期刊论文详细信息
Malaria Journal
Household health care-seeking costs: experiences from a randomized, controlled trial of community-based malaria and pneumonia treatment among under-fives in eastern Uganda
Research
Aisha Nanyiti1  Fred Matovu2  Elizeus Rutebemberwa3 
[1] School of Economics, Makerere University, PO Box 7062, Kampala, Uganda;Development Economics Group, Wageningen University and Research Centre, Wageningen, Holland, Netherlands;School of Economics, Makerere University, PO Box 7062, Kampala, Uganda;Policy Analysis and Development Research Institute, PO Box 16064, Kampala, Uganda;School of Public Health, College of Health Sciences, Makerere University, PO Box 7062, Kampala, Uganda;
关键词: Household cost;    Health care-seeking;    Malaria;    Pneumonia;   
DOI  :  10.1186/1475-2875-13-222
 received in 2014-05-26, accepted in 2014-06-01,  发布年份 2014
来源: Springer
PDF
【 摘 要 】

BackgroundHome and community-based combined treatment of malaria and pneumonia has been promoted in Uganda since mid 2011. The combined treatment is justified given the considerable overlap between the symptoms of malaria and pneumonia among infants. There is limited evidence about the extent to which community-based care reduces healthcare-seeking costs at the household level in rural and urban settings. This paper assesses the rural–urban differences in direct and indirect costs of seeking care from formal health facilities compared to community medicine distributors (CMDs).MethodsExit interviews were conducted for 282 (159 rural and 123 urban) caregivers of children below five years who had received treatment for fever-related illnesses at selected health centres in Iganga and Mayuge districts. Data on the direct and indirect costs incurred while seeking care at the health centre visited were obtained. Using another tool, household level direct and indirect costs of seeking care from CMDs were collected from a total of 470 caregivers (304 rural and 166 urban). Costs incurred at health facilities were then compared with costs of seeking care from CMDs.ResultsHousehold direct costs of seeking care from health facilities were significantly higher for urban-based caregivers than the rural (median cost = US$0.42 for urban and zero for rural; p < 0.0001). The same is true for seeking care from CMDs (p = 0.0038). Overall, caregivers travelled for an average of 75 min to reach health centres and spent an average of 80 min at the health centre while receiving treatment. However, households in rural areas travelled for a significantly longer time (p < 0.001 to reach health care facilities than the urban-based caregivers. Besides travelling longer distances, rural caregivers spent 150 min seeking care from health facilities compared to 30 min from CMDs.ConclusionTime and monetary savings for seeking care from CMDs are significantly larger for rural than urban households. Thus, home and community-based treatment of child febrile illnesses is much more cost-saving for rural poor communities, who would spend more time travelling to health facilities - which time could be re-directed to productive and income-generating activities.

【 授权许可】

CC BY   
© Matovu et al.; licensee BioMed Central Ltd. 2014

【 预 览 】
附件列表
Files Size Format View
RO202311105210746ZK.pdf 232KB PDF download
【 参考文献 】
  • [1]
  • [2]
  • [3]
  • [4]
  • [5]
  • [6]
  • [7]
  • [8]
  • [9]
  • [10]
  • [11]
  • [12]
  • [13]
  文献评价指标  
  下载次数:0次 浏览次数:0次