The household burden of uncomplicated malaria treatment in sub-Saharan Africa; A review

Abstract

In 2003 Chima et al. published a review on the economic impact of malaria to sub-Saharan African households. Since then several initiatives such as the Roll Back Malaria program and the Affordable Medicines Facility malaria have been initiated. In addition many new studies have been conducted in this field. Now the question has arisen whether these initiatives have led to a decrease in the burden of uncomplicated malaria treatment to sub-Saharan African households. To address this question, this thesis reviews available scientific literature from 2003 to September 2012, related to the household burden of uncomplicated malaria treatment in sub-Saharan Africa, and draws conclusions on future policy making and future research initiatives.

Although many differences exist between areas and countries the results of this thesis suggest that the economic household burden of malaria treatment to sub-Saharan African countries is (still) extensive. For many people in sub-Saharan Africa the costs for the treatment of one case of malaria are such a high percentage of monthly income/expenditure that it leads to (household) catastrophe. Also few countries in sub-Saharan Africa have healthcare insurance or subsidies for malaria treatment available, leading to extra catastrophe. Lastly, not in every healthcare facility appropriate treatment for malaria is available, resulting in many ill people receiving incorrect or less effective treatment. These issues may be resolved by implementing several different policies. One may be making more public healthcare facilities available to the public. Another, more easily implementable solution, may be allowing at least part of the retail sector to sell anti malarial drugs, and in particular the newest first line treatments. In several sub-Saharan African countries drug shops already have permission to sell these treatments and sometimes buy them at a subsidized price. In terms of future research, this may be directed at the differences in household burden of uncomplicated malaria treatment between rural and urban areas or directed at the differences in household burden of uncomplicated malaria treatment in different socio-economic groups. Lastly, in order to continue long term subsidies and discounts for malaria treatment in sub-Saharan African countries more research needs to be conducted into sustainable subsidy schemes.