title: Inequities in valuation of benefits, choice of drugs, and mode of payment for malaria treatment services provided by community health workers in Nigeria.
abstract: This study determined inequities of using community health workers (CHWs) for timely and appropriate treatment of malaria in terms of: 1) valuation of benefits; 2) actual purchase of drugs; and 3) payment modality in southeast Nigeria. Socioeconomic status (SES) influenced the valuation of benefits. Also, the poorest households consumed more of the cheaper drug and less of the more expensive drug (P < 0.05). The least poor households mostly paid in full, whereas the poorest households paid mostly through installments (P < 0.05). The use of CHWs improved overall geographic but not socioeconomic equity to the drugs. Hence, interventions for timely and appropriate treatment of malaria should be accompanied by drug delivery and payment strategies that would ensure SES equity in consumption of appropriate malaria treatment services.
authors.affiliation: Gates Malaria Partnership, London School of Hygiene and Tropical Medicine, London, United Kingdom. Onwujekwe@yahoo.co.uk
authors.forename: Obinna
authors.initials: O
authors.lastname: Onwujekwe
authors.forename: Juliana
authors.initials: J
authors.lastname: Ojukwu
authors.forename: Elvis
authors.initials: E
authors.lastname: Shu
authors.forename: Benjamin
authors.initials: B
authors.lastname: Uzochukwu
mesh_terms: D000962:Antimalarials / Q000191:economics* / Q000600:supply & distribution / Q000627:therapeutic use*; D001294:Attitude to Health; D003153:Community Health Services / Q000191:economics / Q000706:statistics & numerical data*; D003150:Community Health Workers / Q000191:economics / Q000706:statistics & numerical data*; D003362:Cost-Benefit Analysis; D005249:Fees and Charges; D005260:Female; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008288:Malaria / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D015397:Program Evaluation; D019035:Rural Health Services; D012923:Social Class; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
chemical_list: D000962:Antimalarials