Determinants of health care seeking patterns and out-of-pocket expenditure for malaria treatment in Zambia

Abstract

Malaria illness places a severe burden on Zambia’s health sector and the country’s economic development. Despite being curable when treatment is sought appropriately, utilization of professional health care services amongst people suffering from malaria illness generally continues to be low in Zambia. With a lack of recent empirical evidence following several advances in Zambia’s campaign against malaria, we are uncertain of the current determinants of health care seeking patterns and out-of-pocket expenditures associated with seeking professional malaria treatment in Zambia. This study used data from the 2013 Zambia Household Health Expenditure and Utilisation Survey to investigate the determinants of health care seeking patterns and out-of-pocket expenditures associated with seeking professional malaria treatment. A Multinomial logistic regression model was used to investigate the former while the latter was investigated with a two part regression model. The study findings reveal urban residency, a higher level of the household head’s education, lower age of the ill individual and higher income to be associated with an increased probability of seeking appropriate malaria treatment. In addition, out of pocket expenditures are positively influenced by urban residency, greater distance travelled in seeking treatment, higher income, increased household head’s education and seeking professional care outside the public sector. From the findings, it is recommended that the government should continue with the construction of primary healthcare facilities in order to reduce the distances travelled and the costs incurred in seeking professional malaria treatment services, especially in the rural areas. It is also recommended that the government escalates awareness campaigns to encourage individuals to seek appropriate malaria treatment and caution on the dangers of self-medication, especially among the male population. Policy makers should also consider training personnel in drug stores on the diagnosis and appropriate treatment of malaria since self-medication is a popular health care option for many Zambians. Finally, it is recommended that the government considers policies to ensure equity in the utilization of malaria treatment services especially among households with lower income and individuals with little or no formal education. Future research may consider a full analysis of the annual disease burden of malaria in Zambia as well as an examination of expenditures associated with in-patient treatment and self-medication for malaria.