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[ Recorded presentation ] Recorded presentation

Burden on households to finance malaria services in Rwanda; equity implications

Susna R. De, MSc, MPH, International Health Area, Abt Associates Inc., 214 Stanley Drive, Waterloo, ON N2L 1H4, Canada, 519 342 7948, susna_de@abtassoc.com and Ken Carlson, Abt Associates, 55 Wheeler Street, Cambridge, MA 02138.

Malaria is the leading cause of morbidity and mortality in Rwanda. Given this and the surge in targeted funds for HIV/AIDS, policymakers are concerned about the level of available funds for malaria. This paper presents a comprehensive review of malaria expenditures drawing upon primary and secondary data from households, providers, government, donors, and NGOs. It finds that only 16 percent of 2003 donor health funds (US$ 2.4m) were used for malaria care and prevention. In 2005, this share decreased to 3 percent (US$ 1.6m when scaled to 2003 prices), representing a sizeable drop in absolute and relative terms. Thus, malaria seems to be a decreasing priority for donors, which could mean that the burden of financing may, by default, shift to households or result in decreased use of malaria services. The study finds that households spend more (29% of all malaria health expenditures) on malaria services than the government (24%). Moreover, malaria is a significant burden for the poor. The richest quintiles are twice as likely as the poorest quintile to use hospitals, clinics, or health centres when suffering from malaria. The poor, by contrast, are more likely to see traditional healers (TH); in fact, of those who reported seeing TH, all were in the poorest quintile. In addition, 20% of the richest quintile self-medicates and this rate doubles at the poorer income levels. These findings highlight disparities with respect to accessing care. Such data can inform the resource allocation process so as to better address the needs of vulnerable groups.

Learning Objectives:

Keywords: Access to Health Care, Financing

Presenting author's disclosure statement:

Any relevant financial relationships? No

[ Recorded presentation ] Recorded presentation

Malaria: History, Equity, and Prevention

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA