Health-Care-Seeking Patterns in the Emerging Private Sector in Burkina Faso: A Population-Based Study of Urban Adult Residents in Ouagadougou

Beogo, Idrissa; Liu, Chieh‐Yu; Chou, Yiing Jenq; Chen, Chuan Yu; Huang, Nicole

doi:10.1371/journal.pone.0097521

Cited by 19 publications

(28 citation statements)

References 63 publications

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“…Finally the utilization of private for pro t health facilities has been shown in previous research to be dependent on factors such as insurance coverage, high education level, and being a formal job holder (20). These ndings are consistent with our results which similarly indicate that education, health-insurance, monthly income and socio-economic status are strong predictors of where care is usually accessed.…”

Section: Discussionsupporting

confidence: 92%

“…Furthermore, better educated and wealthier participants in a Ghanaian based study were signi cantly more likely to visit private health facilities compared to public health facilities (22). Importantly, given the context of this current study, controlling for health-insurance was previously found to lessen the in uence of factors such as education and occupation (20). Our study reveals that potential impact on volumes could mean that while most high visit frequency patients currently access care in the public sector, a portion of these visits may be distributed to the private sector under NHI which might result in more than the estimated three annual visits per person per year (23) (24).…”

Section: Discussionmentioning

confidence: 65%

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Primary Healthcare Seeking Behaviour of Low-income, Uninsured Patients Across the Public and Private Health Sectors in South Africa

Govender¹,

Girdwood²,

Letswalo³

et al. 2020

Preprint

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Background: The proposed National Health Insurance (NHI) system aims to re-engineer primary healthcare (PHC) in South Africa, envisioning both private sector providers and public sector clinics as independent contracting units to the NHI Fund. In 2017, 16% of the South African population had private medical insurance and predominately utilised private providers. However, it is estimated that up to 28% of the population access private PHC services, with a meaningful segment of the low-income, uninsured population paying for these services out-of-pocket. The study objective was to characterise the health seeking behaviour of low-income, uninsured patients accessing PHC services in both the public and private sectors, patient movement between sectors, and factors influencing their facility choice. Methods: We conducted once-off patient interviews on a random sample of 153 patients at 7 private PHC providers (primarily providing services to the low-income uninsured patient population) and their matched public PHC clinic (7 facilities). Results: The majority of participants were economically active (96/153, 63%), 139/153 (91%) did not have health insurance, and 104/153 (68%) earned up to $621/month. A multiple response question found affordability (67%) and convenience (60%) were ranked as the most important reasons for choosing to usually access care at public clinics (48%); whilst convenience (71%) and quality of care (59%) were key reasons for choosing the private sector (32%). There is movement between sectors: 23/76 (30%) of those interviewed at a private facility and 8/77 (10%) of those interviewed at a public facility indicated usually accessing PHC services at a mix of private and public facilities. Results indicate cycling between the private and public sectors with different factors influencing facility choice. Conclusions: It is imperative to understand the potential impact on where PHC services are accessed once affordability is mitigated through the NHI as this has implications on planning and contracting of services under the NHI.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 65%

Primary Healthcare Seeking Behaviour of Low-income, Uninsured Patients Across the Public and Private Health Sectors in South Africa

Govender¹,

Girdwood²,

Letswalo³

et al. 2020

Preprint

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“…They consist of for-profit (FP) and non-for-profit providers (NFP); the former are defined as benefit-focused and the latter include philanthropic medical institutions. Institutional stewardship is further considered to complete the definition of the private healthcare sector, because in LMICs, services delivered in the private sector may be publicly financed—commonly in NFP [42]. …”

Section: Methodsmentioning

confidence: 99%

Determinants and materno-fetal outcomes related to cesarean section delivery in private and public hospitals in low- and middle-income countries: a systematic review and meta-analysis protocol

Beogo

Rojas²,

Gagnon

2017

Syst Rev

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BackgroundDespite the well-established morbidity, mortality, long-term effects, and unnecessary extra-cost burden associated with cesarean section delivery (CSD) worldwide, its rate has grown exponentially. This has become a great topical challenge for the international healthcare community and individual countries. Estimated at three times the acceptable rate as defined by the World Health Organization in 1985, the continued upward trend has been fuelled by higher income countries. Some low- and middle-income countries (LMICs) have now taken the lead, and the factors contributing to this situation are poorly understood. The expansion of the private healthcare sector may be playing a significant role. Distinguishing between the public and private hospitals’ role is critical in this investigation as it has not yet been approached. This review aims to systematically synthesize knowledge on the determinants of the CSD rate rise in private and public hospitals in LMICs and to investigate materno-fetal and materno-infant outcomes of CSD in perinatal period, between private and public hospitals.Methods/designWe will include studies published in English, French, Spanish, and Portuguese since 2000, using any experimental design, including randomized controlled trials (RCTs), non-RCTs, quasi-experimental, before and after studies, and interrupted time series. Outcomes of interest are the determinants of CSD and materno-fetal and materno-infant outcomes. We will only include studies carried out in private and public hospitals in LMICs. The literature searches will be conducted in the following databases: MEDLINE, Embase, CINAHL, Cochrane database, LILACS, and HINARI. We will also include unpublished studies in the gray literature (theses and technical reports). Using the two-person approach, two independent review authors will screen eligible articles, extract data, and assess risk of bias. Disagreements will be resolved through discussion with a third author. Results will be presented as structured summaries of the included studies. If possible, a meta-analysis will be conducted and, subsequently, an analysis for heterogeneity will be implemented.DiscussionThe proposed systematic review of the CSD rate rise will provide up-to-date evidence in regard to differences in proportions, determinants, and materno-fetal and materno-infant outcomes in perinatal period, between private and public hospitals in LMICs. We believe that this knowledge synthesis will help to shed light on the evidence and support evidence-informed decision-making with a view to addressing the issue in LMICs.Systematic review registrationPROSPERO CRD42016036871 Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-016-0402-6) contains supplementary material, which is available to authorized users.

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“…The foundations of Universal Health Coverage are grounded in public healthcare systems, yet private healthcare services play a crucial role in contributing to healthcare delivery in many lower-income countries [17], and are expanding in sub-Saharan Africa [18]. Examining factors associated with the type of outpatient healthcare provider among older adults may help to improve health service delivery and health system governance.…”

Section: Introductionmentioning

confidence: 99%

Predictors of public and private healthcare utilization and associated health system responsiveness among older adults in Ghana

Awoke

Negin

Möller

et al. 2017

Global Health Action

104

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Background: Previous studies investigating factors associated with healthcare utilization by older Ghanaians lack distinction between public and private health services. The present study examined factors associated with public and private healthcare service use, and the resulting perceived health system responsiveness. Objectives: To identify factors associated with public and private healthcare utilization among older adults aged 50 and older in Ghana; and to compare perceived differences in health system responsiveness between the private and public sectors. Methods: Cross-sectional data was analyzed from the World Health Organization Study on global AGEing and adult health (SAGE) Wave 1 in Ghana. Using Andersen’s conceptual framework, public and private outpatient care utilization was examined using multinomial logistic regression to estimate and identify predictor variables associated with the type of outpatient healthcare facility accessed. Health system responsiveness was compared using chi-square tests. Results: Of 2517 respondents who used outpatient care in the 12 months preceding interview, 51.7% of respondents used a public facility, 17.8% a private facility, and 30.5% used other facilities. Older age group, higher education and higher wealth were associated with the use of private outpatient healthcare services. Using public outpatient care facilities was associated with having health insurance. Respondents with two or more chronic conditions were more likely to use public and private outpatient care than other facilities. Perceived health system responsiveness was better in private for-profit than in public and private not-for-profit healthcare facilities. Conclusions: This study suggested that higher wealth and multimorbidity were significant predictors of public and private outpatient healthcare utilization; however, health insurance was a predictor only for the use of public facilities. Future mixed-method studies could further elucidate factors influencing the choice of public and private outpatient healthcare use.

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Health-Care-Seeking Patterns in the Emerging Private Sector in Burkina Faso: A Population-Based Study of Urban Adult Residents in Ouagadougou

Cited by 19 publications

References 63 publications

Primary Healthcare Seeking Behaviour of Low-income, Uninsured Patients Across the Public and Private Health Sectors in South Africa

Primary Healthcare Seeking Behaviour of Low-income, Uninsured Patients Across the Public and Private Health Sectors in South Africa

Determinants and materno-fetal outcomes related to cesarean section delivery in private and public hospitals in low- and middle-income countries: a systematic review and meta-analysis protocol

Predictors of public and private healthcare utilization and associated health system responsiveness among older adults in Ghana

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