenez & Charles N Noussair, 2017. "Exposure to Poverty and Productivity," PLOS ONE, Public Library of Science, vol. 12(1), pages 1-19, January.
    15. Ahsan, Md Nazmul & Maharaj, Riddhi, 2018. "Parental human capital and child health at birth in India," Economics & Human Biology, Elsevier, vol. 30(C), pages 130-149.
    16. Rossi, Pauline & Villar, Paola, 2020. "Private health investments under competing risks: Evidence from malaria control in Senegal," Journal of Health Economics, Elsevier, vol. 73(C).
    17. Darius Erlangga & Shehzad Ali & Karen Bloor, 2019. "The impact of public health insurance on healthcare utilisation in Indonesia: evidence from panel data," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 64(4), pages 603-613, May.
    18. Janet Currie & Tom Vogl, 2013. "Early-Life Health and Adult Circumstance in Developing Countries," Annual Review of Economics, Annual Reviews, vol. 5(1), pages 1-36, May.
    19. Bénédicte Apouey & Gabriel Picone & Joshua Wilde & Joseph Coleman & Robyn Kibler, 2017. "Paludisme et anémie des enfants en Afrique subsaharienne : effet de la distribution de moustiquaires," Revue économique, Presses de Sciences-Po, vol. 68(2), pages 163-197.
    20. Gabriella Conti & Rita Ginja, 2023. "Who Benefits from Free Health Insurance?: Evidence from Mexico," Journal of Human Resources, University of Wisconsin Press, vol. 58(1), pages 146-182.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pntd00:0006431. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosntds (email available below). General contact details of provider: https://journals.plos.org/plosntds/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.