The determinants of access to formal health care services in Kenya

Abstract

Kenya, like most developing countries, has concentrated on the enhancement of good health through the provision of either free or highly subsidized health care services. Despite these strategies, a large percentage of ill individuals in Kenya have continued to rely on self-care or self-medication. Since the propensity to utilize various forms of health care varies from one individual to another, the factors that may encourage the use of one form of health care provider or another constitute an area of interest. This study has used individual characteristics and facility attributes to identify the factors which influence the choice of a formal health care provider in Kenya. The study used a national representative household survey conducted in Kenya in 2003 and adopted a multinomial logit specification in its analysis. The model was estimated using maximum likelihood estimation method. Most of the variables had the expected directions of influence. The results showed that education, attitude as influenced by the advice given by staff, attitude as influenced by employer/insurance requirement and treatment costs are important and had a negative effect in determining a shift between a health centre and a dispensary and also between a hospital and a health centre. Even though age was also important, it had a positive effect in determining a shift between a health centre and a dispensary and also between a hospital and a health centre. On the other hand, gender, education and attitude as influenced by the cleanliness of a facility were found to be important and had a negative effect in determining a shift between a hospital and a dispensary whereas attitude as influenced by advice given by staff, attitude as influenced by staffs qualification, attitude as influenced by employer/insurance requirement, waiting time and treatment cost were also important but had positive effects.