title: Economic impact of malaria in Malawian households.
abstract: Household heads were questioned about household income and household expenditures on the treatment or prevention of malaria in a nationwide malaria knowledge, attitudes, and practices (KAP) survey conducted in Malawi in 1992. Very low income households with an average annual income of $68 constituted 52% of the sampled households. The primary income source for these households was farm production (92%), with the majority of goods produced consumed by the household and not available as discretionary income. Expenditure on malaria prevention varied with household income level. Only 4% of very low income households spent resources on malaria preventive measures compared to 16% of other households. In contrast, over 40% of all households, independent of income level, reported expenditures on malaria treatment. Almost half of the reported malaria cases sought treatment at a health facility at a cost of $0.21 per child case and $0.63 per adult case. The overall direct expenditure on treatment of malaria illness in household members was $19.13 per year (28% of annual income) among very low income households and $19.84 per year (2% of annual income) among low to high income households. The indirect cost of malaria, calculated on the basis of days of work lost, was $2.13 per year (3.1% of annual income) among very low income households and $20.61 per year (2.2% of annual income) among low to high income households. Very low income households carried a disproportionate share of the economic burden of malaria, with total direct and indirect cost of malaria among these households consuming 32% of annual household income compared to 4.2% among households in the low to high income categories.
authors.affiliation: Vector Biology and Control Project, United States Agency for International Development, Arlington, VA.
authors.forename: M
authors.initials: M
authors.lastname: Ettling
authors.forename: D A
authors.initials: DA
authors.lastname: McFarland
authors.forename: L J
authors.initials: LJ
authors.lastname: Schultz
authors.forename: L
authors.initials: L
authors.lastname: Chitsulo
mesh_terms: D000328:Adult; D000962:Antimalarials / Q000191:economics; D002648:Child; D017281:Cost of Illness; D003625:Data Collection; D004526:Efficiency; D005260:Female; D005102:Health Expenditures; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007182:Income; D008288:Malaria / Q000188:drug therapy / Q000191:economics* / Q000517:prevention & control; D008295:Malawi; D008297:Male
chemical_list: D000962:Antimalarials