Community perceptions and factors influencing utilization of health services in Uganda
Community perceptions and factors influencing utilization of health services in Uganda
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DOI：
10.1186/1475-9276-8-25
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发表时间：
2009-07-14
影响因子：
4.8
通讯作者：
Pariyo, George W.
中科院分区：
文献类型：
--
作者：
Bakeera, Solome K.;Wamala, Sarah P.;Pariyo, George W.
背景：医疗保健利用作为一个公共卫生和发展问题具有特殊意义。与物质和人力资本不同，在发展中国家，社会资源在克服医疗保健利用障碍方面的效用几乎没有经验证据。我们试图评估社会资源的相关性，在克服障碍，以healthcare utilization.Study Objective：探讨三个不同的财富类别之间的社区观念的影响因素，医疗保健利用率在东部Uganda.Methods：我们采用了定性研究设计，使用焦点小组讨论（FGD）进行研究。最初举行社区会议是为了使用基于资产所有权和收入来源的贫困排名来确定不同财富类别（“最不贫困”、“中等”和“最贫困”）的FGD参与者。从三个同质财富类别进行了九个FGD。使用内容分析法对FGD的数据进行了分析，揭示了财富类别对医疗服务利用的常见障碍和促进因素。健康获取生计框架被用来检查和解释的findings.Results：障碍，医疗保健利用存在于所有的财富类别沿着三个不同的轴，包括：健康寻求过程;卫生服务的提供;和生计资产的所有权。收入来源，交通工具所有权和健康素养被报告为克服“最不贫穷”和“贫穷”财富类别的医疗保健利用的一些障碍的核心有用。“最贫穷”的财富类别热衷于利用免费的公共卫生服务。另一方面，也有人认为，公共卫生设施提供的护理质量低下，长期存在缺口，如基本用品短缺。除了个人物质资源和免费公共保健服务的提供之外，社会资源被认为是克服利用障碍的重要因素。然而，有迹象表明，有机会获得社会资源可能会弥补物质资源的缺乏，主要是为最贫穷的财富category.Conclusion：社会资源的差异模式可以解释或有助于持续存在的不公平的医疗保健利用。需要使用定量分析方法进行更多的研究，以测试社会资源对利用和获得保健服务的贡献的稳健性。
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.