Community &Treatment Bill Brieger | 07 Dec 2011 11:07 pm
Household cost in treating fevers in the Dangme West District, Ghana
Is malaria treatment affordable in a rural district of Ghana? – a poster presentation at the American Society of Tropical Medicine and Hygiene annual meeting.
Alexander A. Nartey, Patricia Akweongo, Christine Clerk, Elizabeth Awini, Jonas Akpakli, Margaret Gyapong: Dodowa Health Research Centre, Accra, Ghana
Although Ghana has instituted a national health insurance scheme (NHIS) as a measure to lessen the burden of health care cost to households, majority of people continue to pay cash directly to seek care, a study has revealed.
The study which was conducted in Dangme West District from October 2009 to August 2011 under the INDEPTH Effectiveness and Safety Studies of Antimalarials in Africa (INESS) platform was to assess household cost in treating fevers and the socio-economic burden of fever/malaria to households in the district. Malaria ranks first on the top ten list of most important diseases within the district.
The study showed that 78.9 per cent of the 511 people interviewed from pre-selected households paid out of their own pockets for the treatment of fever while the remaining 21.1 per cent used their health insurance. The majority of the people had health insurance cover but paid directly for care because they claimed it took too long for them to be attended to at the hospital if they presented their health insurance card. Additionally, some of the respondents paid out of their pockets because they preferred the private clinics where they received prompt care for their fevers.
The study also showed that 79.5 per cent of the respondents sought care outside home by visiting a drug store or health facility. An average of ¢5.00 ($3.3 USD) was spent before seeking care at the health facility and direct average cost per visit to health facility was ¢11.5 ($7.8 USD).
The average number of days lost due to malaria was six days while reduction of productivity due to malaria accounted for 28 per cent. About 1.6 per cent of the patients borrowed money to access health care.
It is evident that a household spends substantial amount on drugs, transport and food for an episode of fever within the district. Out-of-pocket payment is very high and places a high burden on household income. A household may spend an average of 12 working days of the daily minimum wage for the treatment of a fever episode.
The study, therefore, recommended that there is the need to investigate why individuals who are insured with the NHIS have to pay to get prompt treatment at NHIS accredited health facilities. Additionally, home based management of fever should be rolled out in rural communities to help reduce household burden of treating fevers.