The economic burden of illness for households: A review of cost of illness and coping strategy studies focusing on malaria, tuberculosis and HIV/AIDS

This paper from the Project on Disease Control Priorities in Developing Countries (DCPP) reviews and summarise studies that have measured the economic costs and consequences of illness for patients and their families, focusing on malaria, tuberculosis and HIV/AIDS. In particular it looks at household responses to these illness costs (such as borrowing and asset strategies), and the impact on household livelihoods and processes of impoverishment. Finally, it reviews studies that discuss ways in which health service characteristics exacerbate or mitigate illness costs for poor households.

The author argues that policy research and debates should address access constraints, factors that increase costs for poor households, and a range of other assets and strategies that households use to cope with illness costs. In addition to supporting direct medical costs, policy should focus on how to mitigate the indirect costs of illness such as transport and special foods. Government agencies must link with non-governmental and community-based organisations, not only on the issue of savings and assets, but also through counselling and caring initiatives. Finally, supporting the future assets of the community – children orphaned by AIDS and withdrawn from school – is a particularly urgent priority for governments. [adapted from author]