Navrongo Health Research Centre, Navrongo, Ghana.
Community Development Alliance Ghana, Wa, Ghana.
PLoS One. 2018 Apr 13;13(4):e0195533. doi: 10.1371/journal.pone.0195533. eCollection 2018.
There is limited knowledge on cost of treating malaria in children under-five years in northern Ghana which poses a challenge in determining whether interventions such as the National Health Insurance Scheme (NHIS) and Community-based Health Planning and Services (CHPS) have reduced the economic burden of malaria to households or not. This study examined the malaria care seeking and cost of treatment in children under-five years in the Upper West Region of Ghana.
The study used a cross-sectional, quantitative design and data were collected between July and August 2016 in three districts in the Upper West Region of Ghana. A total of 574 women who had under-five children were interviewed. Socio-demographic characteristics of respondents, malaria seeking patterns for under-five children with malaria as well as direct medical and non-medical costs associated with treating under-five children with malaria were collected from the patient perspective. Analysis was performed using STATA 12.
Out of 574 women visited, about 63% (360) had children who had malaria and sought treatment. Most treatment was done at formal health facilities such as the health centres (37%) and the CHPS (35%) while 3% had self-treatment at home. The main reason for choice of place of treatment outside home was nearness to home (53%). The average direct medical and non-medical costs associated with treating an under-five child with malaria were US$4.13 and US$3.04 respectively. The average cost on transportation alone was US$2.64. Overall, the average direct medical and non-medical cost associated with treating an under-five child with malaria was US$4.91(range: minimum = US$0.13 -maximum = US$46.75). Children who were enrolled into the NHIS paid an average amount of US$4.76 compared with US$5.88 for those not enrolled, though the difference was not statistically significant (p-value = 0.15).
The average cost to households in treating an under-five child with malaria was US$4.91. This amount is considerably high given the poverty level in the area. Children not insured paid a little over one US dollar for malaria treatment compared to those insured. Efforts to improve enrolment into the NHIS may be needed to reduce the cost of malaria treatment to households. Construction of more health facilities near to community members and at hard to reach areas will improve access to health care and reduce direct non-medical cost such as transportation costs.
在加纳北部，针对五岁以下儿童治疗疟疾的成本知之甚少，这给确定国民健康保险计划（NHIS）和社区卫生规划与服务（CHPS）等干预措施是否减轻了疟疾给家庭带来的经济负担带来了挑战。本研究调查了加纳上西部地区五岁以下儿童的疟疾治疗寻求和治疗费用。
本研究采用了横断面、定量设计，数据于 2016 年 7 月至 8 月间在加纳上西部的三个区收集。共访谈了 574 名有五岁以下儿童的妇女。从患者角度收集了受访者的社会人口特征、五岁以下儿童的疟疾求医模式以及与五岁以下儿童疟疾治疗相关的直接医疗和非医疗费用。使用 STATA 12 进行分析。
在接受访谈的 574 名妇女中，约有 63%（360 名）的儿童患有疟疾并接受了治疗。大多数治疗是在正规卫生机构进行的，如卫生中心（37%）和 CHPS（35%），而 3%的患者在家中进行了自我治疗。选择在家庭以外的地方进行治疗的主要原因是离家近（53%）。与治疗五岁以下儿童疟疾相关的平均直接医疗和非医疗费用分别为 4.13 美元和 3.04 美元。仅交通费用的平均花费就达 2.64 美元。总的来说，与治疗五岁以下儿童疟疾相关的平均直接医疗和非医疗费用为 4.91 美元（范围：最小值= 0.13 美元-最大值= 46.75 美元）。参加 NHIS 的儿童平均支付 4.76 美元，而未参加的儿童则支付 5.88 美元，尽管差异无统计学意义（p 值=0.15）。
治疗五岁以下儿童疟疾的家庭平均费用为 4.91 美元。考虑到该地区的贫困水平，这一数额相当高。与参保儿童相比，未参保儿童治疗疟疾只需多支付 1 美元多一点。可能需要努力增加 NHIS 的参保人数，以降低家庭的疟疾治疗费用。在靠近社区成员和难以到达的地区建设更多的卫生设施将改善获得医疗保健的机会，并降低直接非医疗费用，如交通费用。
