TY - JOUR

T1 - Access and utilisation of healthcare services in rural Tanzania

T2 - A comparison of public and non-public facilities using quality, equity, and trust dimensions

AU - Shayo, Elizabeth H.

AU - Senkoro, Kesheni P.

AU - Momburi, Romanus

AU - Olsen, Øystein E.

AU - Byskov, Jens

AU - Makundi, Emmanuel A.

AU - Kamuzora, Peter

AU - Mboera, Leonard E. G.

PY - 2016

Y1 - 2016

N2 - This study compared the access and utilisation of health services in public and non-public health facilities in terms of quality, equity and trust in the Mbarali district, Tanzania. Interviews, focus group discussions, and informal discussions were used to generate data. Of the 1836 respondents, 1157 and 679 respondents sought healthcare services on their last visit at public or non-public health facilities, respectively. While 45.5% rated the quality of services to be good in both types of facilities, reported medicine shortages were more pronounced among those who visited public rather than non-public health facilities (OR = 1.7, 95% CI 1.4, 2.1). Respondents who visited public facilities were 4.9 times less likely than those who visited non-public facilities to emphasise the influence of cost in accessing and utilising health care (OR = 4.9, CI 3.9–6.1). A significant difference was also found in the provider–client relationship satisfaction level between non-public (89.1%) and public facilities (74.7%) (OR = 2.8, CI: 1.5–5.0), indicating a level of lower trust in the later. Revised strategies are needed to ensure availability of medicines in public facilities, which are used by the majority of the population, while strengthening private–public partnerships to harmonise healthcare costs.

AB - This study compared the access and utilisation of health services in public and non-public health facilities in terms of quality, equity and trust in the Mbarali district, Tanzania. Interviews, focus group discussions, and informal discussions were used to generate data. Of the 1836 respondents, 1157 and 679 respondents sought healthcare services on their last visit at public or non-public health facilities, respectively. While 45.5% rated the quality of services to be good in both types of facilities, reported medicine shortages were more pronounced among those who visited public rather than non-public health facilities (OR = 1.7, 95% CI 1.4, 2.1). Respondents who visited public facilities were 4.9 times less likely than those who visited non-public facilities to emphasise the influence of cost in accessing and utilising health care (OR = 4.9, CI 3.9–6.1). A significant difference was also found in the provider–client relationship satisfaction level between non-public (89.1%) and public facilities (74.7%) (OR = 2.8, CI: 1.5–5.0), indicating a level of lower trust in the later. Revised strategies are needed to ensure availability of medicines in public facilities, which are used by the majority of the population, while strengthening private–public partnerships to harmonise healthcare costs.

KW - access

KW - Health care

KW - quality

KW - Tanzania

KW - utilisation

U2 - 10.1080/17441692.2015.1132750

DO - 10.1080/17441692.2015.1132750

M3 - Journal article

C2 - 26883021

AN - SCOPUS:84959120235

VL - 11

SP - 407

EP - 422

JO - Global Public Health

JF - Global Public Health

SN - 1744-1692

IS - 4

ER -