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The Economic Burden of Malaria on Households and the Health System in Enugu State Southeast Nigeria

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  • Obinna Onwujekwe
  • Nkoli Uguru
  • Enyi Etiaba
  • Ifeanyi Chikezie
  • Benjamin Uzochukwu
  • Alex Adjagba

Abstract

Background: Malaria is the number one public health problem in Nigeria, responsible for about 30% of deaths in under-fives and 25% of deaths in infants and 11% maternal mortality. This study estimated the economic burden of malaria in Nigeria using the cost of illness approach. Methods: A cross-sectional study was undertaken in two malaria holo-endemic communities in Nigeria, involving both community and hospital based surveys. A random sample of 500 households was interviewed using interviewer administered questionnaire. In addition, 125 exit interviews for inpatient department stays (IPD) and outpatient department visits (OPD) were conducted and these were complemented with data abstraction from 125 patient records. Results: From the household survey, over half of the households (57.6%) had an episode of malaria within one month to the date of the interview. The average household expenditure per case was 12.57US$ and 23.20US$ for OPD and IPD respectively. Indirect consumer costs of treatment were higher than direct consumer medical costs. From a health system perspective, the recurrent provider costs per case was 30.42 US$ and 48.02 US$ for OPD and IPD while non recurrent provider costs were 133.07US$ and 1857.15US$ for OPD and IPD. The mode of payment was mainly through out-of-pocket spending (OOPS). Conclusion: Private expenditure on treatment of malaria constitutes a high economic burden to households and to the health system. Removal of user fees and interventions that will decrease the use of OOPS for treatment of malaria will significantly decrease the economic burden of malaria to both households and the health system.

Suggested Citation

  • Obinna Onwujekwe & Nkoli Uguru & Enyi Etiaba & Ifeanyi Chikezie & Benjamin Uzochukwu & Alex Adjagba, 2013. "The Economic Burden of Malaria on Households and the Health System in Enugu State Southeast Nigeria," PLOS ONE, Public Library of Science, vol. 8(11), pages 1-5, November.
    • Handle: RePEc:plo:pone00:0078362
    DOI: 10.1371/journal.pone.0078362
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    References listed on IDEAS

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    1. Asenso-Okyere, W. K. & Dzator, Janet A., 1997. "Household cost of seeking malaria care. A retrospective study of two districts in Ghana," Social Science & Medicine, Elsevier, vol. 45(5), pages 659-667, September.
    2. Jeffrey Sachs & Pia Malaney, 2002. "The economic and social burden of malaria," Nature, Nature, vol. 415(6872), pages 680-685, February.
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    1. Ijeoma Nkem Okedo‐Alex & Ifeyinwa Chizoba Akamike & Obumneme Benaiah Ezeanosike & Chigozie Jesse Uneke, 2019. "A review of the incidence and determinants of catastrophic health expenditure in Nigeria: Implications for universal health coverage," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(4), pages 1387-1404, October.
    2. Nahlah Elkudssiah Ismail & Nanloh Samuel Jimam & Khang Wen Goh & Ching Siang Tan & Long Chiau Ming, 2023. "Economic Burdens of Uncomplicated Malaria in Primary Health Care (PHC) Facilities of Plateau State, Nigeria: Patients’ Perspectives," IJERPH, MDPI, vol. 20(2), pages 1-13, January.
    3. Gracious M. Diiro & Menale Kassie & Beatrice W. Muriithi & Nancy G. Gathogo & Michael Kidoido & Rose Marubu & John Bwire Ochola & Clifford Maina Mutero, 2020. "Are Individuals Willing to Pay for Community-Based Eco-Friendly Malaria Vector Control Strategies? A Case of Mosquito Larviciding Using Plant-Based Biopesticides in Kenya," Sustainability, MDPI, vol. 12(20), pages 1-15, October.
    4. Sarah M Beargie & Colleen R Higgins & Daniel R Evans & Sarah K Laing & Daniel Erim & Sachiko Ozawa, 2019. "The economic impact of substandard and falsified antimalarial medications in Nigeria," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-16, August.

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