Heterogeneity in health seeking behaviour for treatment, prevention and urgent care in four districts in western Kenya.

Journal Article (Journal Article)

OBJECTIVES: The impact of effective, life-saving health interventions is limited by access to and use of health services. Health seeking behaviour is likely to vary geographically and by type of health concern. However, little is known about the extent of this heterogeneity. STUDY DESIGN: A representative cluster-randomized sample of households in four districts in western Kenya was interviewed using a structured, interviewer-administered survey. GPS coordinates of all households and all local health facilities were also collected. METHODS: Household surveys measured health seeking behaviour for three distinct health needs: family planning which is a form of prevention, delivery which is an urgent care need but can be planned in advance, and childhood febrile illness which is an unexpected and potentially life-threatening concern. Logistic regression models were used to explore the relationship between seeking health services and maternal and household characteristics, with special attention to geographic and financial access to care. RESULTS: Use of health services for these three different health issues varied between the districts and also differed from national estimates. Place of delivery was most strongly correlated with the type of health services available to the family, whereas family planning was correlated with the relationship of the mother to the head of household. There was no strong interaction between socio-economic status and distance to services. CONCLUSIONS: The level of services available nearest to households rather than the distance to travel influences treatment-seeking behaviour, particularly for urgent care. Maternal factors and household wealth were often important but, even within the same households, their effect changes based on the type of health concern. Generalizing from nationwide surveys may obscure important local heterogeneity, particularly in delivery location and fever treatment.

Full Text

Duke Authors

Cited Authors

  • O'Meara, WP; Karuru, S; Fazen, LE; Koech, J; Kizito, B; Tarus, C; Menya, D

Published Date

  • November 2014

Published In

Volume / Issue

  • 128 / 11

Start / End Page

  • 993 - 1008

PubMed ID

  • 25443099

Electronic International Standard Serial Number (EISSN)

  • 1476-5616

Digital Object Identifier (DOI)

  • 10.1016/j.puhe.2014.08.010


  • eng

Conference Location

  • Netherlands