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Does socio-economic status explain use of modern and traditional health care services?

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  • Sato, Azusa
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    Although socioeconomic status is acknowledged to be an important determinant of modern health care utilisation, most analyses to date have failed to include traditional systems as alternative, or joint, providers of care. In developing countries, where pluralistic care systems are common, individuals are likely to be using multiple sources of health care, and the order in which systems are chosen is likely to vary according to income. This paper uses self-collected data from households in Ghana and econometric techniques (biprobit modelling and ordered logit) to show that rising income is associated with modern care use whilst decreasing income is associated with traditional care use. When utilisation is analysed in order, results show rising income to have a positive effect on choice of modern care as a first provider, whilst choosing it second, third or never is associated with decreasing income. The effects of income on utilisation patterns of traditional care are stronger: as income rises, utilisation of traditional care as a first choice decreases. Policy should incorporate traditional care into the general utilisation framework and recognise that strategies which increase income may encourage wider utilisation of modern over traditional care, whilst high levels of poverty will see continued use of traditional care.

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    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 75 (2012)
    Issue (Month): 8 ()
    Pages: 1450-1459

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    Handle: RePEc:eee:socmed:v:75:y:2012:i:8:p:1450-1459
    DOI: 10.1016/j.socscimed.2012.05.032
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    1. Develay, A. & Sauerborn, R. & Diesfeld, H. J., 1996. "Utilization of health care in an African urban area: Results from a household survey in Ouagadougou, Burkina-Faso," Social Science & Medicine, Elsevier, vol. 43(11), pages 1611-1619, December.
    2. Moses, Stephen & Muia, Esther & Bradley, Janet E. & Nagelkerke, Nico J. D. & Ngugi, Elizabeth N. & Njeru, Erastus K. & Eldridge, Gloria & Olenja, Joyce & Wotton, Kay & Plummer, Francis A. & Brunham, R, 1994. "Sexual behaviour in Kenya: Implications for sexually transmitted disease transmission and control," Social Science & Medicine, Elsevier, vol. 39(12), pages 1649-1656, December.
    3. Asante, Augustine Danso & Zwi, Anthony Barry & Ho, Maria Theresa, 2006. "Equity in resource allocation for health: A comparative study of the Ashanti and Northern Regions of Ghana," Health Policy, Elsevier, vol. 78(2-3), pages 135-148, October.
    4. Leonard, Kenneth L., 2003. "African traditional healers and outcome-contingent contracts in health care," Journal of Development Economics, Elsevier, vol. 71(1), pages 1-22, June.
    5. John Anyanwu, 2007. "Demand for Health Care Institutions' Services: Evidence from Malaria Fever Treatment in Nigeria," African Development Review, African Development Bank, vol. 19(2), pages 304-334.
    6. David E. Sahn & Stephen D. Younger & Garance Genicot, 2003. "The Demand for Health Care Services in Rural Tanzania," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 65(2), pages 241-260, May.
    7. Tsey, Komla, 1997. "Traditional medicine in contemporary Ghana: A public policy analysis," Social Science & Medicine, Elsevier, vol. 45(7), pages 1065-1074, October.
    8. Kroeger, Axel, 1983. "Anthropological and socio-medical health care research in developing countries," Social Science & Medicine, Elsevier, vol. 17(3), pages 147-161, January.
    9. Magnus Lindelow, 2005. "The Utilisation of Curative Healthcare in Mozambique: Does Income Matter?," Journal of African Economies, Centre for the Study of African Economies (CSAE), vol. 14(3), pages 435-482, September.
    10. Mwabu, Germano M., 1986. "Health care decisions at the household level: Results of a rural health survey in Kenya," Social Science & Medicine, Elsevier, vol. 22(3), pages 315-319, January.
    11. Kenneth L. Leonard & Joshua Graff Zivin, 2005. "Outcome versus service based payments in health care: lessons from African traditional healers," Health Economics, John Wiley & Sons, Ltd., vol. 14(6), pages 575-593.
    12. Habtom, GebreMichael Kibreab & Ruys, Pieter, 2007. "The choice of a health care provider in Eritrea," Health Policy, Elsevier, vol. 80(1), pages 202-217, January.
    13. Stekelenburg, Jelle & Jager, Bastiaan E. & Kolk, Pascal R. & Westen, Esther H. M. N. & Kwaak, Anke van der & Wolffers, Ivan N., 2005. "Health care seeking behaviour and utilisation of traditional healers in Kalabo, Zambia," Health Policy, Elsevier, vol. 71(1), pages 67-81, January.
    14. Sachs, Lisbeth & Tomson, Göran, 1992. "Medicines and culture--A double perspective on drug utilization in a developing country," Social Science & Medicine, Elsevier, vol. 34(3), pages 307-315, February.
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