Health Service Utilization in Amhara Region of Ethiopia

Abstract

Background: Information on health service utilization is crucial for planning, organizing and evaluation of health services. Objective: To assess perceived morbidity, and to examine the factors associated with utilization of health services in a population sample living in the Amhara Region of Ethiopia. Methods: Questionnaires were administered in 7 urban and 14 rural kebeles in four administrative zones during 1998. A total of 17 780 people were included in the study. Results: Of the 200 reported deaths, 118 (59%) visited health institutions for the killer disease. Over the 2-week period preceding the survey, 995 (5.6%) people claimed that they were sick and 38.7% of them visited health institutions. The most important reasons for not visiting health institutions were the belief that the disease did not need treatment in health institutions (31.9%), buying drugs from drug vendors (27.2), and visiting traditional healers (20.2%). In multivariate analysis, urban residence (odds ratio (OR)=2.8; 95% confidence interval (CI), 1.8-4.5) and educational status of the household head (OR=3.4; 95% CI, 2.1-5.5) were significantly related to utilization of modern health institutions. Adolescents and persons aged >60 years were less likely to visit modern health services. Conclusion: There is a wide gap between perceived morbidity, mortality, and modern health service utilization. In addition to the problems of accessibility and illiteracy of household heads, assumptions that modern health institutions are not helpful for certain disease conditions appear to be the main reason for low utilization of health services.