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Please use this identifier to cite or link to this item: https://hdl.handle.net/2445/123527
Patients' costs, socio-economic and health system aspects associated with malaria in pregnancy in an endemic area of Colombia
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Abstract
Malaria in pregnancy threatens birth outcomes and the health of
women and their newborns. This is also the case in low
transmission areas, such as Colombia, where Plasmodium vivax is
the dominant parasite species. Within the Colombian health
system, which underwent major reforms in the 90s, malaria
treatment is provided free of charge to patients. However,
patients still incur costs, such as transportation and value of
time lost due to the disease. We estimated such costs among 40
pregnant women with clinical malaria (30% Plasmodium falciparum,
70% Plasmodium vivax) in the municipality of Tierralta, Northern
Colombia. In a cross-sectional study, women were interviewed
after an outpatient or inpatient laboratory confirmed malaria
episode. Women were asked to report all types of cost incurred
before (including prevention), during and immediately after the
contact with the health facility. Median total cost was over
16US$ for an outpatient visit, rising to nearly 30US$ if other
treatments were sought before reaching the health facility.
Median total inpatient cost was 26US$ or 54US$ depending on
whether costs incurred prior to admission were excluded or
included. For both outpatients and inpatients, direct costs were
largely due to transportation and indirect costs constituted the
largest share of total costs. Estimated costs are likely to
represent only one of the constraints that women face when
seeking treatment in an area characterized, at the time of the
study, by armed conflict, displacement, and high vulnerability
of indigenous women, the group at highest risk of malaria.
Importantly, the Colombian peace process, which culminated with
the cease-fire in August 2016, may have a positive impact on
achieving universal access to healthcare in conflict areas. The
current study can inform malaria elimination initiatives in
Colombia.
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SICURI, Elisa, et al. Patients' costs, socio-economic and health system aspects associated with malaria in pregnancy in an endemic area of Colombia. PLoS Neglected Tropical Diseases. 2018. Vol. 12, num. 5, pags. e0006431. ISSN 1935-2727. [consulted: 16 of August of 2026]. Available at: https://hdl.handle.net/2445/123527