Quality and Demand for Health Care in Rural Uganda: Evidence from 2002/03 Household Survey

Good health, as people know from experience, is a crucial part of well-being and socioeconomic development. From an economic viewpoint, improved health contributes to growth in many ways. It reduces production losses caused by worker illness; it permits the use of natural resources that were inaccessible due to diseases; it frees resources for alternative use, other than being spent on treating illness; and it promotes child development through increased school enrolment and better learning. This report provides quantitative evidence on the importance of individual, household, and community characteristics on individual care seeking decisions during periods of illness. The report uses a "flexible" multinomial choice model to determine the key factors behind the decisions to seek a particular type of treatment using data from the 2002/03 National Household Survey for Uganda. This kind of analysis is premised on a basic theoretical framework of utility maximization and household production of health. In addition, complementary data on quality of facilities and costs were collected from sampled health facilities in the four regions (Central, Northern, Western and Eastern) of Uganda. The results show the importance of age, gender, per capita consumption (income) and number of days sick as individual determinants of health seeking behaviour. Surprisingly, education does not appear important in choice of health care in rural Uganda. The quality characteristics measured by structural indicators such as electricity and price characteristics stand out as important determinants of choice. The location also has an effect on choice of the type of health care provider. From a policy perspective, policies aimed at providing energy from gas and generators to improve quality, increasing incomes and price/cost reduction will have substantial outcomes on the demand for health care.