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Bypassing Health Centres in Tanzania: Revealed Preferences for Quality

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  • Kenneth L. Leonard
  • Gilbert R. Mliga
  • Damen Haile Mariam

Abstract

When patients bypass one health facility to seek care at another, strong preferences are revealed. The patterns of bypassing observed in Iringa Rural district in Tanzania show evidence of patients' understanding of various measures of quality at the facilities that they visit and bypass. We match two data sets that measured quality in health facilities with a sample of patient choice of health facilities. We use a conditional logit regression on patient choice of provider to show the relationship between patient behaviour and objective measures of technical quality in the health facilities. The paper shows that patients seek facilities that provide high quality consultations and prescriptions, are staffed by more knowledgeable physicians, and are better stocked with basic supplies. Patients avoid facilities that use injections too liberally or over-prescribe medication. Furthermore, the patterns differ significantly by illness condition and show evidence that patients understand the relative importance of these qualities for the condition from which they suffer. Copyright 2002, Oxford University Press.

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Bibliographic Info

Article provided by Centre for the Study of African Economies (CSAE) in its journal Journal of African Economies.

Volume (Year): 11 (2002)
Issue (Month): 4 (December)
Pages: 441-471

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Handle: RePEc:oup:jafrec:v:11:y:2002:i:4:p:441-471

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Cited by:
  1. Ottar Mæstad & Gaute Torsvik & Arild Aakvik, 2009. "Overworked? The relationship between workload and health worker performance in rural Tanzania," CMI Working Papers 2, CMI (Chr. Michelsen Institute), Bergen, Norway.
  2. World Bank, 2007. "India - Rural governments and Service Delivery : Volume 2. Note," World Bank Other Operational Studies 8008, The World Bank.
  3. Mæstad, Ottar & Torsvik, Gaute & Aakvik, Arild, 2010. "Overworked? On the relationship between workload and health worker performance," Journal of Health Economics, Elsevier, vol. 29(5), pages 686-698, September.
  4. Jeuland, Marc & Lucas, Marcelino & Clemens, John & Whittington, Dale, 2010. "Estimating the private benefits of vaccination against cholera in Beira, Mozambique: A travel cost approach," Journal of Development Economics, Elsevier, vol. 91(2), pages 310-322, March.
  5. Kruk, Margaret E. & Rockers, Peter C. & Mbaruku, Godfrey & Paczkowski, Magdalena M. & Galea, Sandro, 2010. "Community and health system factors associated with facility delivery in rural Tanzania: A multilevel analysis," Health Policy, Elsevier, vol. 97(2-3), pages 209-216, October.
  6. Van Rijsbergen, Bart & D’Exelle, Ben, 2013. "Delivery Care in Tanzania: A Comparative Analysis of Use and Preferences," World Development, Elsevier, vol. 43(C), pages 276-287.
  7. World Bank, 2007. "India - Rural Governments and Service Delivery : Volume 3. Main Report," World Bank Other Operational Studies 8009, The World Bank.
  8. Magnus Lindelow, 2004. "Understanding spatial variation in the utilization of health," Development and Comp Systems 0409058, EconWPA.

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