Assessment of equity on outpatient service utilization in selected health centers of Addis Ababa- Ethiopia, 2018
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Date
2018-11
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Addis Ababa University
Abstract
Background - Equity is the absence of avoidable or remediable differences among populations or groups defined socially, economically, demographically or geographically. The Ethiopia Federal Ministry of Health (FMOH) has formulated and implemented various effective polices and strategies to the benefit of the nation’s citizens. Inequity often manifests as a large and growing gap between the best-off and worst-off people in urban areas.
Objective–The objective of this study was to assess equity on outpatient health services utilization in selected health centers of Addis Ababa, Ethiopia.
Methodology–A facility based cross sectional study design was conducted in selected health centers of Addis Ababa. A stratified sampling technique with proportional allocation of sample size was used by considering the sub-city as a group and then a total of 10 health centers were assessed. Study participants were selected by systematic random sampling. A total of 466 sample size was determined. A structured questionnaire was used to collect data. Data was entered into Epi data version 3.1 and was exported to Stata/SE 14.0 and SPSS version 20. Illness report in Health service utilization and expenditure survey 2017 constituted the reference population. The result was summarized by using tables and charts. Wealth index was built by principal component analysis. Chi-squared goodness test was used to test the significant difference between the socio demographic variables of outpatient visitors with individuals reported illness in the survey.
Results–A total of 457 participated in the study with response rate of 98.07%. Mean age of respondents was 34.5 ranging from 0.8 – 81 years. There were 296 (64.8%) female and 161 (35.2%) male respondents. To assess equity, data of OPD visitors of the study sample were
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compared with individuals reported illness in health service utilization and expenditure survey 2017. There were significant differences in the proportion of male and female populations’ [χ2 (1, n = 457) = 211.917, (p < 0.000)], educational statuses [χ2 (3, n = 457) = 297.2, (p < 0.000)], employment statuses [χ2 (2, n = 457) = 642.4, (p < 0.000)] and wealth statuses [χ2 (1, n = 457) = 10.46, (p < 0.033)] identified in the current sample as compared with the values that was obtained in the survey.
Conclusions and recommendations - Findings in this study showed being male, having primary education, being employed and having lowest and 4thwealth status contributed to inequity in outpatient service utilization. But further analysis is required that incorporate different health facilities at different level of care across regions and residences.
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Keywords
Equity , outpatient service , health centers