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Globalization and Health
Published in: Globalization and Health 1/2018

Open Access 01-12-2018 | Research

Does quality influence utilization of primary health care? Evidence from Haiti

Authors: Anna D. Gage, Hannah H. Leslie, Asaf Bitton, J. Gregory Jerome, Jean Paul Joseph, Roody Thermidor, Margaret E. Kruk

Published in: Globalization and Health | Issue 1/2018

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Abstract

Background

Expanding coverage of primary healthcare services such as antenatal care and vaccinations is a global health priority; however, many Haitians do not utilize these services. One reason may be that the population avoids low quality health facilities. We examined how facility infrastructure and the quality of primary health care service delivery were associated with community utilization of primary health care services in Haiti.

Methods

We constructed two composite measures of quality for all Haitian facilities using the 2013 Service Provision Assessment survey. We geographically linked population clusters from the Demographic and Health Surveys to nearby facilities offering primary health care services. We assessed the cross-sectional association between quality and utilization of four primary care services: antenatal care, postnatal care, vaccinations and sick child care, as well as one more complex service: facility delivery.

Results

Facilities performed poorly on both measures of quality, scoring 0.55 and 0.58 out of 1 on infrastructure and service delivery quality respectively. In rural areas, utilization of several primary cares services (antenatal care, postnatal care, and vaccination) was associated with both infrastructure and quality of service delivery, with stronger associations for service delivery. Facility delivery was associated with infrastructure quality, and there was no association for sick child care. In urban areas, care utilization was not associated with either quality measure.

Conclusions

Poor quality of care may deter utilization of beneficial primary health care services in rural areas of Haiti. Improving health service quality may offer an opportunity not only to improve health outcomes for patients, but also to expand coverage of key primary health care services.
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Metadata
Title
Does quality influence utilization of primary health care? Evidence from Haiti
Authors
Anna D. Gage
Hannah H. Leslie
Asaf Bitton
J. Gregory Jerome
Jean Paul Joseph
Roody Thermidor
Margaret E. Kruk
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Globalization and Health / Issue 1/2018
Electronic ISSN: 1744-8603
DOI
https://doi.org/10.1186/s12992-018-0379-0

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