CHAPTER 2:

LITERATURE REVIEW

This chapter presents reviews of literature in the scope of the study, it comprises literature on
malaria and how it is related to agriculture, malaria and how it affects the economic base of
farmers and their households and those relating to productivity especially concerning maize
farmers. As stated earlier on this field is relatively underexplored and thus literature relating to
the topic is very scant.

2.1 Malaria and Agriculture

According to Berg et al (2006) malaria has strong linkages with agriculture and farmers in
malarious regions have a central role to play in either the creation or control of the conditions
that favour the transmission of the disease. This they said, is because agricultural environments
provide conditions well suited for the breeding of the anopheles mosquito which transmits the
disease. They also highlighted that the use of broad spectrum insecticides by the farmers in the
control of insect pests on their farms contributes immensely to insecticide-resistance in the
mosquito vector which constitutes a major challenge in the global fight against malaria. Most
importantly they made mention of the fact that agriculture generates income and influences
living conditions, which can affect the transmission and severity of the disease malaria. Malaria
in turn impedes human output and agricultural productivity especially at times that agricultural
activities peak (in the wet season)

Asante F.A. et al (2009) also re-echoed the fact that human activities including agriculture have
been recognized as one of the reasons for the increased intensity of malaria around the world,
because it supports the breeding of mosquitoes that carry the malaria parasite.

From this literature we observe that it is generally agreed that malaria and agriculture are related
with latter providing the conditions necessary for the breeding of the vector that transmits the
disease.

2.2 Malaria and the Economic Base of Farmers And Households.

In their article, Attanayake et al (2000) described malaria as having immense direct and indirect
cost implications on households in Sri Lanka on average households incur a cost of US$7 per
patient who fully recovers from the disease the breakdown is as follows; 24% was direct cost
which largely included the drugs and complementary goods such as vitamins and foods
considered as nutrition. 44% in indirect cost for the patient which was measured ad valued on the
basis of output / income losses that were incurred at the household level and 32% in direct costs
for the household. They noted also that loss of output and wages accounted for the highest
proportion of indirect cost f patients and households. They further explained that since more
young adults and middle aged people relative to children had malaria, it caused greater economic
loss in those age groups.

Gallup et al (2001) reveal that in 1995 the income levels of countries with severe malaria were
only 33% of that of countries without malaria whether or not those countries were in Africa.
They continued by saying that within the half century, countries that have eliminated malaria
have all been either islands or subtropical countries and those countries have registered
substantially higher economic growth rates in the five years following the elimination of malaria
than those of their neighbouring countries. They also stated that countries with intense malaria
grew at 1.3% less per person per year and a 10% reduction in malaria was associated with 0.3
higher growth.

Even in Sri Lanka where health care services are free at the points of delivery, total cost burden
of malaria was approaching 10% of monthly household income according to Russells (2004), He
further said that here in Ghana, the cost f controlling malaria was estimated to be lower than the
value of output due to the disease making it very important to control the disease.

Sachs J. et al (2002) said that where malaria prospers most human society prospers least, ant that
the global distribution of per capita gross domestic product shows a striking correlation between
malaria and poverty and that malaria endemic countries have lower rates of economic growth.
He said that some of the ways malaria impedes development include; effects on fertility,
population growth, saving and investment, worker productivity, absenteeism, premature
mortality and medical costs.

Asenso-Okyere (1994) says that in the Ashanti communities of Kojo Ashong, Barekese
Barekuma and Oyereko where his stud was conducted malaria is understood as having adverse
impact on the ability of adults t go to work and children to go to school and that the annual
economic burden of malaria on Africa as a whole was $0.8 billion in 1987; and by 1995 was
expected to be $1.7 Billion.

Nur E. T. (1993) said that malaria generally affects low-income agriculture based segments of
the work force and identified the forms f productivity losses as complete loss due to total
incapacitation from the disease, and partial loss resulting from workers toiling the fields at the
onset of infection or prior to full recovery, complete labour withdrawal was highest at harvest
while partial loss was highest just before harvest. This phenomenon caused women and children
to fill the labour void that was left and where they could not be called upon, other tenants helped
on a reciprocal basis.

The Economics of Malaria (1999), showed that in Kenya and Nigeria respectively, production
losses due to malaria rage from 2 -6% and 1- 5% and a percentage of work days lost to malaria
are 3 – 14% for Kenya and 1 – 8% for Nigeria it further went on to explain that these losses of
productive working hours were either due to adults falling ill or they taking care of children who
have fallen ill.

Our study is going to be different from those reviewed above because we shall first seek to find
out the nature of the effects of malaria on the farmers then well shall further attempt to determine
the extent to which malaria morbidity affects to productive output of farmers and further suggest
ways of dealing with reducing the menace.