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Does quality influence utilization of primary health care? Evidence from Haiti.
Gage, Anna D; Leslie, Hannah H; Bitton, Asaf; Jerome, J Gregory; Joseph, Jean Paul; Thermidor, Roody; Kruk, Margaret E.
Afiliación
  • Gage AD; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 1637 Tremont St Rm 105, Boston, MA, 02120, USA. agage@hsph.harvard.edu.
  • Leslie HH; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 1637 Tremont St Rm 105, Boston, MA, 02120, USA.
  • Bitton A; Department of Health Care Policy, Harvard Medical School, Ariadne Labs, Brigham and Women's Hospital and Harvard T.H. Chan School of Public Health, Boston, USA.
  • Jerome JG; Zanmi LaSante, Port-au-Prince, Haiti.
  • Joseph JP; Zanmi LaSante, Port-au-Prince, Haiti.
  • Thermidor R; Ministry of Health, Port-au-Prince, Haiti.
  • Kruk ME; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 1637 Tremont St Rm 105, Boston, MA, 02120, USA.
Global Health ; 14(1): 59, 2018 06 20.
Article en En | MEDLINE | ID: mdl-29925416
BACKGROUND: Expanding coverage of primary healthcare services such as antenatal care and vaccinations is a global health priority; however, many Haitians do not utilize these services. One reason may be that the population avoids low quality health facilities. We examined how facility infrastructure and the quality of primary health care service delivery were associated with community utilization of primary health care services in Haiti. METHODS: We constructed two composite measures of quality for all Haitian facilities using the 2013 Service Provision Assessment survey. We geographically linked population clusters from the Demographic and Health Surveys to nearby facilities offering primary health care services. We assessed the cross-sectional association between quality and utilization of four primary care services: antenatal care, postnatal care, vaccinations and sick child care, as well as one more complex service: facility delivery. RESULTS: Facilities performed poorly on both measures of quality, scoring 0.55 and 0.58 out of 1 on infrastructure and service delivery quality respectively. In rural areas, utilization of several primary cares services (antenatal care, postnatal care, and vaccination) was associated with both infrastructure and quality of service delivery, with stronger associations for service delivery. Facility delivery was associated with infrastructure quality, and there was no association for sick child care. In urban areas, care utilization was not associated with either quality measure. CONCLUSIONS: Poor quality of care may deter utilization of beneficial primary health care services in rural areas of Haiti. Improving health service quality may offer an opportunity not only to improve health outcomes for patients, but also to expand coverage of key primary health care services.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Atención Primaria de Salud / Calidad de la Atención de Salud Tipo de estudio: Observational_studies / Prevalence_studies / Risk_factors_studies Aspecto: Implementation_research Límite: Humans País/Región como asunto: Caribe / Haiti Idioma: En Revista: Global Health Año: 2018 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Atención Primaria de Salud / Calidad de la Atención de Salud Tipo de estudio: Observational_studies / Prevalence_studies / Risk_factors_studies Aspecto: Implementation_research Límite: Humans País/Región como asunto: Caribe / Haiti Idioma: En Revista: Global Health Año: 2018 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido