Enyi Etiaba, Obinna Onwujekwe, Benjamin Uzochukwu, Alex Adjagba.

1. Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine,
University of Nigeria Enugu-Campus, Enugu, Nigeria:
2. Department of Health Administration and Management, College of Medicine, University of Nigeria
Enugu-Campus, Enugu, Nigeria
3. Department of Community Medicine, College of Medicine, University of Nigeria Enugu- Campus,
Enugu, Nigeria
4. SIVAC Initiative, Agence de Medecine preventive (AMP), Paris.

Abstract
Background: Given the enormous economic burden of malaria in Nigeria and in sub-Saharan Africa, it is important to determine how different population groups cope with payment for malaria treatment. This paper provides new information about the differences in household coping mechanisms for expenditures on malaria treatment.

Methods: The study was undertaken in two communities in Southeast Nigeria. A total of 200 exit interviews were conducted with patients and their care givers after consultation and treatment for malaria. The methods that were used to cope with payments for malaria treatment expenditures were determined. The coping mechanisms were disaggregated by socio-economic status (SES).

Results: The average expenditure to treat malaria was $22.9, which was all incurred through out-of- pocket payments. Some households used more than one coping method but none reported using health insurance. It was found that use of household savings (79.5%) followed by reduction in other household expenses (22.5%) were the most common coping methods.
The reduction of other household expenses was signifcantly more prevalent with the average (Q4) SES group (p<0.05). .

Conclusion: People used different coping strategies to take care of their malaria expenditures, which are mostly paid outof-pocket. The average socio-economic household had to forego other basic household expenditures in order to cope with malaria illness; otherwise there were no other signifcant differences in the coping mechanisms across the different SES groups. This could be indicative of the catastrophic nature of malaria treatment expenditures. Interventions that will reduce the burden of malaria expenditures on all households, within the context of Universal Health Coverage are needed so as to decrease the economic burden of malaria on households.

Key words: malaria, coping, household, expenditures, payments, socio-economic status.
DOI: http://dx.doi.org/10.4314/ahs.v15i1.6