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Determinants of provider choice for malaria treatment: Experiences from The Gambia

Listed author(s):
  • Wiseman, Virginia
  • Scott, Anthony
  • Conteh, Lesong
  • McElroy, Brendan
  • Stevens, Warren

Malaria is responsible for an estimated one million deaths per year, the vast majority in sub-Saharan Africa. Many of these deaths are attributed to delays in seeking treatment and poor adherence to drug regimes. While there are a growing number of studies describing the factors influencing treatment seeking for malaria, far less is known about the relative weight given to these factors in different settings. This study estimates two models of demand for malaria treatment in the Farafenni region of The Gambia. The first examines the determinants of seeking malaria treatment outside the home versus no treatment or self-care while the second identifies the determinants of provider choice conditional on having decided to seek malaria treatment outside the home. Providers included hospital; health centre; and 'other' which included pharmacies, kiosks; petty traders; neighbours; and traditional healers. Results show that older people were more likely to opt for self-care, or no treatment. The longer the time spent ill or the more severe the fever, the more likely a treatment was sought outside the home. Time of the year and availability of community infrastructure played a key role in both models. Poorer households and those from the Fula ethnic group were much more likely to visit an 'other' provider than a hospital. The policy and methodological implications of these findings are discussed.

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File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(08)00214-1
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Article provided by Elsevier in its journal Social Science & Medicine.

Volume (Year): 67 (2008)
Issue (Month): 4 (August)
Pages: 487-496

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Handle: RePEc:eee:socmed:v:67:y:2008:i:4:p:487-496
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  1. Morey, Edward R. & Sharma, Vijaya R. & Mills, Anne, 2003. "Willingness to pay and determinants of choice for improved malaria treatment in rural Nepal," Social Science & Medicine, Elsevier, vol. 57(1), pages 155-165, July.
  2. Margaret Grosh & Paul Glewwe, 2000. "Designing Household Survey Questionnaires for Developing Countries : Lessons from 15 Years of the Living Standards Measurement Study, Volume 3," World Bank Publications, The World Bank, number 15195, September.
  3. Akin, John S. & Guilkey, David K. & Hazel?Denton, E., 1995. "Quality of services and demand for health care in Nigeria: A multinomial probit estimation," Social Science & Medicine, Elsevier, vol. 40(11), pages 1527-1537, June.
  4. Margaret Grosh & Paul Glewwe, 2000. "Designing Household Survey Questionnaires for Developing Countries : Lessons from 15 Years of the Living Standards Measurement Study, Volume 2," World Bank Publications, The World Bank, number 15194, September.
  5. Williams, Holly Ann & Jones, Caroline O. H., 2004. "A critical review of behavioral issues related to malaria control in sub-Saharan Africa:: what contributions have social scientists made?," Social Science & Medicine, Elsevier, vol. 59(3), pages 501-523, August.
  6. Asenso-Okyere, W. Kwadwo & Osei-Akoto, Isaac & Anum, Adote & Appiah, Ernest N., 1997. "Willingness to pay for health insurance in a developing economy. A pilot study of the informal sector of Ghana using contingent valuation," Health Policy, Elsevier, vol. 42(3), pages 223-237, December.
  7. McCombie, S. C., 1996. "Treatment seeking for malaria: A review of recent research," Social Science & Medicine, Elsevier, vol. 43(6), pages 933-945, September.
  8. Dzator, Janet & Asafu-Adjaye, John, 2004. "A study of malaria care provider choice in Ghana," Health Policy, Elsevier, vol. 69(3), pages 389-401, September.
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