Community and individual factors influencing healthcare use in Uganda

Abstract

Understanding key influencing factors of health service utilisation has a particular relevance as a public health and development issue. Furthermore, evidence on this subject is a good reference for public health policymakers. Previous studies have looked at sociodemographic and economic factors that influence use of maternal health services, malaria, HIV, and cancer treatment services. Little is known about key determinants of the general health service use regardless of the type of services. Also, none of these past studies have examined factors that influence healthcare use at individual and community simultaneously especially in Uganda’s context. Hence, this study examined the community and individual-level factors associated with healthcare utilisation Data used for analysis were obtained from 2017 Uganda National Household Survey conducted by UBOS in 10 regions of Uganda. The study adopted a two-stage stratified sampling design which allowed estimations at the national level. This study drew a sample of 9,648 household members aged 15 years and above. Data was analysed at univariate, bi-variate and multivariate level using StataSE 17.0. Of the 9,648 samples studied, 83.8% of those who fell ill or injured during the last 30 days of the survey actually sought healthcare services, this finding indicated high healthcare use. However, bivariate and multivariate analysis results revealed that health services utilisation was uneven for people of different communities and social class. In specific terms, sex, age, marital status, education level, severity of illness, residence and regions of location were significantly associated with healthcare use. Multivariate results showed that females had higher odds of using healthcare than males, older persons were less likely to use healthcare than the young, married persons were more likely to use compared to nonmarried, higher education level were associated to increased use of healthcare and the effects of community context on healthcare use was significant. In conclusion, both community and individual-level factors play significant role in determining health services utilisation, as such, the study recommends that government should ensure primary healthcare services are accessible by people of low social class and in all communities, but most importantly, strengthen community-based health extension services that suits community-specific context.