The Economic Cost of Malaria and the Behavior of Farmers Towards Malaria Care in Amansie East And Kwaebbirem Districts of Ghana.

CHAPTER ONE

IN T R O D U C T IO N 1.0

The setting The amount of money a household is willing to devote to malaria care is related to the behaviour of the household towards general malaria care. Knowledge of such behaviour is useful in designing malaria control programmes and cost sharing schemes. Although malaria is the major health problem in Africa, there is very little research on its economic impact. Factors promoting certain patterns of health care seeking behaviour such as the user charges borne by' individuals and families for seeking health care were introduced recently. Comprehensive estimates of the economic costs of malaria to individuals and communities are rare in many African countries although they are important for decision making. 1.1 The Problem Agriculture is the main source of income in most rural areas in Ghana and labour is the most important single input in rural agricultural production apart from land. Malaria has important economic consequences for rural agricultural communities. The relatively high prevalence of the disease during and just after the rainy season which unfortunately coincides with peak agricultural activities have serious implications for agricultural labour supply 1 which has already been diminishing with increasing migration of young men and women to the cities. Often demand for agricultural labour supply overshoots its supply during the wet season and thus pull up wages for farm labour. With the increase in farm wages, households are expected to substitute hired labour with its own labour. However, this source of labour has been dwindling with children going to school and polygamy reducing in many communities. The households labour supply situation can be exacerbated when diseases such as malaria inflict on some of the members of the household. It is therefore important that immediate care is sought so that household productivity is not unduly compromised. The dramatic change in peoples behaviour towards health care observed after the introduction of the Hospital Fees Regulation (1985) in Ghana as documented by Waddington and Enyimayew (1988) suggests that there exist some form of relationship among cost of health care services, income and health care seeking behaviour of people. However,quantitative evidence is limited in the literature in many African countries. This makes it difficult to devise equitable health care financing schemes. The availability of the cost of care and knowledge about the malaria care seeking behaviour of individuals and or households will therefore be useful in guiding the enactment of pragmatic policies that will ensure the utilisation of health services for human resource development.