Utilization of Health Services: The Case of Assin District

ABSTRACT

It is essential to recognize the relative importance of the various barriers to the utilization if effective health services are to be delivered. This study set out to find the factors leading to the observed underutilization in health facilities in the Assin District. It involved the administration of questionnaires to one-hundred household heads of selected communities of Assin District. Focus group discussions were also conducted with community members. In-depth interviews were carried out with service managers and opinion leaders. The data collected was processed and analysed manually and by SPSS computer programme. The main finding was that the study population preferred hospital services for most of their health problems but financial constraints inhibited them from the use of formal health services in the district. Other service and community factors which contributed to low health service utilization were staff attitude, the existence of alternative forms of health care, socio-cultural factors and distance. Recommendations were made to policy makers (MOH), the District Assembly and the District Health Management Team. Some of the recommendations were:- 1. There should be a review of the user fees in the health facilities, especially in the district hospital by the Hospital Management, DHMT and District Assembly. 2. The District Assembly should identify Poverty Alleviation Programmes which are realistic and sustainable to help deprived communities. 3. Collaboration of the DHMT (MOH) with other sectors like the Ministry of Education was recommended for the implementation of comprehensive health education programmes targeted at the special needs of the study population. 4. Periodic Quality Assurance Programmes, with effective monitoring and evaluation were recommended to the DHMT; disciplinary measures were to be taken against erring staff in the discharge of their duties. 5. Periodic Supervision, Monitoring and Performance Appraisal of CCAs was recommended to enhance their work. 6. The District Assembly should advocate for the improvement of the Road Network in the District. 7. Finally the DHMT and District Assembly should encourage and ensure Community Participation in all health programmes for health and socio-economic development in the entire district.