Determinants of access and utilization to health care services post medical research: a case of a malaria vaccine trial in Kilifi County, Kenya

Abstract

Health care is acknowledged as one of the basic rights of every human being. Different strategies have been recognized to ensure improvement in health care. Some of the strategies employed by different governments include medical research to enhance the search of appropriate interventions. However, despite the strategies put in place, studies have shown that uptake of the developed interventions has been way below expectations. Empirical findings have identified different factors that could determine uptake of the services to the targeted population. These factors include knowledge, attitude and cultural values and beliefs in relation to the health problem and recommended service; affordability, accessibility, perceived quality of care as well as the attitudes of health care services providers; distance from health care facility, household income, authoritative sources of information among others. Medical research projects conducted in Health Facilities (HF) especially in developing countries often provide support in form of construction or expansion of facility buildings, hire additional staff and provide improved quality of care (ambulatory services, skilled staff) and these could benefit all facility users. In resource poor settings, studies have shown that individuals join health research to utilize health care services, often provided for free in studies especially in context of vast unmet health needs. Consequently, exit of research projects have the potential to impact negatively on the healthcare services uptake when project resources and services are removed. Little is known about the potential effects when research projects are withdrawn especially on the access and utilization of health care services, hence the need for more empirical work. This project, focussed on the determinants of access and utilization of health care services after the exit of a Malaria vaccine trial, which was carried out by Kenya Medical Research Institute/Wellcome Trust Research Programme (KWTRP) in Kilifi County. Objectives of the study were to establish how economic factors, quality of care and cultural values and beliefs determined access and utilization of health care services post medical research. The study was carried out in Madamani community which had participated in the malaria vaccine trial. It involved a sample of 22 respondents who took part in In-depth interviews, Focus Group Discussions and filling questionnaires. It employed a descriptive survey research design. The study identified economic factors, quality of care, severity of illness as well as cultural values and beliefs as key determinants for access and utilization to health care services after the exit of a trial