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Health Policy Plan. 2005 Nov;20(6):337-46. Epub 2005 Sep 9.

Fever and its treatment among the more and less poor in sub-Saharan Africa.

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Development Research Group, The World Bank, 1818 H Street NW, Washington, DC 20433, USA.


This paper uses individual and household level data to explore empirically the associations between household wealth and the incidence and treatment of fever, as an indicator of malaria, among children in sub-Saharan Africa. The data used are from Demographic and Health Surveys collected in the 1990s from 22 countries where malaria is prevalent. The results suggest that the incidence of fever and its treatment are related to poverty in sub-Saharan Africa. Incidence is typically lower at the very top of the wealth distribution. The relationship, however, is not strong, especially after controlling for potentially confounding factors. Treatment patterns are strongly related to poverty as wealthier households are more likely to seek care or advice. While it is perhaps unsurprising that treatment from private sources increases with household wealth, government services--despite their public nature--are typically also used more by wealthier households. While general results hold for many of the countries, there is sufficient variation across countries that any policy seeking to reform the health sector in order to better cater to the poor needs to be informed by country-specific work.

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