Does quality influence utilization of primary health care? Evidence from Haiti.

摘要: Expanding coverage of primary healthcare services such as antenatal care and vaccinations is a global health priority; however, many Haitians do not utilize these services. One reason may be that the population avoids low quality facilities. We examined how facility infrastructure service delivery were associated with community utilization in Haiti. constructed two composite measures for all Haitian facilities using 2013 Service Provision Assessment survey. geographically linked clusters from Demographic Health Surveys to nearby offering assessed cross-sectional association between four services: care, postnatal sick child well one more complex service: delivery. Facilities performed poorly on both quality, scoring 0.55 0.58 out 1 respectively. In rural areas, several cares (antenatal vaccination) was delivery, stronger associations Facility there no care. urban either measure. Poor deter beneficial areas Improving offer an opportunity only improve outcomes patients, but also expand key