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Defining Access to Health Care: Evidence on the Importance of Quality and Distance in Rural Tanzania

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  • Heather Klemick
  • Kenneth L. Leonard
  • Melkiory C. Masatu

Abstract

We examine the implications of health-seeking behavior on access to quality health care using a unique dataset that combines a household survey from rural Tanzania with the location and quality of all health facilities available to households. Patients do not always visit the nearest facility, but choose from among multiple facilities, improving the quality of care they receive by bypassing low quality facilities. Recognizing this behavior alters the projected benefits to health interventions, reducing the value of focusing on the staff qualifications and increasing the value of focusing on travel time and the motivation of current staff. Copyright 2007, Oxford University Press.

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  • Heather Klemick & Kenneth L. Leonard & Melkiory C. Masatu, 2007. "Defining Access to Health Care: Evidence on the Importance of Quality and Distance in Rural Tanzania," American Journal of Agricultural Economics, Agricultural and Applied Economics Association, vol. 91(2), pages 347-358.
    • Handle: RePEc:oup:ajagec:v:91:y:2007:i:2:p:347-358
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    File URL: http://hdl.handle.net/10.1111/j.1467-8276.2009.01252.x
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    References listed on IDEAS

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    1. Abhijit Banerjee & Esther Duflo, 2006. "Addressing Absence," Journal of Economic Perspectives, American Economic Association, vol. 20(1), pages 117-132, Winter.
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    3. Duflo, Esther & Hanna, Rema, 2005. "Monitoring Works: Getting Teachers to Come to School," CEPR Discussion Papers 5426, C.E.P.R. Discussion Papers.
    4. Leonard, Kenneth L, 2007. "Learning in Health Care: Evidence of Learning about Clinician Quality in Tanzania," Economic Development and Cultural Change, University of Chicago Press, vol. 55(3), pages 531-555, April.
    5. Chomitz, Kenneth M. & Setiadi, Gunawan & Azwar, Azrul & Ismail, Nusye & Widiyarti, 1998. "What do doctors want? developing incentives for doctors to serve in Indonesia's rural and remote areas," Policy Research Working Paper Series 1888, The World Bank.
    6. Leonard, Kenneth & Masatu, Melkiory C., 2006. "Outpatient process quality evaluation and the Hawthorne Effect," Social Science & Medicine, Elsevier, vol. 63(9), pages 2330-2340, November.
    7. Magnus Lindelow, 2004. "Understanding spatial variation in the utilization of health," Development and Comp Systems 0409058, University Library of Munich, Germany.
    8. Abhijit Banerjee & Angus Deaton & Esther Duflo, 2004. "Health care delivery in rural rajasthan," Framed Field Experiments 00120, The Field Experiments Website.
    9. Paul Collier & Stefan Dercon & John Mackinnon, 2002. "Density versus Quality in Health Care Provision: Using Household Data to Make Budgetary Choices in Ethiopia," World Bank Economic Review, World Bank Group, vol. 16(3), pages 425-448, December.
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    1. Hadija Kassim Mwendah, 2020. "Do Institutions Matter? Explaining HIV Prevalence Variations Across Regions in Tanzania," International Journal of Asian Social Science, Asian Economic and Social Society, vol. 10(1), pages 10-28, January.

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