Measuring equity in access to health care : a case study of malaria control interventions in the Kassena-Nankana district of Northen Ghana

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dc.contributor.advisorThiede, Michaelen_ZA
dc.contributor.authorAkweongo, Patriciaen_ZA
dc.date.accessioned2014-11-08T08:03:01Z
dc.date.available2014-11-08T08:03:01Z
dc.date.issued2005en_ZA
dc.descriptionIncludes bibliographical references (leaves 236-251).en_ZA
dc.description.abstractThis thesis develops a methodology for measuring equity in access to health care. The thesis deconstructs the concept of access into dimensions that represent the supply and demand side of health care and tests each of these dimensions by using the example of access to malaria services in the Kassena-Nankana district of northern Ghana. An innovative framework and a disadvantage index are developed herein, and are used to analyse the primary factors of access and to measure inequities in such access. A cross-sectional survey of 1880 household heads, focus group discussions, in-depth and key informant interviews with community members and health providers were used to explore issues in respect of malaria management, health care access and perceptions of poverty. The principal component and factor analysis statistical methods were then applied to estimate access factors and to compile a disadvantaged index of access. The key findings indicate that the dimensions, availability, affordability, information and acceptability primarily determine access to health care. On the availability dimension, physical distance to health care, provision of primary and inpatient are and travel distance are significant factors. The primary factors of affordability are associated more with the socio-economic characteristics of the household than with direct user costs. The information dimension is determined primarily by knowledge to treat levels of severity of malaria and the source of information for treatment. The acceptability of health care is related to methods and services for managing severity of levels of malaria at home as well as using qualified health care providers. The disadvantage index and poverty maps show significant disparities in health care access between geographic areas and socio-economic groups', with areas in the outskirts of the Kassena district being the most disadvantaged in terms of availability, acceptability and information. These areas are however not economically disadvantaged. The poorest households have the lowest accessibility scores across all dimensions.en_ZA
dc.identifier.apacitationAkweongo, P. (2005). <i>Measuring equity in access to health care : a case study of malaria control interventions in the Kassena-Nankana district of Northen Ghana</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Health Economics Unit. Retrieved from http://hdl.handle.net/11427/9346en_ZA
dc.identifier.chicagocitationAkweongo, Patricia. <i>"Measuring equity in access to health care : a case study of malaria control interventions in the Kassena-Nankana district of Northen Ghana."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Health Economics Unit, 2005. http://hdl.handle.net/11427/9346en_ZA
dc.identifier.citationAkweongo, P. 2005. Measuring equity in access to health care : a case study of malaria control interventions in the Kassena-Nankana district of Northen Ghana. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Akweongo, Patricia AB - This thesis develops a methodology for measuring equity in access to health care. The thesis deconstructs the concept of access into dimensions that represent the supply and demand side of health care and tests each of these dimensions by using the example of access to malaria services in the Kassena-Nankana district of northern Ghana. An innovative framework and a disadvantage index are developed herein, and are used to analyse the primary factors of access and to measure inequities in such access. A cross-sectional survey of 1880 household heads, focus group discussions, in-depth and key informant interviews with community members and health providers were used to explore issues in respect of malaria management, health care access and perceptions of poverty. The principal component and factor analysis statistical methods were then applied to estimate access factors and to compile a disadvantaged index of access. The key findings indicate that the dimensions, availability, affordability, information and acceptability primarily determine access to health care. On the availability dimension, physical distance to health care, provision of primary and inpatient are and travel distance are significant factors. The primary factors of affordability are associated more with the socio-economic characteristics of the household than with direct user costs. The information dimension is determined primarily by knowledge to treat levels of severity of malaria and the source of information for treatment. The acceptability of health care is related to methods and services for managing severity of levels of malaria at home as well as using qualified health care providers. The disadvantage index and poverty maps show significant disparities in health care access between geographic areas and socio-economic groups', with areas in the outskirts of the Kassena district being the most disadvantaged in terms of availability, acceptability and information. These areas are however not economically disadvantaged. The poorest households have the lowest accessibility scores across all dimensions. DA - 2005 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2005 T1 - Measuring equity in access to health care : a case study of malaria control interventions in the Kassena-Nankana district of Northen Ghana TI - Measuring equity in access to health care : a case study of malaria control interventions in the Kassena-Nankana district of Northen Ghana UR - http://hdl.handle.net/11427/9346 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/9346
dc.identifier.vancouvercitationAkweongo P. Measuring equity in access to health care : a case study of malaria control interventions in the Kassena-Nankana district of Northen Ghana. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Health Economics Unit, 2005 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/9346en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentHealth Economics Uniten_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherPublic Health and Family Medicineen_ZA
dc.titleMeasuring equity in access to health care : a case study of malaria control interventions in the Kassena-Nankana district of Northen Ghanaen_ZA
dc.typeDoctoral Thesis
dc.type.qualificationlevelDoctoral
dc.type.qualificationnamePhDen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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