A.T. Salawu, O.I. Fawole, and M.D. Dairo
Dept. of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan
Background: Malaria accounts for about 60% of all clinic attendance in Nigeria. About 300,000 children die of malaria annually while an estimated 4,500 pregnant women are lost annually on account of malaria in Nigeria alone. High cost of treatment is a barrier to the uptake of health services in low resource settings, therefore an exploration of the cost of malaria management will reveal possible components that may benefit from intervention and thus reveal important clues for improving access to malaria treatment. Objective of this study therefore is to describe patronage and cost of malaria treatment in private hospitals in Ibadan.
Method: This was a descriptive cross sectional study, carried out in private hospitals in Ibadan, South Western Nigeria. A self-administered questionnaire with open and close-ended questions was used to collect data on patronage and cost of treatment in adults, children and pregnant women attending private health facilities in Ibadan, Nigeria. Data were presented using tables of frequencies and proportions while analysis was by descriptive statistics.
Results: A total of 40 doctors and hospitals participated in the study. Average patronage for malaria, both complicated and uncomplicated per month was 153 patients per hospital. Malaria cases accounts for 331 (46.2%) of total clinic cases seen in private hospitals in a month. About 121 (78%) of malaria cases seen were uncomplicated while 32 (21%) of cases were complicated malaria. Average amount charged patient for treating uncomplicated malaria in private hospitals was N3,941. Average amount spent on antimalarial drugs was about N2,443 (62%) while N1,064 (27.7%) was spent on laboratory investigation and N406.00 (10.3%) for medical consultation.
Conclusion: Drugs cost constitute the bulk of expenses on malaria treatment. Policy makers may improve access to malaria treatment by subsidizing the cost of anti-malaria drugs for pregnant women and children, who might not be able to afford treatment.
Keywords: Patronage, Drugs, Cost, Medical consultation, Laboratory investigation
Dr. A.T. Salawu
Dept. of Epidemiology & Medical Stat,
Faculty of Public Health,
College of Medicine,
University of Ibadan.
Malaria transmission occurs in all six WHO regions. Globally, an estimated 3.3 billion people are at risk of being infected with malaria and developing disease, and 1.2 billion are at high risk1.
According to the latest estimates, 214 million new cases of malaria occurred globally in 2015, leading to 438 000 deaths. The burden was heaviest in WHO African Region where an estimated 90% of all malaria death occurred and in children aged under 5 years, who accounted for 10% of all deaths2.
Malaria is an endemic disease in Nigeria with about 60% all clinic attendance and is the cause of 1 in 4 cases of anemia in children. A child with severe malaria can die within 24 hours if not given prompt and effective treatment3. The disease accounts for 25% of infant mortality and 30 per cent of childhood mortality in Nigeria thereby imposing a great burden on the country in terms of pains and trauma suffered by its victims as well as loss in outputs and cost of treatments3. In Nigeria, about 300,000 children die of malaria annually and 4,500 pregnant women are lost annually on account of this disease4. About 25% of household income is expended on malaria control and treatment while 71% of expenditure on malaria treatment comes from household. About N132 billons is lost on account of malaria every year5 .
Unfortunately, patronage of unqualified personnel by malaria sufferer is widespread and leads to delay in presentation at designated health facilities6. This may account for the number of deaths due to malaria. This cannot be allowed to continue, if the nation is to sustain the gain on Millennium Development Goals (MDGs).
Previous studies had suggested that the cost of hospital services are unaffordable by many families and may account for the delays observed in accessing hospital services for medical treatment.7 Studies on how much consumers pay for the treatment of malaria in hospital and what part of the cost carries the highest burden need to be explored in order to identify potential avenues for intervention. Exploration of cost of malaria management will reveal possible component that may benefit from intervention and thus reveal important clues for improving access to malaria treatment. This study therefore aims to describe patronage and cost of malaria treatment in private hospitals in Ibadan.