SEASONAL-VARIATIONS OF HOUSEHOLD COSTS OF ILLNESS IN BURKINA-FASO

This paper assesses the seasonal variations of the time and financial costs of illness for rural households in Burkina Faso. It is based on a multiple round survey of 566 households, which included a time alloc ation study. The economic parameters of households which influence hea lth seeking behavior changed substantially between the dry and rainy s easons: revenues fell in the rainy season and were exceeded by expendi tures. Household production was at its peak in the rainy season result ing in significantly higher opportunity costs of time. At the same tim e illness perception changed: in the rainy season, significantly fewer illness episodes were perceived, and of those, the proportion perceiv ed as severe decreased over-proportionally. Households shifted their h ealer choice in the rainy season away from high cost treatment, such a s the hospital and dispensary, to low cost home treatment. For all the se reasons, households incurred significantly fewer costs of illness i n the rainy season (27% of dry season costs). Household health care ex penditures were reduced to 1/6 of dry season levels, the time costs in curred by healthy household members to tend to the sick was reduced to 1/5 and the time costs of work incapacity due to sickness fell to abo ut 1/2 of dry season levels. The authors stress the need to carry out research in all relevant seasons when studying health seeking behavior and the household costs of illness in order to avoid serious seasonal bias. They suggest policy options to increase health care utilization in the rainy season by reducing the financial and time costs of acces s to health care. Finally, the authors put forward a hypothesis to be tested by future research: They argue that the cognitive (changes in i llness perception) and behavioral changes (different health care seeki ng) reflect the high opportunity costs of time and the low availabilit y of cash households face during the rainy season. The paper discusses the negative implication that untreated illness has on the health sta tus of household members. Copyright (C) 1996 Elsevier Science Ltd