Browsing by Author "Okorafor, Okore"

Now showing 1 - 11 of 11
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    Analysis of equity in the pattern of health care utilisation in South Africa
    (2009) Olabimpe, Oboirien Kafayat; Okorafor, Okore
    The study seeks to assess South Africa’s health care utilisation pattern in the post apartheid era. This is based on the equity driven policy objectives of the health care system that were meant to have impact on individuals’ health care utilisation patterns. A framework of factors influencing health care utilisation is outlined to explain the determinants of health care utilisation. It gives some insights into the socio-economic and racial differences influencing the use and choice of health care in South Africa. It also attempts to investigate how these factors have changed and whether the pattern of health care utilisation among those with higher need has changed over time.
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    Demand for health care services in the urban areas of Zimbabwe : a case study of the Harare city
    (2003) Mapira, Wendy; Thiede, Michael; Okorafor, Okore
    The study attempts to evaluate the impact of the health sector deregulation policy on the choice of health care providers 12 years after its implementation. It gives some insights into the pattern of health care choices in Harare, the capital city of Zimbabwe with the aim of drawing some conclusions about the urban areas of Zimbabwe. The other objective is to highlight the impact of personal characteristics and factors related to the facility on the choice between public and private health care providers. Some coping mechanisms being used by urban dwellers in dealing with illness are also investigated. Micro data was gathered by administering a questionnaire to randomly selected individuals who experienced some illness or injury during the reference period. For empirical estimation, logistic regression was used. The results of the study show that the urban poor rely heavily on public health care providers, informal forms of care, and they have limited access to private sector facilities. Although the deregulation policy managed to bring in new players in the health sector, the amount of competition was not enough to lower the cost of health care because the cost of drugs and consultation fees continued to soar. The major factors found to influence health care choices are gender, net monthly income, education, occupation, and availability of essential drugs, fees and the cost of drugs. The results of the study show a clear message that deregulation of the health sector did manage to increase the size of the private sector but failed to widen the scope of provider choices especially for the poorer urban residents.
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    Economic consequences for households of illness and of paying health care in Zimbabwe: A case study
    (2009) Maredza, Mandy; Okorafor, Okore
    This study investigates the economic consequences of illness and of paying for health care in Zimbabwe. It explores the incidence of out-of-pocket (OOP) payments, catastrophic health expenditure (CHE), impoverishment and the factors, (particularly socio-economic factors) associated with them. In addition, this study determines the strategies that households employ to cope with the financial burden of OOP payments in Zimbabwe. Data was collected from 499 households in Harare urban and Seke rural districts of Zimbabwe. Total monthly household OOP health expenditure was defined as 'catastrophic' if it exceeded the threshold level of 40% of a household's monthly capacity to pay. Logistic regression analysis was used to identify the factors that influence the incidence of CHEs. A non-poor household was impoverished by OOP health expenditure if its total household expenditure after deducting OOP payments was lower than the subsistence expenditure. The results of this study indicated that, the incidence of CHEs was very high amongst the study population. Households at all levels of wealth incurred catastrophic health expenditures, and the proportion of households incurring CHEs was similar across the asset quintiles. Out-of-pocket payments precipitated impoverishment of non-poor households. Poor households, households with members above 65 years, female headed households, households with member(s) suffering from chronic illness and households with greater use of health services were at higher risk of incurring CHEs. On the contrary, households with a disabled member were less likely to incur CHEs. Besides 'avoiding seeking care', selling of assets and borrowing were the 2 most popular strategies used to cope with OOP health care payments. An analysis of these results suggests that, targeted exemption of vulnerable households, as well as provision of subsidised health services could reduce the economic impact of illness on households. The results of this study also point out to the need for strengthening risk pooling mechanisms through the implementation of community based health insurance schemes and enhancing tax collection. In addition, other strategies that extend beyond the health sector such as economic empowerment of women could be effective in mitigating the economic impact of illness amongst female headed households in Zimbabwe.
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    Equity in the allocation of primary health care resources in Uganda
    (2006) Kiracho, Elizabeth Ekirapa; Okorafor, Okore
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    Factors associated with diabetes prevalence and utilisation of diabetes care services in Mauritius
    (2010) Diop, Kine Bibi; Okorafor, Okore
    Diabetes is a growing problem worldwide. It is estimated that at least 171 million people have diabetes worldwide and this figure is projected to more than double by 2030. Mauritius has not been spared from diabetes. Indeed, it has one of the highest diabetes prevalence in the world. It is creating tremendous pressure not only on households but on the health care system.
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    Factors influencing the price of medical services : a survey of the pricing behaviour of private medical providers in Kampala, Uganda
    (2004) James, Batuka; Okorafor, Okore; Thiede, Michael
    Understanding the pricing behaviour of medical providers in private clinics is important for the effective regulation of the private sector and ensuring that there is no extortion of patients. There is a global trend to encourage delivery of health services by the private sector reducing the public role to stewardship. Understanding the factors that influence the price of medical services in an out of pocket setting is important in designing strategies necessary to control the price of medical care. The study investigated the factors that influenced the price of medical services in Kampala district, Uganda. The respondents reported cost of drugs given to patients (type and dose of drug), other overhead expenditures, type of disease, income status of the patient and need to make profit as factors which influence the price of medical services. On regression analysis, it was found that rent was a significant factor on the price of medical services across all disease conditions. It was concluded that governments need to put in place effective regulatory mechanisms to ensure proper functioning of the private health sector.
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    Factors that influence household health care utilization patterns in two districts of Zambia : a rural - urban comparative evaluation
    (2005) Nkosi, Moremi Eric; Okorafor, Okore
    This research project was undertaken with the primary objective of determining whether there are differential household health care utilization patterns between rural and urban areas in Zambia and what factors, if any, are responsible for such spatial variations. The factors considered in this study include: the gender of the household head, age of individual household members, religious affiliation of the household, the marital status of the household head, the size of the household, the educational status of the household head, the household head's employment status, and the socio-economic status of the household. The data was collected using a household health survey with questionnaires administered to the household head. A total of 660 households (3,150 persons) were sampled, 320 households (1,696 persons) in Chipata District and 340 households (1,454 persons) in Ndola District. The data included information on socio-economic and demographic factors that have been regularly considered in the theoretical literature and empirical evidence as impacting upon household and individual decision-making when it comes to utilization of both formal and informal care. A multinomial logistic regression model was used to analyse the data quantitatively in Stata® Version 8.0 software. Close to a quarter ofthe overall sample admitted to suffering an illness or injury in the 4-week period preceding the interview. Self-care at the household level was the most frequently reported type of care chosen for minor and moderate illnesses or injuries (35.80 percent). Bivariate analysis and the multinomial logistic regression results indicate that the variables considered not only produce differential effects on household health care utilization patterns in both districts but also that the effects are different depending on location of the household. The results from our sample analyses show that household religious affiliation (Christianity) is negatively associated with formal health care utilization in the urban area while the age of the individual increases the household's utilization of formal and informal care, and the gender of the household head (female), hislher marital status, educational attainment, and employment status all have a positive impact on formal health care use in the rural area.
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    The impact of costs and perceived quality on utilisation of primary health care in Tanzania : rural-urban comparison
    (2003) Munga, Michael A; Thiede, Michael; Okorafor, Okore
    Health services utilisation, which is sometimes used as a proxy measure for equity is a complex subject to study. Identifying and explaining the important factors determining health care utilisation is a key to a better assessment of whether countries' health policies address the equity concerns of their populations in a comprehensive way. It is extensively documented that meeting the health needs of people especially those disadvantaged by such factors as geographical location, joblessness, low income, gender inequalities and lack of education among others, is an important strategy to preventing the increase in poverty and eventually reducing equity gaps. Realising this goal is not easy unless studies are done to establish policy and theoretical arguments related to why some sections of populations are more likely to use/or not to use available health care services than others. This cross-sectional study principally aims at assessing the impact of perceived quality and costs of health care on utilisation of PHC services in rural and urban areas of Tanzania. Using both quantitative and qualitative methods, it intends to explore whether there are differences between rural and urban users in terms of their perceptions of quality of health services and how these perceptions affect household decisions in utilising health services. It further examines the extent to which costs of health care are important determinant in health services utilisation and how rural and urban users are affected by this factor when it comes to deciding to use or not to use government health facilities. The study concludes that consumers of health care in rural Tanzania are highly responsive to health care costs than they are to quality concerns. As the two categories of rural and urban are affected differently by costs and their perceptions of quality when it comes to health care utilisation, it is possible that the observed utilisation trends can partly be attributed to these two factors. Furthermore, the study highlights that socio-economic variables such as gender, income, education, wealth and household size are important not only in determining user's decision making on the amount and appropriate time to seek care but also mitigates effectively on the extent to which costs and perception of quality of care affect rural and urban users of health care services. The study recommends that the government should strive to provide better "quality " information to its consumers. It further recommends that a critical evaluation of important quality aspects be done to see which mostly determine household decisions on utilisation of care among rural and urban users of care. The study has found that the kit system has had some problems, hence the study recommends that government devises mechanisms of ensuring that drugs are available at points of service. Acknowledging the existing geographical inequities, the need to incorporate the private sector in PHC provision and improve quality of health care, the study recommends for more resources to be devoted to research and venture on new opportunities provided by the ongoing reforms as a way of introduction, chapter one of the study report presents the country background information and how the health system is organised. The remainder of the report is organised as follows. In chapter two, the report presents the literature review whilst chapter three covers conceptual framework and methodology. This is followed by presentation of results and analysis in chapter four before putting forward a brief discussion of the findings in chapter five. In chapter six, conclusions and policy recommendations are presented.
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    Patterns and determinants of health care utilization : an assessment of high density urban areas in Harare, Zimbabwe
    (2008) Bandason, Nyasha; Okorafor, Okore
    Zimbabwe has been well known, since independence in 1980, to have one of the best health care systems in Sub-Saharan Africa regardless of a low economic growth pattern. The gains in health status that have been reaped in the 1980s and early 1990s have now been reversed due to the combination of the effects of structural adjustments policies, intermittent drought, a decline in the quality of health care services and severe economic decline. The current economc environment places pressure on households, especially the poorest, to meet the rising costs of individual medical care. The study focused on the evaluation of the patterns and determinants of health care utilization, which can aid in understanding the responsiveness of individuals to the current health care system in light of the economc climate. A detailed assessment of health seeking behaviour and health care utilization was performed using a cross-sectional household community survey comprising of 527 households (2302 individuals) that were randomly selected in three high density suburbs in Harare, Zimbabwe. Information pertaining to demographics, socio-economic status, and health status in addtion to the experiences in the use of health care services or health care providers was collected using a questionnaire.
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    Resource allocation for primary health care in the local government areas of Ekiti state, Nigeria : how equitable?
    (2006) Olubajo, Olalekan Olugbenga; Okorafor, Okore
    The aim of the study was to determine how equitable allocations to primary health care are, identify the factors that influence allocation and make recommendations on how to promote equitable resource allocation for primary health care in the local government areas of Ekiti state.
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    A study to evaluate support for the health sector devolution policy in Zambia : an actor analytic perspective
    (2005) Kagulula, Solomon S; Thomas, Stephen; Okorafor, Okore
    This study is an evaluation of Support for the Health Sector Devolution Policy in Zambia. The study adopts a stakeholder analytical approach and its central objective is to study characteristics of key stakeholders, analyse how these influence support for implementing the devolution policy in the Zambian Health Sector and recommend strategies for taking forward the decentralisation process.