In spite of interventions, cost of malaria treatment remains high in Nigeria
“I could only gather NGN1800, please help my granddaughter,” a 70-year old grandma begged the health officer in charge of a primary health center located at Oloya area in the heart of Ibadan southwest Nigeria.
In the midst of nursing mothers that brought their children to the clinic for immunization was the aged woman who brought a four-year old for medical examination.
The child was said to have high temperature (fever) which started about 6 days ago but was treated with herbal medications that was prepared by Grandma and was combined with paracetamol.
The fever was said to be well controlled until the child’s activities reduced. She lost interest in pleasurable activities, refused to eat and she started vomiting the night before presentation at the health center.
They immediately attended to the child. The center’s officers measured temperature and weight, in addition to a rapid test for malaria parasite was done which unsurprisingly came back positive (+++).
As tepid sponging was going on, the nurse beckoned Grandma.
“Card is two hundred naira and the tests are six hundred naira. Your granddaughter will receive injection for three days which will cost 1200 Naira. The antimalarial drug itself is N1200 making a total of N3200,” the nurse said.
The aged woman then rummaged her bag and could only gather N1800.
The nurse said scenarios like this are quite familiar at the primary health center and several others in other parts of the state and beyond. According to her, a large proportion of Nigerians that attend primary health centers cannot afford to pay for malaria diagnosis and treatment.
Medical experts that spoke to healthnews.africa noted that the high cost of treatment of malaria is still a barrier to the uptake of health services in low resource settings and a lot of infants are still dying even though they are not captured by government’s data since they did not present to the hospital.
“Reducing the cost of treatment would go a long way to encourage communities to patronize their so-called health facilities,” an expert said.
According to a study on the patronage and cost of malaria treatment in private hospitals in Ibadan north local government area south western, Nigeria, malaria accounts for about 60% of all clinic attendance in Nigeria.
About 300,000 children die of malaria annually while an estimated 4,500 pregnant women are lost annually on account of malaria in Nigeria alone. According to the study mentioned earlier, the average amount each patient is charged for treating uncomplicated malaria in Nigeria’s private hospitals was N3,941. Average amount spent on anti-malarial drugs was about N2,443 (62%) while N1,064 (27.7%) was spent on laboratory investigation and N406.00 (10.3%) for medical consultation.
Free treatment for malaria actually exists
“Antimalarial medications are free in state government-owned hospitals, though a lot of people are not aware because even my friends would call and ask for help to see doctors here, not knowing consultation at children outpatient is free of charge”, said Nurse A.O, a staff nurse at Adeoyo Maternity Teaching Hospital, Oyo state.
There appears to be very poor public awareness on the availability of free treatment and this also affected several other state-championed health initiatives.
If the grandma mentioned earlier was aware that medical consultation and treatment are free at the state hospital, she would only use a fraction of her N1800 to get to the hospital.
Since this is playing out across Nigeria, it is safe to say that the major setback to wide adoption of malaria control initiatives that offer free treatment is that the people the free drugs are meant for do not even know about their existence.
“When people know that they will be treated for free by experts, they won’t be wasting time talking to local practitioners and herbalists, they will choose to go to the clinic instead,” an analyst told health.africa
But there is a bigger question. If antimalarial medications can be obtained for free at secondary health facilities, why not also at the primary health centers across Nigeria where malaria management is competing with private establishments at the level where the community need them most?
“Primary health centers are situated in the community to make healthcare available, accessible, and affordable to individuals and community as a whole, when will Nigeria get it right?” the analyst quipped.