Demand for health services in Nairobi

Abstract

This study analyses factors that influence demand for selected types of health services in the City of Nairobi. The services studied are: Outpatient care, Immunization, Obstetric, Ante-Natal and Family Planning Services. The factors which determine demand for health services in the City of Nairobi were gouped into four categories, namely, socio-economic, environmental, quality and provider characteristics. The data used to eLt mate effects of these variables on utilization were collected through a field survey on patients attending various health facilities in Nairobi between Januery 26th and March 4th, 1988. A multi-stage sampling procedure was designed and used to collect data for this study. The estimated results indicate that economic variables, that is income, time, cost of treatment and of drugs have little effect on demand for outpatient services in Government and Nairobi City Commission facilities. But some of these factors, especially income, are very important determinants of health care demand in private facilities. The results further show that demand for medical services in Nairobi is not stable across different health care providers. Except for the government facilities, health care demand functions shift downwards as one moves from traditional clinics to modern health care facilities. vii The price and income elasticities obtained in this study are quite low. These elasticities suggest that ln order to increase demand for curative services in the City of Nairobi, prices paid by consumers (including time prices), would have to be reduced or their incomes increased by a large proportion so as to increase demand significantly. The study further demonstrates that demand for curative services provided by Nairobi City Commission facilities was increased by the closure of KNH's adult-outpatient services. These and other results are used to make some policy recommendations.