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There is little evidence on the impact of malaria control on the health system, particularly at the facility level. Using retrospective, longitudinal facility-level and patient record data from two hospitals in Zambia, we report a pre-post comparison of hospital admissions and outpatient visits for malaria and estimated costs incurred for malaria admissions before and after malaria control scale-up. The results show a substantial reduction in inpatient admissions and outpatient visits for malaria at both hospitals after the scale-up, and malaria cases accounted for a smaller proportion of total hospital visits over time. Hospital spending on malaria admissions also decreased. In one hospital, malaria accounted for 11% of total hospital spending before large-scale malaria control compared with < 1% after malaria control. The findings demonstrate that facility-level resources are freed up as malaria is controlled, potentially making these resources available for other diseases and conditions.


Comfort, A., et al. (2014). Hospitalizations and costs incurred at the facility level after scale-up of malaria control: Pre-post comparisons from two hospitals in Zambia. American Journal of Tropical Medicine and Hygiene 90(1) 20-32.

© 2014 American Journal of Tropical Medicine and Hygiene. Original published version available at

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