Determinants of health care provider choice in Kenya

Abstract

Despite the governments' efforts to enhance good health through provision of highly subsidized or free medical care, patients have continued to respond to illnesses in diverse modalities. In Kenya, a large percentage of ill individuals continue to rely on lay care despite the strategies. The practice is obviously dangerous for the general population health considering that some sickness may turn out to be different from what the sick think, when diagnosed by qualified medical personnel. In this study, the determinants of health care provider choice in Kenya have been explored using data from "The Kenya National Health Accounts, Household Expenditure and Utilization Survey, 2003" which was conducted by Ministry of Health. The estimations are based on nested multinomial legit model. Individuals, households and provider characteristics have been used in the analysis with most of the variables having expected signs. Age of individual/household head and household size have a significant negative effect on the choice of provider. Similarly, monetary and non-monetary costs (total treatment time and distance to the health facility) have also been found to significantly influence the demand for health care negatively. Socio-economic status, education level and having a health insurance all have positive and significant effect on the choice of provider. III individuals are more responsive to changes in total treatment time than changes in cost of treatment at the public facilities. This indicates that quality (total treatment time as a quality measure) is more of a deterrent factor in choosing a public provider than the cost of treatment.