Socio-economic inequalities in cost of seeking treatment for malaria in south-east Nigeria

Abstract

Background: To investigate the socio-economic differentials in health seeking and costs of malaria treatment in Southeast Nigeria

Methods: A cross-sectional study design using questionnaires was conducted. The study areas are four malaria holo-endemic communities (towns) in Enugu State, Southeast Nigeria, namely Udi and Nachi in Udi Local government area (LGA) with Inyi and Oji-river (Oji) in Oji-River LGA. Udi and Oji were the local government headquarters, while Nachi and Inyi were not. Principal components analysis was used to generate a socio-economic status (SES) index, which was used to examine inequity.
Results: Similar pattern of health seeking was found for both adult and childhood malaria with treatment mostly sought from patent medicine dealers. All SES were likely to incur similar level of costs to treat malaria implying that the poorest are spending a greater proportion of their income on the disease. The non-financial costs were considerable at about 1000 Naira per episode of malaria. The huge time cost would inevitably lead to a reduction in household production and could lead to adverse coping mechanisms especially by the poorer households.
Conclusion: In order to decrease the inequity in costs of treatment and ensure the ready availability of appropriate treatment to the poorest households, the government should increase the availability of formal healthcare services for the provision of near and appropriate treatment of malaria. This strategy would decrease the financial costs (especially transportation) and maybe non-financial costs of seeking care for treatment of malaria and other illnesses.

Key words: socioeconomic, inequalities, malaria, treatment seeking