Determinants of healthcare demand in Uganda : a multilevel analysis

Abstract

Despite the fact that the UNHS report 2016/2017 indicates that overall, eight in every ten persons (83%) sought healthcare, there still exist regional disparities in the healthcare-seeking behavior of individuals. A comparison of the findings between 2012/13 and 2016/17 shows that, reductions in health-seeking behavior were registered in all sub-regions with exception of Busoga, Central I, and Kigezi which registered an increase. The study utilized secondary data from the most recent Uganda National Household Survey (UNHS) 2016/2017 which covered all the 112 districts in Uganda at the time of the survey. A Mixed-Effects Logistic Regression model was employed to better understand what determines healthcare demand at individual and household level. The adults (31-60 years) and elderly (above 60 years) were less likely to seek care compared to the children (0-17 years). Individuals who have never been married were less likely to seek care compared to their married counterparts. Individuals who were able to read or write or both were more likely to seek care compared to those who were unable to read and write. Individuals suffering from a non-communicable disease were more likely to seek care compared to those having no non-communicable disease. Household health expenditure and household size were positively related to healthcare demand. Individuals from poor households were less likely to seek care compared to individuals from non-poor households. The study recommends the need for a National Health Insurance Scheme given the rising healthcare expenditures. The government should implement policies that improve healthcare access for the elderly. More emphasis should be put on providing basic education to the people and promoting household income-generating activities to reduce poverty.