Utilization of health care in an African urban area: Results from a household survey in Ouagadougou, Burkina-Faso

Develay, A.; Sauerborn, Rainer; Diesfeld, Hans Jochen

doi:10.1016/s0277-9536(96)00061-5

Cited by 54 publications

(66 citation statements)

References 16 publications

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“…Comparable results have been reported elsewhere (Kroeger 1983;Kloos et al 1987;Develay et al 1996;Van der Meer et al 1996;Fantahun and Degu 2003;Buor 2004;Ahmed et al 2005). In Ethiopia, most public medical services are cheap; for the poorest even free (Tassew et al 1996;Haile Mariam and Kloos 2006).…”

Section: Discussionsupporting

confidence: 90%

“…However, we cannot exclude that stigma delays health-seeking behaviour. The order in which treatment alternatives are explored cannot be fully appreciated with these data either, but they do suggest that patients expand the range of therapy with a longer duration of illness, and possibly also as their condition deteriorates (see also Feierman 1981;Kroeger 1983;Develay et al 1996;Ngalula et al 2002).…”

Section: Discussionmentioning

confidence: 99%

“…As in other developing countries, health services are often provided through several, sometimes overlapping, channels that include both modern and traditional forms of medicine and healing (Beals 1976;Feierman 1981;Kroeger 1983;Hunte and Sultana 1992;Develay et al 1996;Ngalula et al 2002;Nyamongo 2002;Hatchett et al 2004;Case et al 2005;de-Graft Aikins 2005). In Addis Ababa, the treatment with self-administered medicine (herbal or modern) and the pursuit of other alternative curative options are relatively common, despite the widespread availability of relatively cheap modern medical services (Kloos et al 1987;Gedif and Hahn 2002).…”

Section: Introductionmentioning

confidence: 99%

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Health services utilization during terminal illness in Addis Ababa, Ethiopia

Reniers¹,

Tesfai²

2009

Health Policy and Planning

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ObjectivesWe describe modern and alternative health services use in terminal illness of adults, and assess whether utilization patterns of TB/AIDS patients are distinct from those of patients suffering from other illnesses. MethodsData are from post-mortem interviews with close relatives or caretakers of the deceased. We provide descriptive statistics of health care utilization in adults and discuss their covariates in multivariate analyses. ResultsOver 85% of terminally sick patients visited a modern medical facility, but less than 40% spent more than 24 hours in a medical facility and only 25% died in one. Traditional healer (11%) and holy water (46%) visits offer a common treatment and healing alternative, but these visits do not co-vary in any consistent manner with the utilization of modern medical services. In terms of the cause of death, we find a higher contact rate with both modern and alternative medical service providers among TB/AIDS patients compared with those suffering from other medical conditions. The duration of illness seems to account for a good share of that variability. Other covariates of health services utilization are socio-economic status, education and age.Conclusions The contact rate of adults with modern medical facilities in terminal illness is almost universal, but their usage intensity is rather low. Alternative curative options are less commonly used, and do not exclude modern health services use. This suggests that both types of services are considered complements rather than alternatives for each other. Because the contact rate with health service providers is greatest for TB/AIDS patients, it is unlikely that HIV/AIDS-related stigma is an impediment to seeking care. We cannot exclude, however, that it delays health-seeking behaviour.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Health services utilization during terminal illness in Addis Ababa, Ethiopia

Reniers¹,

Tesfai²

2009

Health Policy and Planning

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“…Au Burkina-Faso, par exemple, une étude (Develay et al 1996) a montré que les populations recourent en priorité à l'automédication. Or, en ce moment à Ouagadougou, seuls 30% de la ville était couverts en SSP et les structures des soins périphériques étaient sous-équipées, tant en personnel qu'en matériel.…”

Section: Le Recours Aux Structures Des Soinsunclassified

“…Cependant, peu d'études similaires ont été menées en milieu urbain africain, surtout au sud du Sahara, afin de montrer les motifs du comportement de recours au centre de santé (Develay et al 1996).…”

Section: Introductionunclassified

Les déterminants du comportement de recours au centre de santé en milieu urbain africain: résultats d'une enquête de ménage menée à Kinshasa, Congo

Manzambi

Tellier

Bertrand

et al. 2000

Tropical Med Int Health

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RésuméCette étude analyse les déterminants de choix des populations pour les centres de santé par une enquête de comportement des ménages sur un échantillon représentatif de 1000 ménages, dans les zones de santé de Kinshasa, Congo en 1997. Pour le dernier épisode de maladie, les répondants ont recouru à 7 types des soins: le centre de santé (37%), le dispensaire privé (26,5%), l'automédication pharmaceutique (23,9%), le tradipraticien (21%), l'automédication traditionnelle (16,9%), la polyclinique conventionnée (16,7%) et un hôpital de référence (10,4%). La régression logistique a montré que l'on recourt d'autant plus au centre de santé qu'à une autre structure de soins (P Ͻ 0,05) lorsqu'on recherche la qualité des soins, l'application de bons tarifs et l'offre de services polyvalents. Par contre, le souci de proximité géographique par rapport au lieu de résidence du ménage appelle à utiliser le dispensaire privé. Lorsqu'on recherche la présence d'un médecin ou l'existence d'une convention on choisit plutôt la polyclinique privée conventionnée. Ceux qui ont cherché une solution à un type particulier de maladie ont plutôt choisi le tradipraticien. En conclusion, les résultats de cette étude montrent que si les populations choisissent les soins offerts par le centre de santé, c'est parce qu'elles les jugent de bonne qualité. Des soins intégrés et offerts par le même technicien, de formation requise, sont un atout majeur à l'acceptabilité du premier échelon des soins de santé primaires à Kinshasa. Cette étude suggère qu'il serait sans doute bénéfique d'intégrer les structures de soins privées non officielles dans le système des soins de santé primaires, pour autant qu'elles puissent atteindre un niveau de qualité comparable à celui des centres de santé. Pour que le tradipraticien puisse jouer un rôle complémen-taire important dans la réalisation des soins de santé primaires, même en milieu urbain, il est suggéré d'étudier la possibilité de privilégier des lieux de communication. En outre, étant donné le faible pouvoir d'achat des habitants de la ville et l'existence préalable des tontines de solidarité, des conventions apportant un allégement du coût des soins de santé dans le chef des communautés locales devraient pouvoir être intégrées dans l'organisation du système de santé urbain. SummaryThis study analyses the choice determinants of the population for health centres through a survey of the behaviour of families in a representative sample of 1000 households in the health districts of Kinshasa, Congo in 1997. For the most recent episode of illness, the respondents turned to seven types of care: the health centre (37%), private dispensaries (26.5%), self-medication through a pharmacy (23.9%), traditional practitioner (21%), traditional self-medication (16.9%), private outpatients' clinic (16.7%) and a reference hospital (10.4%). Past logistics have shown that patients resort to a health centre rather than another type of care structure (P ϭ 0.05) when looking for quality care, reasonable prices and the availabil...

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Are user charges efficiency‐ and equity‐enhancing? A critical review of economic literature with particular reference to experience from developing countries

Sepehri

Chernomas

2001

J of Intl Development

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User charges have come to play a significant role in the financing and delivery of publicly provided health services in many developing countries. As a response to health care financing crises, user charges are often promoted as a way of rationalizing the use of care, raising revenue, and improving the coverage and quality of services. The primary purpose of this paper is to provide a critical review of the main arguments for the efficiency- and equity-enhancing potential of user charges. The extent and scope of welfare gains from user charges are found to be very limited in practice. Using a less restrictive theoretical choice model and estimation technique, the most recent demand studies' findings indicate that household's utilization of health services are more responsive to changes in price and income than was initially reported by the early demand studies. Response to price changes are also found to be greater among the poor than the rich. These findings, combined with modest retained fee revenues and the failure of exemption mechanisms to protect the poor tend to cast doubt on the net benefits of user charges policy, particularly in the area of equity. Copyright © 2001 John Wiley & Sons, Ltd.

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Utilization of health care in an African urban area: Results from a household survey in Ouagadougou, Burkina-Faso

Cited by 54 publications

References 16 publications

Health services utilization during terminal illness in Addis Ababa, Ethiopia

Health services utilization during terminal illness in Addis Ababa, Ethiopia

Les déterminants du comportement de recours au centre de santé en milieu urbain africain: résultats d'une enquête de ménage menée à Kinshasa, Congo

Are user charges efficiency‐ and equity‐enhancing? A critical review of economic literature with particular reference to experience from developing countries

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