Do consumers' preferences for improved provision of malaria treatment services differ by their socio-economic status and geographic location? A study in southeast Nigeria

Abstract

BackgroundImprovement of utilization of malaria treatment services will depend on provision of treatment services that different population groups of consumers prefer and would want to use. Treatment of malaria in Nigeria is still problematic and this contributes to worsening burden of the disease in the country. Therefore this study explores the socio-economic and geographic differences in consumers' preferences for improved treatment of malaria in Southeast Nigeria and how the results can be used to improve the deployment of malaria treatment services.MethodsThis study was undertaken in Anambra state, Southeast Nigeria in three rural and three urban areas. A total of 2,250 randomly selected householders were interviewed using a pre tested interviewer administered questionnaire. Preferences were elicited using both a rating scale and ranking of different treatment provision sources by the respondents. A socio-economic status (SES) index was used to examine for SES differences, whilst urban-rural comparison was used to examine for geographic differences, in preferences.ResultsThe most preferred source of provision of malaria treatment services was public hospitals (30.5%), training of mothers (19%) and treatment in Primary healthcare centres (18.1%). Traditional healers (4.8%) and patent medicine dealers (4.2%) were the least preferred strategies for improving malaria treatment. Some of the preferences differed by SES and by a lesser extent, the geographic location of the respondents.ConclusionPreferences for provision of improved malaria treatment services were influenced by SES and by geographic location. There should be re-invigoration of public facilities for appropriate diagnosis and treatment of malaria, in addition to improving the financial and geographic accessibility of such facilities. Training of mothers should be encouraged but home management will not work if the quality of services of patent medicine dealers and pharmacy shops where drugs for home management are purchased are not improved. Therefore, there is the need for a holistic improvement of malaria treatment services.

Rational Choice Theory and the Choice of Healthcare Services in the Treatment of Malaria in Nigeria

“…In accessing the various preferences of the patients, a study in Anambra state, Nigeria, (2010), showed that the choice of treatment and the most preferred source of provision of malaria treatment services for the respondents was based on the availability of such treatment which was public hospitals followed by training of mothers, treatment in Primary healthcare centers, traditional healers and patent medicine dealers were the least preferred strategies for improving malaria treatment. Some of the preferences differed by socio-economic status and by a lesser extent, the geographical location of the patient (Uguru, et al, 2010).…”

The Impact of Malaria on the People of Anambra State Nigeria and their Response to the Disease

“…Changing climate conditions give rise to increased infectious disease such as malaria [3]. Water from rainfall can accumulate in places that become breeding sites for anopheles mosquitoes to lay and deposit their eggs, and larvae and pupae develop into adulthood.…”

“…The disease is the most common cause of outpatient visits in Nigeria [3]. Most rural Nigerian towns experience high malaria transmission, with an estimated 990,000 people dying from malaria in 1995; that is more than 2,700 deaths per day, or 2 deaths per minute.…”

“…During harvest seasons, agricultural workers might sleep in fields or nearby locales, without protection against mosquito bites. It has been speculated that current trends of global warming may increase the geographic range of malaria and may be responsible for malaria epidemic [3]. Global environmental degradation that includes soil erosion from heavy rains, deforestation, no clean drinking water and clean environments all contribute to increased risks of infectious disease including malaria [9].…”

“…Malaria has been identified as a major public health problem in sub-Saharan African countries such as Nigeria, where the disease's morbidity and mortality for children under 5 years of age, pregnant women and the very old is very high [1]. Malaria is one of the major causes of preventable death and the third leading cause of death among infectious diseases [3]. It is a common infectious disease that is widespread in most tropical regions of the world, especially Asia and Sub-Saharan African countries where malaria infects about 515 million persons a year and is responsible for 1.5 to 2 million deaths per annum among children under age 5.…”