Preventive or Curative Treatment of Malaria? Evidence from Agricultural Workers in Nigeria

Investments in one’s health require a comparison of the potential benefits and costs of providing either preventive or curative care. While preventive care lowers the probability of falling ill, and is often less costly than curative treatments, it does not provide full insurance against illness. An advantage of curative treatments, while more expensive, is that they do not requiring up-front investment. Focusing on malaria among agricultural workers in Nigeria, we study the benefits of preventive versus curative care. Using a static bench mark model to estimate the expected income to workers from adopting either preventive or curative malaria treatment in one period underlines how the tradeoff depends crucially on the unconditional probability of infection and the effectiveness of the preventive treatment. Focusing on bednet use as preventive measure the results shows that workers only choose malaria prevention when using bednets reduces the probability of infection by 6 percentage points. A dynamic simulation that explicitly takes into account the epidemiological dynamics, modelling the probability of infection as a function of both preventative choices and epidemiological conditions shows higher expected incomes from adopting bednets, but income effects are consistently less than 5% of a standard deviation of a worker’s earnings. The results also indicate that there are no significant gains to adopting multiple malaria prevention measures in comparison to solely adopting a bednet. The results may be driven partly by low initial adoption levels of prevention which causes infection rates to remain high even if workers use preventive measures. The findings reinforce the importance of vector control strategies to be implemented in tandem with individual or household level preventative interventions.