The effects of medicines availability and stock-outs on household's utilization of healthcare services in Dodoma region, Tanzania.
Cross-Sectional Studies
Drugs, Essential
/ supply & distribution
Health Care Surveys
Health Education
Health Facilities
/ statistics & numerical data
Health Services Accessibility
/ statistics & numerical data
Humans
Insurance, Health
/ statistics & numerical data
Patient Acceptance of Health Care
/ statistics & numerical data
Tanzania
Dodoma
Medicines availability
Tanzania
healthcare utilization
Journal
Health policy and planning
ISSN: 1460-2237
Titre abrégé: Health Policy Plan
Pays: England
ID NLM: 8610614
Informations de publication
Date de publication:
01 Apr 2020
01 Apr 2020
Historique:
accepted:
10
12
2019
pubmed:
17
1
2020
medline:
15
12
2020
entrez:
17
1
2020
Statut:
ppublish
Résumé
Low- and middle-income countries have been undertaking health finance reforms to address shortages of medicines. However, data are lacking on how medicine availability and stock-outs influence access to health services in Tanzania. The current study assesses the effects of medicine availability and stock-outs on healthcare utilization in Dodoma region, Tanzania. We conducted a cross-sectional study that combined information from households and healthcare facility surveys. A total of 4 hospitals and 89 public primary health facilities were surveyed. The facility surveys included observation, record review over a 3-month period prior to survey date, and interviews with key staff. In addition, 1237 households within the health facility catchment areas were interviewed. Data from the facility survey were linked with data from the household survey. Descriptive analysis and multivariate logistic regressions models were used to assess the effects of medicine availability and stock-outs on utilization patterns and to identify additional household-level factors associated with health service utilization. Eighteen medicines were selected as 'tracers' to assess availability more generally, and these were continuously available in ∼70% of the time in facilities across all districts over 3 months of review. The main analysis showed that household's healthcare utilization was positively and significantly associated with continuous availability of all essential medicines for the surveyed facilities [odds ratio (OR) 3.49, 95% confidence interval (CI) 1.02-12.04; P = 0.047]. Healthcare utilization was positively associated with household membership in the community health insurance funds (OR 1.97, 95% CI 1.23-3.17; P = 0.005) and exposure to healthcare education (OR 2.75, 95% CI 1.84-4.08; P = 0.000). These results highlight the importance of medicine availability in promoting access to health services in low-income settings. Effective planning and medicine supply management from national to health facility level is an important component of quality health services.
Identifiants
pubmed: 31942625
pii: 5702177
doi: 10.1093/heapol/czz173
pmc: PMC7152726
doi:
Substances chimiques
Drugs, Essential
0
Types de publication
Journal Article
Langues
eng
Pagination
323-333Informations de copyright
© The Author(s) 2020. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.
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