Household Socio-demographic Characteristics and Progress towards Attainment of Universal Health Coverage in Kilimanjaro, Tanzania

Abstract

Universal Health Coverage (UHC) attainment has been associated with households’ socio-demographic characteristics. Empirical findings have hardly dwelt on assessing the association between household socio-demographic characteristics and UHC attainment. This article assessed the association between socio-demographic features and attainment of UHC in Kilimanjaro Region, Tanzania. Specifically, the article: (i) analysed the perceptions on households’ socio-demographic characteristics in relation to UHC factors; (ii) determined the association between socio-demographic characteristics and UHC attainment; and (iii) estimated the level of UHC service coverage in the study area. The study employed a cross-sectional research design in which 384 households were selected through a multi-stage sampling approach and interviewed using a questionnaire. The Kruskal Wallis H test and Mann Whitney U test were used as tests for association of socio-demographic variables and UHC factors. Geometric mean computation was used to estimate the level of UHC attainment. Results indicate; the level of UHC service coverage score of 69.9%, which is fairly good in relation to the WHO recommendation of 80%. Occupation (p = 0.012), general household health condition (GHHC) (p=0.039), health insurance membership (HIM) (p=0.039), and presence of non-communicable disease (p=0.032) were significantly associated with health services delivery quality. GHHC (p=0.041) was significantly associated with service accessibility. Income (p=0.000), occupation (p=0.000), education (p=0.004), health check-up frequency (p=0.001), and HIM (p=0.000) were significantly associated with health services affordability. Health services accessibility was not of great concern to most of the households. Some households could easily afford the cost of health services and others could not. Service providers, LGAs, and MoH should promote affordability and accessibility of health services by the population regardless of their socio-demographic characteristics. The promotion of a single universal health insurance fund is essential for improved progress to UHC attainment.