Large local variations in the use of health services in rural southern Ethiopia: An ecological study.

Autor:	Areru HA; School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.; Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway., Dangisso MH; School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia., Lindtjørn B; School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.; Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway.
Jazyk:	angličtina
Zdroj:	PLOS global public health [PLOS Glob Public Health] 2022 May 25; Vol. 2 (5), pp. e0000087. Date of Electronic Publication: 2022 May 25 (Print Publication: 2022).
DOI:	10.1371/journal.pgph.0000087
Abstrakt:	Ethiopia is behind schedule in assuring accessible, equitable and quality health services. Understanding the geographical variability of the health services and adjusting small-area level factors can help the decision-makers to prioritize interventions and allocate scarce resources. There is lack of information on the degree of variation of health service utilisation at micro-geographic area scale using robust statistical tools in Ethiopia. Therefore, the objective of this study was to assess the health service utilisation and identify factors that account for the variation in health service utilisation at kebele (the smallest administrative unit) level in the Dale and Wonsho districts of the Sidama region. An exploratory ecological study design was employed on the secondary patient data collected from 1 July 2017 to 30 June 2018 from 65 primary health care units of the fifty-four kebeles in Dale and Wonsho districts, in the Sidama region. ArcGIS software was used to visualise the distribution of health service utilisation. SaTScan analysis was performed to explore the unadjusted and covariate-adjusted spatial distribution of health service utilisation. Linear regression was applied to adjust the explanatory variables and control for confounding. A total of 67,678 patients in 54 kebeles were considered for spatial analysis. The distribution of the health service utilisation varied across the kebeles with a mean of 0.17 visits per person per year (Range: 0.01-1.19). Five kebeles with health centres had a higher utilisation rate than other rural kebeles without health centres. More than half (57.4%) of the kebeles were within a 10 km distance from health centres. The study found that distance to the health centre was associated with the low health care utilisation. Improving the accessibility of health services by upgrading the primary health care units could increase the service use. Competing Interests: The authors have declared that no competing interests exist. (Copyright: © 2022 Areru et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze:	MEDLINE
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