Household and Health System Cost of malaria in Sub Sahara Africa: Systematic review analysis

Background Malaria is a significant public health problem in sub-Saharan Africa (SSA), causing a substantial burden on households and population. This systematic review aims to analyze the cost burden faced by malaria patients and health systems in sub-Saharan Africa (SSA) Methods We conducted the current review according to the Preferred Reporting Items for Systematic Reviews (PRISMA) guideline. Studies reporting direct and indirect outpatient and inpatient costs incurred by malaria patients and the health system in SSA were included in the review. A pooled mean estimate for household and health system costs of malaria was conducted using random effects model of the Dersimonia_Laird method using Stata version 17 software. Results We included 43 studies in the current analysis. Nearly a quarter of studies (21.74%) reported costs using both household and health system perspectives. The pooled outpatient household cost per episode of malaria was $23.03 (range $17.64–$28.42). For inpatient care of severe malaria, the average household cost per episode from the studies was $90.79 (range $64.93–$116.65). For health system costs, the average outpatient cost was $20.58 (range $5.88–$35.29), and the average inpatient cost was $94.18 (range $55.22–$133.15). Conclusions Our study found that malaria had a significant economic burden to households and health systems in SSA. Our findings provide important evidence for the planning of malaria programs and health insurance policies to optimise resource allocation and healthcare strategies for malaria in SSA.