Determinants of utilization of health services

Manisha Arora, George Koshy, Vandana Gangadharan


Background: Health care in India is a complex amalgam involving various stakeholders. For decades it has been a neglected area with reluctance in increasing the inputs such as finance or infrastructure required to drive this system. Utilization and access to this health system is a key indicator and major determinant of health seeking behaviour.

Methods: This community based cross sectional study was conducted from January-February 2016 in, the urban slum located in a metro city using a pretested, semi-structured questionnaire. The data was analyzed using SPSS 22.

Results: More than half of the participants preferred to seek treatment from a public health care facility compared to a private. One of the most predominant determining factors on choosing a particular health facility was affordability. Main barriers perceived in utilization of health services were long waiting time at the health facility and expenditure on treatment.

Conclusions: The key for ensuring adequate and appropriate utilization of health care services is in having an efficient government health care delivery system which can offer quality and affordable medical care to one and all.



Utilization, Health services, Determinants, Barriers

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Azhar G, Amir A, Khalique N, Khan Z. A Study of Determinants of Use of Healthcare Services in India. Int J Med Public Health. 2011;1(3):62–6.

Barua N, Pandav CS. The allure of the private practitioner: Is this the only alternative for the urban poor in India? Indian J Public Health. 2011;55(2):107.

Dhingra B, Dutta AK. National Rural Health Mission. Indian J Pediatr. 2011;78(12):1520–6.

Musoke D, Boynton P, Butler C, Musoke MB. Health seeking behaviour and challenges in utilising health facilities in Wakiso district, Uganda. Afr Health Sci. 2014;14(4):1046–55.

Ghafari M, Shamsuddin K, Amiri M. Barriers to Utilization of Health Services: Perception of Postsecondary School Malaysian Urban Youth. Int J Prev Med. 2014;5(7):805–6.

Abubakar A, Van Baar A, Fischer R, Bomu G, Gona JK, Newton CR. Socio-Cultural Determinants of Health-Seeking Behaviour on the Kenyan Coast: A Qualitative Study. Jenkins N, ed. PLoS ONE. 2013;8(11):e71998.

Patil SP, Parbhankar SS, Study of health seeking behaviour and its determinants among its attendees of urban health centre, Dharavi, Mumbai. Int J Community Med Public Health. 2016;3(7):1856-61.

Gupta I, Guin P. Health status and access to health services in Indian slums. Health. 2015;7:245-55.

Gupta, I. and Mitra, A. Basic Amenities and Health in Urban India. National Med J India, 2002;15:26-31.

Gupta I, Mitra A, Jha M. Slum Dwellers in Delhi: An Unhealthy Population. IEG Working Paper No. E/ 194/98, Institute of Economic Growth, Delhi; 1998.

Kumar S. Health Care Is among the Most Corrupt Services in India. British Medical Journal. 2003;326:10.

World Bank. World Bank and Government of India Agree Action to Stamp out Health Project Fraud and Corruption. Press Release No:2008/234/SAR. World Bank, Washington DC; 2009.

Sinha K. CAG to Audit NRHM Scheme in 18 States. The Times of India, New Delhi; 2008.

Dash DK, Lalchandani N, Pandit A. Mayor May Seek CBI Probe into Fake MCD Staff Scam. The Times of India, New Delhi; 2009.

Oladipo JA. Utilization of health care services in rural and urban areas: a determinant factor in planning and managing health care delivery systems. Afri Health Sci. 2014;14(2):322–33.