Household costs of 'malaria' morbidity: a study in Matale district, Sri Lanka

Shore-run economic consequences of 'malaria' on households were examined in a household survey in Matale, a malaria-endemic district of Sri Lanka. On average a household incurred a total cost of Rs 318 (US$ 7) per patient who fully recovered from 'malaria'. 24% of this was direct cost, 44% indirect cost for the patient and 32% indirect cost for the household. Direct costs were greater for those seeking treatment in the private sector. Notably a l arge proportion of direct costs was spent on complementary goods such as vi tamins and foods considered to be nutritional. Indirect cost was measured a nd valued on the basis of output/income losses incurred at the household le vel rather than using a general indicator such as average wage rate. Loss o f output and wages accounted for the highest proportion of the indirect cos t of the patients as well as the households. Relative to children, more you ng adults and middle-aged people had 'malaria' which also caused greater ec onomic loss in these age groups. Women tended to care for patients rather t han substitute their labour to cover productive work lost due to illness. W e compare the methods used by other researchers for valuing indirect cost, demonstrating the significant impact that methods of measurement and valuat ion can have on the estimation of indirect cost, and justify the recommenda tion for methodological research in this area.