Infrastructure Provisioning and Health Service Utilization in Africa

2017 ◽  
Vol 3 (1) ◽  
pp. 47-69 ◽  
Author(s):  
Amm Quamruzzaman
Keyword(s):  
Health Service ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Access To Health Care ◽  
National Level ◽  
Health Sector ◽  
Local Health ◽  
African Countries ◽  
Individual Level ◽  
Different Levels

Although the positive developmental effects of infrastructure provisioning are well documented, research on the potential role of governance in the improvement of infrastructure performance and individual-level service utilization is lacking. I explore the effect of infrastructure provisioning on individual-level health service utilization, paying close attention to whether governance at different levels shapes people's access to health care. The different geographical levels of infrastructure provisioning, governance, and health service utilization require a multilevel analysis, which I perform using Afrobarometer Round 5 survey data on 34 African countries in a three-stage mixed-effects modeling. Results show that the presence of health infrastructure is crucial for enhancing people's health service utilization. However, people encounter certain problems when receiving services at their local health clinics or hospitals, and these problems are directly linked with governance in the health sector as well as overall governance at the country level. Improvements in people's health service utilization therefore require both better infrastructure provisioning and better governance at different levels, as the former does not guarantee the latter. Development scholars need to widen their focus beyond national-level governance and help policy makers identify at which level state interventions are most needed for removing barriers to development.

scholarly journals Health service utilization, perspectives, and health-seeking behavior for maternal and child health services in the Amazon of Peru, a mixed-methods study

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Christopher M. Westgard ◽  
Ally Rogers ◽  
Giselle Bello ◽  
Natalia Rivadeneyra
Keyword(s):  
Child Health ◽  
Health Service ◽  
Health Services ◽  
Service Utilization ◽  
Maternal And Child Health ◽  
Health Service Utilization ◽  
Local Health ◽  
Health Seeking ◽  
Seeking Behavior ◽  
And Child Health

Abstract Background Various factors influence health service utilization at the community level. Research on the barriers to uptake of local health services is essential to reduce maternal and child mortality and morbidity. The Amazon region of Peru has some of the poorest health indicators in the country. The current study set out to better understand the health-seeking behavior and perspectives of mothers in Amazonian communities, exploring individual- and contextual-level barriers for seeking care at local health facilities for common maternal and child health issues. Methods The study employed a mixed-methods design by conducting 50 structured interviews with mothers of children under the age of 4. The study took place in 5 communities in Loreto, Peru. The quantitative data was analyzed with descriptive statistics to identify participants’ socio-demographic characteristics and reported utilization of health services. The qualitative data was analyzed in three rounds: inductive codebook development, application of the codebook, and thematic synthesis to contextualize the quantitative results and better understand the perspectives of the mothers regarding maternal and child health issues and the local health services. Results Overall, reported health service utilization among study participants was relatively high. However, the mothers identified several individual- and contextual-level factors that may affect their experiences and the health-seeking behaviors of other mothers in their communities: (i) embarrassment, fear, and trust, (ii) insufficient number and poor attitudes of health personnel, (iii) limited supply of basic medicines and materials in the health facility, and (iv) low demand for family planning services and limited awareness of adolescent-specific services. Conclusion Several findings in the current study reflect the reduced conditions of health services, while others display that many mothers maintain a positive outlook on the health services available to them and are proactive in the care of their child. The study provides valuable insight into the use of local health services and the common perspectives that are hindering further uptake at the community level in the Amazon of Peru, with important implications for health policy.

scholarly journals Health literacy and health outcomes in China’s floating population: mediating effects of health service

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hai-YanYu ◽  
Wei-Ling Wu ◽  
Lin-Wei Yu ◽  
Lei Wu
Keyword(s):  
Health Literacy ◽  
Health Service ◽  
Health Services ◽  
Health Outcomes ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Mediating Effect ◽  
Floating Population ◽  
Equation Modeling ◽  
Mediating Effects

Abstract Background The floating population in China consists primarily of internal immigrants and represents a typical health vulnerable group. Poor health literacy has recently become an obstacle in the accessibility and utilization of health services for the vulnerable population, leading to adverse health outcomes. This study aimed to examine whether health literacy affected health outcomes in China’s floating population and whether health service utilization had a mediating effect between health literacy and health outcomes. Method The current study utilized a cross-sectional stratified, multistage, proportional to scale (PPS) study in Zhejiang Province, China, in November and December 2019. In total, 657 valid self-reported questionnaires were recovered and used for data collection. Questionnaires included questions regarding sociodemographic characteristics, health literacy, health outcomes, and health service utilization. Confirmatory factor analysis was used to test questionnaire validity; descriptive statistics were used to understand the demographic characteristics of the floating population; and structural equation modeling was used to determine whether health service utilization mediated health literacy and health outcomes. Results We report positive correlations between health literacy, health service utilization, and health outcomes. Mediation analysis demonstrated that health service utilization had partial mediating effects between health literacy and health outcomes. In the relationship between health literacy and health outcomes, the indirect effects of health service utilization accounted for 6.6–8.7% of the total effects. Conclusion Complete health literacy, through health care literacy and health promotion literacy, affects the mobile population’s initiative to use health services, which, in turn, affects health outcomes. Thus, improving the health literacy of the floating population will help to improve health outcomes. Furthermore, health service providers should enhance the diversity of health service supply to ensure that the floating population has the external resources to improve personal health literacy.

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