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|Title: ||Community perceptions and factors influencing utilisation of health services in Uganda|
|Authors: ||Bakeera, Solome|
Wamala, Sarah P.
Pariyo, George W.
|Issue Date: ||2009 |
|Publisher: ||BioMed Central|
|Citation: ||Bakeera, S.K., Wamala, S.P., Galea, S., State, A., Peterson, S., Pariyo, G.W. (2009). Community perceptions and factors influencing utilization of health services in Uganda. International Journal for Equity in Health, 8(25)|
|Abstract: ||Background: Healthcare utilization has particular relevance as a public health and development
issue. Unlike material and human capital, there is little empirical evidence on the utility of social
resources in overcoming barriers to healthcare utilization in a developing country context. We
sought to assess the relevance of social resources in overcoming barriers to healthcare utilization.
Study Objective: To explore community perceptions among three different wealth categories on
factors influencing healthcare utilization in Eastern Uganda.
Methods: We used a qualitative study design using Focus Group Discussions (FGD) to conduct
the study. Community meetings were initially held to identify FGD participants in the different
wealth categories, ('least poor', 'medium' and 'poorest') using poverty ranking based on ownership
of assets and income sources. Nine FGDs from three homogenous wealth categories were
conducted. Data from the FGDs was analyzed using content analysis revealing common barriers as
well as facilitating factors for healthcare service utilization by wealth categories. The Health Access
Livelihood Framework was used to examine and interpret the findings.
Results: Barriers to healthcare utilization exist for all the wealth categories along three different
axes including: the health seeking process; health services delivery; and the ownership of livelihood
assets. Income source, transport ownership, and health literacy were reported as centrally useful
in overcoming some barriers to healthcare utilization for the 'least poor' and 'poor' wealth
categories. The 'poorest' wealth category was keen to utilize free public health services.
Conversely, there are perceptions that public health facilities were perceived to offer low quality
care with chronic gaps such as shortages of essential supplies. In addition to individual material
resources and the availability of free public healthcare services, social resources are perceived as
important in overcoming utilization barriers. However, there are indications that having access to
social resources may compensate for the lack of material resources in relation to use of health care
services mainly for the least poor wealth category.
Conclusion: The differential patterning of social resources may explain or contribute to the
persisting inequities in health care utilization. Additional research using quantitative analytical
methods is needed to test the robustness of the contribution of social resources to the utilization
of and access to healthcare services.|
|Appears in Collections:||Research Articles (Health-Sciences)|
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