Where do people from different socio–economic groups receive diagnosis and treatment for presumptive malaria, in south–eastern Nigeria?

Authors: Onwujekwe, O.¹; Ojukwu, J.²; Uzochukwu, B.³; Dike, N.⁴; Ikeme, A.⁵; Shu, E.⁴

Source: Annals of Tropical Medicine and Parasitology, Volume 99, Number 5, July 2005 , pp. 473-481(9)

Publisher: Maney Publishing

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Abstract:

The relationship between the socio–economic status (SES) of a household and its sources of malaria diagnosis and treatment was explored in south–eastern Nigeria. One aim was to see if, as seems likely, the poorest people generally seek care from 'low-level' providers, such as traditional healers and community-based healthworkers, because of their severe budget constraints. Interviewer-administered questionnaires were used to collect information from 1197 randomly selected respondents from four villages where malaria is holo-endemic. An index was used to categorize the study households into SES quartiles. The self-diagnosis of presumptive malaria and the use of patent-medicine dealers for treatment were very common among all the SES groupings. Compared with the other interviewees, however, the least-poor were significantly more likely to rely on laboratory tests for diagnosis and to visit hospitals when seeking treatment for presumptive malaria. The most-poor, in contrast, were significantly more likely to seek treatment from traditional healers or community-based healthworkers. Thus, even though the use of low-level providers was so common, there was still evidence of wealth-related inequity — in terms of the probabilities of the good diagnosis and treatment of malaria. Improvements in the quality of malaria diagnosis and treatment by the providers patronised by the most-poor villagers would help to redress this inequity, at least in the short- to medium-term.

Document Type: Research article

DOI: 10.1179/136485905X51283

Affiliations: 1: Gates Malaria Partnership, London School of Hygiene and Tropical Medicine, 49–51 Bedford Square, London WC1B 3DP, U.K; Health Policy Research Unit, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria Teaching Hospital, P.M.B. 01129, Enugu, Nigeria 2: Department of Paediatrics, Ebonyi State University Teaching Hospital, P.M.B. 077, Abakaliki, Nigeria 3: Department of Community Medicine, College of Medicine, University of Nigeria, P.M.B. 01129, Enugu, Nigeria 4: Health Policy Research Unit, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria Teaching Hospital, P.M.B. 01129, Enugu, Nigeria 5: Department of Obstetrics and Gynaecology, College of Medicine, University of Nigeria, P.M.B. 01129, Enugu, Nigeria

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