Malaria in the Republic of Guinea 2022–2023: costs associated with the care pathway from the patient’s perspective

Elhadj Marouf Diallo (), Fatoumata Bintou Traore, Alice Langlet, Letitia A. Onyango, Marie Blanquet, Bienvenu Salim Camara, Sidikiba Sidibe, Alioune Camara and Laurent Gerbaud
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Elhadj Marouf Diallo: Faculty of Health Sciences and Techniques, University of Conakry
Fatoumata Bintou Traore: Faculty of Health Sciences and Techniques, University of Conakry
Alice Langlet: University Clermont Auvergne, CNRS, Sigma Clermont, Pascal Institute
Letitia A. Onyango: Northwestern University
Marie Blanquet: University Clermont Auvergne, CNRS, Sigma Clermont, Pascal Institute
Bienvenu Salim Camara: Centre National de Recherche et de Formation en Santé Rurale (CNRFSR)
Sidikiba Sidibe: Faculty of Health Sciences and Techniques, University of Conakry
Alioune Camara: Faculty of Health Sciences and Techniques, University of Conakry
Laurent Gerbaud: University Clermont Auvergne, CNRS, Sigma Clermont, Pascal Institute

Health Economics Review, 2024, vol. 14, issue 1, 1-12

Abstract: Abstract Background Access to safe, financial affordable health care is a key factor in reducing health disparities. The malaria is a major public health issue, with significant economic implications in Guinea where the free malaria care services were introduced in 2010. This paper analyzes the costs associated with the care pathway for malaria patients in the Republic of Guinea. Methods An analysis of the costs associated with malaria disease was conducted using data from a cross-sectional survey on the determinants of malaria care pathway between December 2022 and March 2023. The data were collected in health facilities and at community health workers. According to the patient’s perspective, Time-Driven Activity-Based Costing (TDABC) and micro-costing approaches were used to assess the costs associated with care-seeking, cases management, and income loss. Results A total of 3300 patients were recruited in 60 health facilities. The majority were in urban areas (64.8%). One third of the patients were children under five years old. Over half of the patients or caregivers were without formal education, and most households were headed by husbands (78.5%). The median monthly income of the head of households was $116.0. Furthermore, after diagnosis, 25.5% of cases were uncomplicated malaria, 19.2% were complicated, and 52.2% were malaria associated with other diseases. Globally 41% of cases were on their first care pathway. The costs of care-seeking varied according to type of malaria, from $3.5 and $13.5 respectively for uncomplicated and complicated cases. The median direct costs of case management at health facilities were $7.3 (IQR: $4.1,13.3) for uncomplicated and $30.5 (IQR: 15.7, 51.4) for complicated cases. The total costs associated with the global care pathway differed across types of malaria and age groups, with median costs estimated at $17.4 (IQR: 6.7, 34.8) for uncomplicated cases and $43.5 (IQR: $ 19.7, 74.0) for complicated malaria. A delay in appropriate care-seeking accounted for 19% of the costs incurred by malaria patients in Guinea (p

Keywords: Malaria; Care pathway; Out-of-pockets expenses; Income loss (search for similar items in EconPapers)
Date: 2024
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DOI: 10.1186/s13561-024-00570-y

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