Factors influencing public and private healthcare utilisation in Uganda

Abstract

Background: In Uganda, health care utilisation remains very low despite a number of government reforms that have beenimplemented in the health sector since the 1990’s such as decentralization and removal of user fees in public health facilitiesamong others. Objective: To examine the factors influencing public and private health care utilisation in Uganda. Methods: The study used cross sectional data from the Uganda National Household Survey collected between July 2016 andJune 2017. Anderson’s conceptual framework was used to identify explanatory variables associated with choice of health careproviders and a multinomial logistic regression model was estimated. Results: Out of the 17,912 individuals who sought care, 36% used a government facility, 60% used private facility while 4% hadself- care/treatment. The results show that out of pocket health expenditure, age, level of education, marital status, residence,and type of illness significantly influenced choice of public healthcare providers. Similarly, utilisation of private healthcare providerswas associated with household welfare, level of education, residence, marital status, illness days, and type of illness. Conclusion: The findings highlight the need for a national health insurance scheme to reduce out of pocket payments for healthcare and enable the poor and vulnerable patients visit the modern health facilities. Keywords: Utilisation; multinomial logit; health care provider, policy; Uganda.