Health literacy and household financial loss on malaria treatment for children under five in Ghana : a patients’ perspective

Millicent Ofori BOATENG*, Derek ASUMAN, Nuworza KUGBEY, Padmore Adusei AMOAH, Peter AGYEI-BAFFOUR, Ulrika ENEMARK

*Corresponding author for this work

Research output: Journal PublicationsJournal Article (refereed)peer-review


Inadequate health literacy increases medical costs and leads to poor health outcomes. However, there is a paucity of empirical evidence of such associations in sub-Saharan Africa. This study investigates how the household cost of malaria in children under five in Ghana varies based on different levels of health literacy.

A cross-sectional survey involving 1270 caregivers of children under five was conducted. The survey included health literacy questionnaire and several pieces of sociodemographic and behavioural variables.

We created seven caregiver health literacy profiles by scoring nine dimensions. The mean total cost for managing malaria among respondents was US$20.29 per episode. The total household cost for caregivers with high health literacy (Profile 1) (US$24.77) was higher than all other profiles, with the lowest cost (US$17.93) among the low health literacy profile (Profile 6). Compared with Profile 4, caregivers with high health literacy (Profile 1) spent more on managing malaria in children, while those with the lowest health literacy (Profile 7) spent less.

The current study presents a snapshot of malaria treatment costs, and argues that low health literacy may lead to increased costs due to possible reinfections from delayed healthcare use. There is a need for longitudinal studies to understand causal relationship between health literacy and household expenses on malaria treatment to inform policy development and interventions.
Original languageEnglish
Article numberihae022
JournalInternational Health
Publication statusE-pub ahead of print - 2 Apr 2024

Bibliographical note

© The Author(s) 2024. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.


  • caregivers
  • children
  • health literacy
  • household cost
  • malaria


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