Patterns of healthcare utilisation and barriers affecting access to child healthcare services in low-income urban South African settings

Abstract

Background. Improving access to quality healthcare can contribute to reducing childhood mortality. Therefore, understanding the patterns of healthcare utilisation for common childhood conditions as well as barriers to healthcare use is important in planning appropriate public health programmes and interventions.

Objective. The objective of the present study was to examine patterns of child healthcare uptake and barriers that affect access to healthcare in two South African (SA) low-income urban settings.

Methods. A healthcare utilisation survey was conducted between April and September 2015, using a cross-sectional study design. Data were analysed using descriptive and inferential statistics. Information was collected on 531 children and their caregivers from 503 randomly selected households.

Results. Our findings revealed that 81.9% of respondents preferred clinics as their first choice, and 84.2% preferred hospitals as their second point of call. About 5% of caregivers preferred faith-based/traditional healers as their second point of call. Barriers to accessing healthcare were reported for more than half of the sampled children (52.0%), such as long queues at the health facility (HF), poor attitudes of healthcare workers, lack of medicine and the distance to the HF, which constitute major barriers. These findings were echoed in multivariable analysis. For instance, distance to the HF (odds ratio (OR) 2.01; confidence interval (CI) 1.04 - 3.89, p<0.05) was a strong predictor for barriers to accessing child healthcare services.

Conclusion. Considering the benefits of unrestricted access to quality care for positive child health outcomes, the present study underscores the need for improved access to adequate healthcare in the selected locations in SA.