%0 Journal Article
%T Rethinking the economic costs of malaria at the household level: Evidence from applying a new analytical framework in rural Kenya
%A Jane M Chuma
%A Michael Thiede
%A Catherine S Molyneux
%J Malaria Journal
%D 2006
%I BioMed Central
%R 10.1186/1475-2875-5-76
%X Cross-sectional surveys in a wet and dry season provide data on treatment-seeking, cost-burdens and coping strategies (n = 294 and n = 285 households respectively). 15 case study households purposively selected from the survey and followed for one year provide in-depth qualitative information on the links between malaria, vulnerability and poverty.Mean direct cost burdens were 7.1% and 5.9% of total household expenditure in the wet and dry seasons respectively. Case study data revealed no clear relationship between cost burdens and vulnerability status at the end of the year. Most important was household vulnerability status at the outset. Households reporting major malaria episodes and other shocks prior to the study descended further into poverty over the year. Wealthier households were better able to cope.The impacts of malaria on household economic status unfold slowly over time. Coping strategies adopted can have negative implications, influencing household ability to withstand malaria and other contingencies in future. To protect the poor and vulnerable, malaria control policies need to be integrated into development and poverty reduction programmes.Malaria is commonly referred to as a disease of poverty and is mainly found in the poorest regions of the world [1,2]. Macro-level studies estimate that the per capita GDP in highly endemic regions is on average one-fifth that of non-endemic countries and that annual growth rates in malaria endemic countries are 1.3 percentage points lower than those of non-endemic countries, even after controlling for other factors known to influence economic growth, such as human capital and initial income [1-3]. Malaria is thought to contribute towards national poverty through its impact on foreign direct investment, tourism, labor productivity and trade. At the micro-level, malaria may cause poverty through spending on health care, income losses and premature deaths. Poor people are considered to be at particular risk of being
%U http://www.malariajournal.com/content/5/1/76