Economic burden of malaria on rural households in Gwanda district, Zimbabwe

BACKGROUND Malaria is a serious public health problem in sub-Saharan Africa and is a leading cause of morbidity and mortality. AIM To estimate the economic burden of malaria in rural households. SETTING The study was conducted in Gwanda district of Matabeleland South in Zimbabwe. A total of five malarious wards and all their households were selected for the study frame, out of which 80 households were chosen using clinic records. METHODS A retrospective analysis of secondary data and a cross-sectional household survey were conducted to estimate the household economic burden of malaria. Eighty households from five rural wards were identified from the health facility malaria registers and followed up. A household was eligible for inclusion if there had been at least one reported malaria case during the period of 2013-2015. Interviewer administered questionnaires were used to collect household data on economic costs of malaria. RESULTS Our findings showed that households spent an average of $3.22 and $56.60 for managing an uncomplicated and a complicated malaria episode respectively. A household lost an average of eight productive working days per each malaria episode resulting in an average loss of 24% of the monthly household income. An estimated 35%, mostly poorer households suffered catastrophic health expenditures. CONCLUSION Malaria imposes significant economic burdens particularly on the poorer and vulnerable households. Although there are no user fees at rural clinics, households incur other costs to manage a malaria patient. These costs are far worse for complicated cases.