Defining Access to Health Care: Evidence on the Importance of Quality and Distance in Rural Tanzania

Abstract

We examine the implications of health seeking behavior on access to quality health care using a unique dataset that combines a household survey from rural Tanzania with the location and quality of all health facilities available to households. Patients do not always visit the nearest facility, but choose from among multiple facilities, improving the quality of care they receive by bypassing low quality facilities. Recognizing this behavior alters the projected benefits to health interventions, reducing the value of focusing on the staff qualifications and increasing the value of focusing on travel time and the motivation of current staff.

Defining Access to Health Care: Evidence on the Importance of Quality and Distance in Rural Tanzania

“…We follow the implementation used in Leonard, Masatu, and Vialou (2007). An appendix to this paper details this process (Klemick, Leonard, and Masatu 2009).…”

A spatial decision support system for special health facility location planning in developing regions

“…Some health care seekers often bypass lower quality service to attend facilities providing higher quality services (Klemick et al, 2009). However in a study by Noor et al (2003) it was found that there is a correlation between actual and potential/ theoretical usage of public health facilities in Kenya.…”

Analyzing the Determinants of Health Worker Performance

“…Source: Klemick, Leonard, and Masatu 2009. Note: The figure shows the outcomes of 1,399 health episodes from a household survey in the rural Arusha region in Tanzania for which the patient has completed treatment matched with the average quality provided at the first facility visited for that illness.…”

“…An example of an instrument that can be used is included in the annex as table 7A.2 (Klemick, Leonard, and Masatu 2009). If the research is tracking the presence of individuals, an instrument that records the names of personnel would be necessary.…”