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Seasonal variations of household costs of illness in Burkina Faso


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  • Sauerborn, R.
  • Nougtara, A.
  • Hien, M.
  • Diesfeld, H. J.
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    This paper assesses the seasonal variations of the time and financial costs of illness for rural households in Burkina Faso. It is based on a multiple round survey of 566 households, which included a time allocation study. The economic parameters of households which influence health seeking behavior changed substantially between the dry and rainy seasons: revenues fell in the rainy season and were exceeded by expenditures. Household production was at its peak in the rainy season resulting in significantly higher opportunity costs of time. At the same time illness perception changed: in the rainy season, significantly fewer illness episodes were perceived, and of those, the proportion perceived as severe decreased over-proportionally. Households shifted their healer choice in the rainy season away from high cost treatment, such as the hospital and dispensary, to low cost home treatment. For all these reasons, households incurred significantly fewer costs of illness in the rainy season (27% of dry season costs). Household health care expenditures were reduced to 1/6 of dry season levels, the time costs incurred by healthy household members to tend to the sick was reduced to 1/5 and the time costs of work incapacity due to sickness fell to about 1/2 of dry season levels. The authors stress the need to carry out research in all relevant seasons when studying health seeking behavior and the household costs of illness in order to avoid serious seasonal bias. They suggest policy options to increase health care utilization in the rainy season by reducing the financial and time costs of access to health care. Finally, the authors put forward a hypothesis to be tested by future research: They argue that the cognitive (changes in illness perception) and behavioral changes (different health care seeking) reflect the high opportunity costs of time and the low availability of cash households face during the rainy season. The paper discusses the negative implication that untreated illness has on the health status of household members.

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    Bibliographic Info

    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 43 (1996)
    Issue (Month): 3 (August)
    Pages: 281-290

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    Handle: RePEc:eee:socmed:v:43:y:1996:i:3:p:281-290

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    Keywords: Health care costs health expenditures health care utilization seasonality agricultural production illness perception;


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    Cited by:
    1. repec:ilo:ilowps:375955 is not listed on IDEAS
    2. Hengjin Dong & Adjima Gbangou & Manuela Allegri & Subhash Pokhrel & Rainer Sauerborn, 2008. "The differences in characteristics between health-care users and non-users: implication for introducing community-based health insurance in Burkina Faso," The European Journal of Health Economics, Springer, Springer, vol. 9(1), pages 41-50, February.
    3. Tin Su & Subhash Pokhrel & Adjima Gbangou & Steffen Flessa, 2006. "Determinants of household health expenditure on western institutional health care," The European Journal of Health Economics, Springer, Springer, vol. 7(3), pages 195-203, September.
    4. Pouliot, Mariève, 2011. "Relying on nature’s pharmacy in rural Burkina Faso: Empirical evidence of the determinants of traditional medicine consumption," Social Science & Medicine, Elsevier, Elsevier, vol. 73(10), pages 1498-1507.
    5. Jane Chuma & Catherine Molyneux, 2009. "Coping with the costs of illness: the role of shops and shopkeepers as social networks in a low-income community in coastal Kenya," Journal of International Development, John Wiley & Sons, Ltd., vol. 21(2), pages 252-270.
    6. Hengjin Dong & Bocar Kouyate & John Cairns & Frederick Mugisha & Rainer Sauerborn, 2003. "Willingness-to-pay for community-based insurance in Burkina Faso," Health Economics, John Wiley & Sons, Ltd., vol. 12(10), pages 849-862.
    7. Shahaduz Zaman & Hasanur Rahman & Ross Edgeworth, 2007. "Health Domain of the Ultra Poor: An Exploration," Working Papers id:1002, eSocialSciences.
    8. Fink, Günther & Robyn, Paul Jacob & Sié, Ali & Sauerborn, Rainer, 2013. "Does health insurance improve health?," Journal of Health Economics, Elsevier, vol. 32(6), pages 1043-1056.
    9. Ebere Akobundu & Jing Ju & Lisa Blatt & C. Mullins, 2006. "Cost-of-Illness Studies," PharmacoEconomics, Springer, Springer, vol. 24(9), pages 869-890, September.
    10. Tin Su & Steffen Flessa, 2013. "Determinants of household direct and indirect costs: an insight for health-seeking behaviour in Burkina Faso," The European Journal of Health Economics, Springer, Springer, vol. 14(1), pages 75-84, February.
    11. Su, Tin Tin & Sanon, Mamadou & Flessa, Steffen, 2007. "Assessment of indirect cost-of-illness in a subsistence farming society by using different valuation methods," Health Policy, Elsevier, vol. 83(2-3), pages 353-362, October.
    12. Robyn, Paul Jacob & Fink, Günther & Sié, Ali & Sauerborn, Rainer, 2012. "Health insurance and health-seeking behavior: Evidence from a randomized community-based insurance rollout in rural Burkina Faso," Social Science & Medicine, Elsevier, Elsevier, vol. 75(4), pages 595-603.


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