Health facility utilization differentials: a case of Mathare and Soweto slums, Nairobi
Keraka, Margaret N.
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Evidence from studies carried out by KDHS (1998), UNCHS (1996), Hardoy (1990), Republic of Kenya (1988), UNICEF and WHO 1984 and AMREF (1989) indicate high levels of child mortality in Nairobi. This has been attributed to disparities in availability and utilization of health care facilities and services. This paper, therefore, aims at examining the extent of provision and utilization of health care services, factors affecting utilization and provision of health care facilities, impact ofthe existing disparities in the usage and provision of health on child morbidity, indigenous medical beliefs relating to common ailments, use of traditional and biomedical service. It also gives recommendation of how such disparities and their impact can be avoided. Primary data collected using in-depth interviews and focus group discussion was used. The respondents were mainly caretakers of children under five years and clinical officers from private and public hospitals. Secondary data was also obtained from the KDHS (1998) and thel999 Kenya population Census.The study established that there were fewer modem health care facilities and that the rate of utilization was low. This is evident from the fact that there were more disease incidences reported in study areas compared to those found in the 1999 population Census for Nairobi province.It was recommended that the government gives small loans to slum dwellers that can be used to start income generating activities. This will in turn assist them to participate effectively in the cost-sharing expenditure in medicine. In addition, that there should be increased awareness campaigns to recognize the importance of utilizing available health care facilities.