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Economic burden of malaria and predictors of cost variability to rural households in south-central Ethiopia

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  • Alemayehu Hailu
  • Bernt Lindtjørn
  • Wakgari Deressa
  • Taye Gari
  • Eskindir Loha
  • Bjarne Robberstad

Abstract

Background: While recognizing the recent remarkable achievement in the global malaria reduction, the disease remains a challenge to the malaria endemic countries in Africa. Beyond the huge health consequence of malaria, policymakers need to be informed about the economic burden of the disease to the households. However, evidence on the economic burden of malaria in Ethiopia is scanty. The aims of this study were to estimate the economic burden of malaria episode and to identify predictors of cost variability to the rural households. Methods: A prospective costing approach from a household perspective was employed. A total of 190 malaria patients were enrolled to the study from three health centers and nine health posts in Adami Tullu district in south-central Ethiopia, in 2015. Primary data were collected on expenditures due to malaria, forgone working days because of illness, socioeconomic and demographic situation, and households’ assets. Quantile regression was applied to predict factors associated with the cost variation. Socioeconomic related inequality was measured using concentration index and concentration curve. Results: The median cost of malaria per episode to the household was USD 5.06 (IQR: 2.98–8.10). The direct cost accounted for 39%, while the indirect counterpart accounted for 61%. The history of malaria in the last six months and the level of the facility visited in the health system predominantly influenced the direct cost. The indirect cost was mainly influenced by the availability of antimalarial drugs in the health facility. The concentration curve and the concentration index for direct cost indicate significant pro-rich inequality. Plasmodium falciparum is significantly more costly for households compared to Plasmodium vivax. Conclusion: The economic burden of malaria to the rural households in Ethiopia was substantial—mainly to the poor—indicating that reducing malaria burden could contribute to the poverty reduction as well.

Suggested Citation

  • Alemayehu Hailu & Bernt Lindtjørn & Wakgari Deressa & Taye Gari & Eskindir Loha & Bjarne Robberstad, 2017. "Economic burden of malaria and predictors of cost variability to rural households in south-central Ethiopia," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-16, October.
    • Handle: RePEc:plo:pone00:0185315
    DOI: 10.1371/journal.pone.0185315
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    References listed on IDEAS

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    1. 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.
    2. Martine Audibert & Marilys Victoire Razakamanana & Voahirana Tantely Andrianantoandro, 2022. "Malaria and pneumonia e ects on rice, vanilla production and rural household income in Madagascar: case of the Sava region," Post-Print hal-03904397, HAL.
    3. Ndii, Meksianis Z. & Adi, Yudi Ari, 2021. "Understanding the effects of individual awareness and vector controls on malaria transmission dynamics using multiple optimal control," Chaos, Solitons & Fractals, Elsevier, vol. 153(P1).
    4. Chefke, Mihret & Abro, Zewdu & Meskel, Atnafu G. & Kassie, Menale, 2021. "Health-Seeking Behavior of Rural Households, Malaria, and Productivity in Northwestern Ethiopia," 2021 Conference, August 17-31, 2021, Virtual 315877, International Association of Agricultural Economists.

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