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Household costs and care seeking patterns associated with COVID-19 in Blantyre, Malawi

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Listed:
  • Jobiba Chinkhumba
  • Samuel Mpinganjira
  • Andrew Kumitawa
  • Mercy Malopa
  • Dalitso Longwe
  • Vincent Samuel Phiri
  • Tonney S Nyirenda
  • Victor Mwapasa

Abstract

Economic consequences of COVID-19 illness and healthcare use for households in low income countries are not well known. We estimated costs associated with COVID-19 care-seeking and treatment from a household perspective and assessed determinants of treatment costs. A cross-sectional household survey was conducted between December 2020 and November 2021 in urban and peri-urban areas of Blantyre district. Adults (age ≥18 years) with confirmed COVID-19 were asked to report the symptoms they experienced or prompted them to seek COVID-19 tests as well as healthcare seeking behaviors preceding and following COVID-19 diagnosis. For individuals who sought healthcare, information on out-of-pocket expenditures incurred while seeking and receiving care including on transport, food etc. by both the patients and their guardians was collected. Finally, data on time use seeking, receiving care and during convalesces was recorded. Multivariate Generalized Linear Models were used to evaluate association between household COVID-19 costs and their determinants. Of 171 individuals who took part in the study, the average age was 40.7 years, standard deviation (SD) 15.0, and 50.8% were females. Most participants (85.3%) were symptomatic. Of these, 67.8% sought care at health facilities and the majority (91.7%) were treated as outpatients. The average total household cost associated with COVID-19 seeking, receiving care and convalescence was $62.81 (SD $126.02). Average costs for outpatient and inpatient cases were $52.96 (SD $54.35) and $172.39 (SD $407.08), respectively. Average out-of-pocket household expenditures were $42.62 (SD $123.10), accounting for 62% of total household costs. Being a male COVID-19 patient and engagement in formal employment were significantly associated with high COVID-19 household costs. Households face high economic burden related to COVID-19 sickness and healthcare use. Social policies that support households cope with both the direct and indirect COVID-19 cost are needed to ensure access to healthcare and protect households from COVID-19 related shocks.

Suggested Citation

  • Jobiba Chinkhumba & Samuel Mpinganjira & Andrew Kumitawa & Mercy Malopa & Dalitso Longwe & Vincent Samuel Phiri & Tonney S Nyirenda & Victor Mwapasa, 2023. "Household costs and care seeking patterns associated with COVID-19 in Blantyre, Malawi," PLOS Global Public Health, Public Library of Science, vol. 3(6), pages 1-14, June.
    • Handle: RePEc:plo:pgph00:0002003
    DOI: 10.1371/journal.pgph.0002003
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    References listed on IDEAS

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    1. McIntyre, Diane & Thiede, Michael & Dahlgren, Göran & Whitehead, Margaret, 2006. "What are the economic consequences for households of illness and of paying for health care in low- and middle-income country contexts?," Social Science & Medicine, Elsevier, vol. 62(4), pages 858-865, February.
    2. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453, Decembrie.
    3. Nandita Saikia & Moradhvaj & Jayanta Kumar Bora, 2016. "Gender Difference in Health-Care Expenditure: Evidence from India Human Development Survey," PLOS ONE, Public Library of Science, vol. 11(7), pages 1-15, July.
    4. Lo Bue, Maria C. & Le, Tu Thi Ngoc & Santos Silva, Manuel & Sen, Kunal, 2022. "Gender and vulnerable employment in the developing world: Evidence from global microdata," World Development, Elsevier, vol. 159(C).
    5. Josephson,Anna Leigh & Kilic,Talip & Michler,Jeffrey David, 2020. "Socioeconomic Impacts of COVID-19 in Four African Countries," Policy Research Working Paper Series 9466, The World Bank.
    6. Borislava Mihaylova & Andrew Briggs & Anthony O'Hagan & Simon G. Thompson, 2011. "Review of statistical methods for analysing healthcare resources and costs," Health Economics, John Wiley & Sons, Ltd., vol. 20(8), pages 897-916, August.
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