Utilization of outpatient modern health care and Associated factors in gambella town, gambella State, southwest ethiopia

Abstract

Background: Utilization of healthcare services by the people arise from a complex interaction of different factors as demographic, socioeconomic, morbidity profiles, and health service availability and quality. The objective of this paper assessed utilization of outpatient healthcare services conditional on illness report, and investigate factors that affect use of outpatient healthcare in Gambella town, southwest Ethiopia. Methodology: A community – based cross - sectional study by employed self-report of morbidity in the three months’ recall period was conducted in the five kebeles of Gambella town, southwest Ethiopia from August 07 to August 21, 2014. A total of 834 sampled households selected by simple random sampling methods were included in the study. Data were collected through face-to-face interview by employing a standardized structured pre-tested questionnaire. Data analysis was performed by SPSS Window version 21. Bivariate and multivariate logistic regression were performed to identify statistically significant factors at pvalue of less than 0.05 that affect utilization of outpatient modern healthcare services. Result: Half of the households participated in the study reported illness in the past three months. A 13.8% of morbidity report in study subjects in the past 3 months in the study area. Of those reported illness, 51.9% of them were utilize modern outpatient healthcare services. In the multivariate, perceived severe (AOR=6.76; 95%CI:3.14, 14.55) and moderate (AOR=4.14; 95%CI:2.22, 7.72) illness, ill person from richest20% (AOR=2.10; 95%CI:1.05, 4.16) and upper-middle (AOR=3.82; 95%CI:1.86, 7.85) quintile households, children under five years of age (AOR=5.21; 95%CI:2.30, 11.82), ill persons from households of heads attained college & above education (AOR=3.01; 95%CI:1.58, 6.04), ill persons from femaleheaded households (AOR=0.33, 95%CI:0.16, 0.68), and availability of health facility within walk travel time of less than 30 minutes (AOR=1.94; 95%CI: 1.10, 3.42) were significant determinants/ factors affecting utilization of outpatient modern healthcare services during sickness in Gambella town. Financial cost and physical access of health facilities were the most barriers in accessing modern medical care during sickness. Conclusion & recommendations: Utilization of outpatient healthcare services after sickness among the study participants in the study area was low. To increase utilization of healthcare services interventions like community-based health care insurance scheme should be put in place to reduce the financial burden faced by poor households in using healthcare services as they were most susceptible to ill-health. In bridging the gap in physical access of the community to healthcare facilities, bringing health facilities together with quality services closer to all communities may increase utilization of healthcare services by the populations in the study area. More importantly, investing in education will increase peoples’ use of healthcare services