Cost and performance of malaria surveillance: the patients' perspectives

The study sought to determine the average total costs incurred by patients attending three different types of malaria surveillance service (Malaria Clinics (MC), Village Health Centres (VHC) and Village Malaria Volunteers (VMV) and the factors affecting attendance at a particular type of service. All patients attending malaria surveillance points in two zones (3 and 7) in Region 1, were interviewed during the month of November 1985 (n = 2547) using structured questionnaires. Average total costs to patients varied between 140 Baht at VMVs in Zone 3 to 320 Baht at MCs in the same zone. Eight to fifteen percent was explicit cost (cost of travel and cost of self-prescribed drugs) with the remainder implicit costs (time costs). Average self treatment costs exceeded the average travelling costs incurred by patients attending each of the three types of service. Most patients sought diagnosis at a service point because of headache or fever. However in Zone 3, 20% of all patients sought blood testing and treatment because they had travelled outside their village. The average time between the onset of symptoms (fever or headache) and attendance at a service point ranged from 2.3 to 6.0 days. Many patients decided not to attend their nearest service point, 35% of patients at VMVs (Zone 3) and 80% of patients at MCs (Zones 3 and 7). The major single reason for not attending the nearest service point was convenience of travel.(ABSTRACT TRUNCATED AT 250 WORDS)