NAME: FIDELIS EBUI KANG
MAT N°: SC 24 P186
COURSE TITLE: INTRODUCTION TO HEALTH ECONOMICS
COURSE CODE: MBP 612
LECTURER:
ASSIGNMENT № 1
Title: Economic Burden and Cost Analysis of Malaria in Rural Cameroon: A
Case Study of Ndop District.
Abstract or Overview
Malaria continues to be a significant public health challenge in sub-Saharan Africa,
particularly affecting rural populations. This report examines the economic burden of
malaria in the Ndop Health District of the North West Region of Cameroon, focusing
on direct, indirect, and intangible costs, household coping strategies, and the price
elasticity of treatment demand. Utilizing a mixed-methods approach that includes field
data, interviews, and secondary research, the study offers policy-oriented
recommendations aimed at cost containment and efficient resource allocation.
Introduction
Malaria is a critical health issue in Cameroon, especially in rural areas like the Ndop
District, where high infection rates place immense pressure on both healthcare
systems and household finances. This report aims to provide a comprehensive analysis
of the economic burden of malaria in the region, evaluating costs from the perspective
of households and offering recommendations to optimize health expenditures and
enhance health outcomes.
Methodology
This report employs a mixed-methods framework:
-Quantitative data: Collected from local health centers, pharmacies, and community
health surveys.
-Qualitative data: In-depth interviews conducted with 20 households affected by
malaria.
-Costing Approach: Utilizes the human capital method and willingness-to-pay
assessments for intangible costs.
-Elasticity Analysis: Based on prior differences between public and private health
providers.
Direct Costs of Malaria in Ndop:
Direct costs include out-of-pocket expenses incurred during malaria diagnosis
and treatment.
- Consultation fees: Public clinics charge between [score] and [score] per visit,
while private clinics average [scores] to [score]. Informal providers offer lower
prices but are less reliable.
- Medication Costs: The cost of Artemesinin-based Combination Therapy
(ACT) ranges from 1500 Frs to 3000 Frs per treatment course. Additional
medications such as antihypertics and supplements cost between 500frs and
1000Frs. The average total medication cost per episode is approximately
2000Frs to 4000Frs.
- Transportation: With many households located over 5Km from health centers,
the average round-trip transport cost ranges from 1000Frs to 2500 Frs.
Table 1: Average Direct Cost per Malaria Episode
Cost Component Public Facility (CFA) Private Facility (CFA)
Consultation 1000 4000
Medication 2500 3000
Transportation 1500 2000
Total 5000 9000
Indirect Costs
Indirect costs encompass productivity losses and absenteeism due to malaria.
-Loss of income: Adults typically miss between 3 to 5 working days per malaria
episode. With an average daily wage of CFA 2000, this results in a loss of 6000As to
10000As per adult per episode.
-School Absenteeism: Children miss an average of 4 days, which can lead to long-
term effects on their academic performance and educational attainment.
-Caregiver Burden: Family members often have to miss work or farming duties to care
for sick relatives, compounding the financial loss.
Table 2: Average Indirect Costs per Episode
Cost Type Estimated Value (CFA)
Lost wages 8000
School Absenteeism Not monetized
Caregiver loss 4000
Total 12000 Frs
Intangible Costs:
Intangible costs refer to non-monetary burdens, such as pain, anxiety, and diminished
quality of life.
-Patient suffering: Interviewees expressed significant anxiety regarding recurrent
infections and fears of severe malaria or death, particularly for children.
-Psychological strain: Families reported increased stress levels, especially when
multiple members fell ill simultaneously.
Social Disruption: Community activities and funerals are often disrupted by
outbreaks, negatively affecting social cohesion.
Quantifying these costs is challenging but essential. Willingness-to-pay surveys
revealed an average perceived value of 5000As to avoid suffering, highlighting the
psychological toll of malaria.
Household Coping Mechanisms:
Households adopt various strategies to manage the economic burden of malaria as
follows:
-Borrowing and loans: Approximately 65% of households interviewed resorted to
borrowing money for treatment, often from informal lenders who charge high interest
rates (10-20%).
-Asset Sales: Nearly 30% of households interviewed reported selling livestock or
farming equipment to cover medical expenses, which can impair future income
generation.
Reducing essential consumption: Families often skip meals or delay paying school
fees to manage health-related expenses.
-Case examples: Interviews with local families highlighted specific instances of
selling assets and increased reliance on community support to handle malaria-related
costs.
-Preference for Traditional Medicine: In about 20% of cases, households turned to
herbal remedies as a primary defense to avoid the costs of clinical clinic visits.
Price Elasticity Analysis:
Understanding price elasticity of demand is essential for recognizing how changes in
treatment costs affect care-seeking behavior. For example, data indicates that a 10%
increase in consultation fees results in a 15% decrease in clinic visits.
This correlation emphasizes the need to make malaria treatment more affordable
through subsidies or reduced user fees. Historical data on treatment uptake during
price changes supports this conclusion.
Public clinics exhibit low elasticity. To assess the price responsiveness of malaria
treatment demand, the study compares utilization patterns across different income
levels and types of healthcare providers.
Elasticity estimates
Public clinics exhibit low elasticity (inelastic demand); attendance remains
steady even with low fees.
Conversely, private clinics show a significant drop in demand with price
increases, indicating higher elasticity.
Table 3: Price Elasticity Coefficient Estimates
Provider Type Elasticity Estimate
Public facilities -0.2
Private facilities -0.9
Traditional Healers +0.6
Independent: The negative elasticity for private providers indicates that cost affects
demand. Households tend to substitute private care with traditional healers or self-
medication when prices rise.
Discussion:
The economic burden of malaria in Ndop District is complex:
Direct costs represent a significant out-of-pocket expense for families.
Indirect costs, particularly lost income, often surpass direct costs.
Intangible costs contribute to psychological distress, especially among low-
income households.
Coping strategies like borrowing or asset sales may lead to long-term poverty
traps.
Elasticity patterns indicate that subsidies and free treatment options could
improve access, particularly in the private healthcare sector.
Policy Recommendations:
-Subsidize Treatment Costs: Government or donor funding should cover consultation
and medication fees for vulnerable populations (children under 5 years and pregnant
women).
Improve Access to Public Facilities: Expanding community-based treatment
programs and mobile clinics by involving and training more community health
workers can help lower transportation costs.
Promote Health Insurance: Scaling up community-based health insurance (CBHI)
schemes can spread risk and reduce out-of-pocket expenses.
Invest in Health Education: Educational initiatives focusing on prevention methods
(e.g., bed nets, sanitation) can lower malaria incidence and long-term costs.
Monitor and Regulate Private Providers: Establishing standardized prices and
monitoring service quality can ensure that cost does not hinder access to effective
care.
Support Coping Capacity: Implementing cash transfers or microcredit options can
assist households in managing health shocks without resorting to selling productive
assets.
Conclusion:
Malaria imposes a substantial economic burden on households in rural Cameroon,
particularly in the Ndop District, through direct, indirect, and intangible costs. Current
financing and delivery mechanisms often push families toward harmful coping
strategies. A combination of cost-reduction policies, improved access to care, and
enhanced insurance coverage is essential to alleviate these burdens. Insights from this
case study should inform broader strategies aimed at mitigating malaria's economic
impact across rural Cameroon and similar contexts.
