Preventive Measure Practices and Cost Associated with Malaria Treatment among Staff and Dependents at the University of Ibadan Health Service Center, Ibadan, Nigeria
Keywords:Cost, Malaria treatment, University staff, Preventive practice
The economic burden of malaria in endemic places is a major public health issue that has resulted in a variety of malaria prevention techniques. This study assessed malaria preventive measure practices and the cost of treating malaria among staff and dependents of the University of Ibadan using the patient and provider’s perspectives. This study was both retrospective and cross-sectional. The Retrospective phase involved estimating the direct cost of treating malaria for staff and dependents by the university management (based on the provider’s perspective) between April and September 2019. The direct cost of management which included cost of medications, laboratory investigations and personnel cost related to malaria treatment was calculated based on the hospital’s National Health Insurance Scheme (NHIS) tariff and the average worker’s salary per minute spent on patients, respectively. The cross-sectional phase between July and September 2021, involved the use of a structured questionnaire to assess 300 respondents’ preventive practices against malaria, self-treatment and the out-of-pocket (patient perspective) incurred by the patients in the treatment of malaria. Data were entered into SPSS version 23 and analyzed using descriptive statistics and Chi-square test with p<0.05 considered statistically significant. The total prescriptions retrieved from the NHIS section of the pharmacy unit of UHS during the study period were 17,132, of which 3774 (22.0%) contained antimalarial(s). The cost of treatment of malaria to the healthcare provider was estimated to be ₦15,127,919.8 ($414,463.0) for the 6 months with an average of ₦4,008.5±1,809.2 ($109.8±4.9) per each episode of malaria per patient. The mean age and monthly income of respondents were 48.4±11.8 years and ₦123,684±139,310.6 ($338.9±381.7), respectively. Self-medication claim of N2,189.3±3,189.2 ($6.00±8.7) for out-of-pocket treatment of an episode of malaria. Preventive measures against malaria adequately practiced by the respondents included; Insecticide-treated net (ITNs) 97 (32.5%), Indoor residual spray 44 (14.9%), clearing of bushes 177 (59.0%) and removal of stagnant water around residence 172 (57.3%). There was a significant association between the number of episodes of malaria and adequate use of ITN among participants (p=0.024). About half of the respondents (44.7%) had at least three episodes of malaria in the last 12 months before the study. The use of Insecticide-treated net and indoor residual spray is low among those who reported more frequent episodes of malaria. Malaria imposes a significant financial cost on healthcare providers, and steps to minimise these expenses by reducing the frequency of malaria episodes through improvement in the adoption of malaria prevention measures can be implemented.