The Economic Burden and Catastrophic Expenditure of Presumptive Malaria in Rural Southwest, Nigeria

Abstract

Malaria is endemic and a major public health problem in Nigeria, having negative effect on economic     livelihood of farming households. Malaria treatments at times become catastrophic due to exorbitant out-of-pocket spending. This study examined how catastrophic the financial cost (out-of-pocket spending) of presumptive malaria treatment and prevention among farming households in rural Southwest Nigeria. Data were obtained with the aid of structured questionnaire administered on a randomly selected 395 households. The scenarios used to examine catastrophe were: the percentage of average monthly malaria treatment expenditure as a proportion of monthly income; non-food and total expenditures, using a threshold of 5% in all of the scenarios. Presumptive malaria cost households an average of ₦96,434.94k per year, this include treatment cost of ₦27,642.33, ₦10,434.10 for prevention and ₦58,358.51k as the value of 73.49 workdays lost to the illness. Mean monthly income, non-food and total expenditures and out-of-pocket expenditure on malaria were ₦43053.57, ₦13893.32, ₦48180.30 and ₦2303.53, respectively. The monthly malaria treatment expenditure as a proportion of households’ monthly income, non-food and total expenditures were 5.4%, 16.6% and 4.8%, respectively. Thus, households spend 5.4% of their income on presumptive malaria. The disease also accounted for substantial part of households’ non-food expenditure. Presumptive malaria resulted in a huge loss in household income in the area. The financial cost associated with the disease is catastrophic and it represents a significant burden on the households. The existence of catastrophic costs will negatively affect the health seeking behaviour of the deprived and rural households.