Factors Affecting the Choice of Public Vs Private Healthcare Institutions for Delivery and Postnatal Care-A Study in a Rural District of Pakistan

Abstract

Maternal health is one of the most critical public health challenges in many developing countries availability of comprehensive maternal healthcare services by skilled health professionals can improve the quality of maternal health outcomes. In Pakistan, the rate of institutional delivery is lower than many other developing countries and a significant proportion of mothers seek maternal healthcare in the private health sector. There are many factors associated with utilization of maternal healthcare services including both supply side and demand side factors. The objective of this paper is to identify significant socio-economic factors affecting utilization of delivery and postnatal services in public and private healthcare facilities in district Rajanpur, Pakistan. Using multi-stage random sampling technique, 368 mothers who delivered within 6 months prior to data collection in selected basic health unit (BHU) areas were selected. Multivariate binary logistic regression was applied on primary data collected from Rajanpur district during 1st November, 2020 – 31st January, 2021. The results indicated that the household’s preference for private healthcare sector for delivery and postnatal care increases with increase in households’ education and incomes. It also showed that accessibility to healthcare facilities is significant in utilization of maternal healthcare services. Distance to healthcare facilities, cost of transport and out-of-pocket expenditure are significantly affecting the choice of healthcare institutions.