TY - JOUR
T1 - Health-seeking behaviour and cost of fever treatment to households in a malaria-endemic setting of northern Ghana
T2 - A cross-sectional study
AU - Dalaba, Maxwell Ayindenaba
AU - Welaga, Paul
AU - Dalinjong, Philip Ayizem
AU - Chatio, Samuel
AU - Immurana, Mustapha
AU - Alhassan, Robert Kaba
AU - Klu, Desmond
AU - Manyeh, Alfred Kwesi
AU - Agorinya, Isaiah
AU - Oduro, Abraham
AU - Adongo, Philip Baba
AU - Akweongo, Patricia
N1 - Publisher Copyright:
© Authors 2021
PY - 2021/9/13
Y1 - 2021/9/13
N2 - Objectives To examine the health-seeking behaviour and cost of fever treatment to households in Ghana. Design Cross-sectional household survey conducted between July and September 2015. Setting Kassena-Nankana East and West districts in Upper East region of Ghana. Participants Individuals with an episode of fever in the 2 weeks preceding a visit during routine health and demographic surveillance system data collection were selected for the study. Sociodemographic characteristics, treatment-seeking behaviours and cost of treatment of fever were obtained from the respondents. Results Out of 1845 households visited, 21% (393 of 1845) reported an episode of fever. About 50% (195 of 393) of the fever cases had blood sample taken for testing by microscopy or Rapid Diagnostic Test, and 73.3% (143 of 195) were confirmed to have malaria. Of the 393 people with fever, 70% (271 of 393) reported taking an antimalarial and 24.0% (65 of 271) took antimalarial within 24 hours of the onset of illness. About 54% (145 of 271) of the antimalarials were obtained from health facilities. The average cost (direct and indirect) incurred by households per fever treatment was GH¢27.8/US$7.3 (range: GH¢0.2/US$0.1-GH¢200/US$52.6). This cost is 4.6 times the daily minimum wage of unskilled paid jobs of Ghanaians (US$1.6). The average cost incurred by those enrolled into the National Health Insurance Scheme (NHIS) was GH¢24.8/US$6.5, and GH¢50/US$11.6 for those not enrolled. Conclusions Prompt treatment within 24 hours of onset of fever was low (24%) compared with the Roll Back Malaria Programme target of at least 80%. Cost of treatment was relatively high when compared with average earnings of households in Ghana and enrolment into the NHIS reduced the cost of fever treatment remarkably. It is important to improve access to malaria diagnosis, antimalarials and enrolment into the NHIS in order to improve the case management of fever/malaria and accelerate universal health coverage in Ghana.
AB - Objectives To examine the health-seeking behaviour and cost of fever treatment to households in Ghana. Design Cross-sectional household survey conducted between July and September 2015. Setting Kassena-Nankana East and West districts in Upper East region of Ghana. Participants Individuals with an episode of fever in the 2 weeks preceding a visit during routine health and demographic surveillance system data collection were selected for the study. Sociodemographic characteristics, treatment-seeking behaviours and cost of treatment of fever were obtained from the respondents. Results Out of 1845 households visited, 21% (393 of 1845) reported an episode of fever. About 50% (195 of 393) of the fever cases had blood sample taken for testing by microscopy or Rapid Diagnostic Test, and 73.3% (143 of 195) were confirmed to have malaria. Of the 393 people with fever, 70% (271 of 393) reported taking an antimalarial and 24.0% (65 of 271) took antimalarial within 24 hours of the onset of illness. About 54% (145 of 271) of the antimalarials were obtained from health facilities. The average cost (direct and indirect) incurred by households per fever treatment was GH¢27.8/US$7.3 (range: GH¢0.2/US$0.1-GH¢200/US$52.6). This cost is 4.6 times the daily minimum wage of unskilled paid jobs of Ghanaians (US$1.6). The average cost incurred by those enrolled into the National Health Insurance Scheme (NHIS) was GH¢24.8/US$6.5, and GH¢50/US$11.6 for those not enrolled. Conclusions Prompt treatment within 24 hours of onset of fever was low (24%) compared with the Roll Back Malaria Programme target of at least 80%. Cost of treatment was relatively high when compared with average earnings of households in Ghana and enrolment into the NHIS reduced the cost of fever treatment remarkably. It is important to improve access to malaria diagnosis, antimalarials and enrolment into the NHIS in order to improve the case management of fever/malaria and accelerate universal health coverage in Ghana.
KW - economics
KW - epidemiology
KW - primary care
UR - http://www.scopus.com/inward/record.url?scp=85115145813&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2021-052224
DO - 10.1136/bmjopen-2021-052224
M3 - Article
C2 - 34518274
AN - SCOPUS:85115145813
SN - 2044-6055
VL - 11
JO - BMJ Open
JF - BMJ Open
IS - 9
M1 - e052224
ER -
