Factors associated with health services utilisation in the Philippines

Abstract

The thesis examines the relative contributions of community and household environments and individual characteristics to health services utilisation in the Philippines. The study also explores the disparity in services utilisation behaviour among the different types of community representing the different levels of urbanisation in the country. The utilisation of particular sources of treatment and prenatal care services and the acceptance of maternal tetanus immunisation were examined as illustrations of the curative and preventive aspects of health care. Variables reflecting the community and household environments and individual characteristics associated with the utilisation of these services were examined using primary data from the 1987 National Health Survey and administrative reports provided by the regional health offices of the Department of Health. The influence of community, household and individual-level variables varied according to the type of health service. Community-level factors (place of residence in particular) were important influences on the sort of health care provider used for treatment services ( especially among children under six). The utilisation of certain health providers in preference to other sources of treatment and prenatal care was explained more by household-level factors while the acceptance of maternal tetanus immunisation was accounted for by individual factors, particularly the source of prenatal care. Utilisation of a particular health care provider and the acceptance of maternal immunisation were influenced by community, household and individual factors. The utilisation of modern health care providers for treatment services was more common among residents of MetroManila. Not surprisingly, living in a community with limited public health resources had a negative effect on the utilisation of public personnel and acceptance of maternal immunisation, and a positive influence on the utilisation of private doctors for treatment and prenatal care. Factors in the household environment reflecting low socio-economic status discouraged the utilisation of private doctors but did not deter the utilisation of public health personnel or acceptance of maternal immunisation. The presence of a college-educated woman in the household influenced the utilisation of doctors for the treatment of children under six years, while household perceptions reflecting access and quality of health facilities in the community influenced the utilisation of public health personnel for prenatal care. The number of days since the illness started (in the case of treatment services) and education (in the case of prenatal care) were significant influences in the utilisation of doctors, particularly private doctors. Show more