Abstract
The interrelationship between the public and private sectors, and formal and informal healthcare sectors effects market-level service quality, pricing behaviour and referral networks. However, health utilisation analysis of national survey data from many low and middle income countries is constrained by the lack of disaggregated health provider data. This study is concerned with the pattern of repeat outpatient consultations for a single episode of fever from public and private qualified providers and private unqualified providers. Cross-sectional survey data from 1173 adult respondents sampled from three districts within India’s most populous state—Uttar Pradesh is analysed. Data was collected during the monsoon season—September to October—in 2012. Regression analysis focuses on the pattern of repeats visits for a single episode of mild-sever fever as the dependent variable. Results show that Women and Muslims in rural north India are more likely to not access healthcare, and if they do, consult with low quality unqualified outpatient healthcare providers. For fever durations of four or more days, men are more likely to access unqualified providers compared to women. Results of the current study supports the literature that women’s utilisation of outpatient healthcare for communicable illnesses in LMICs is often less than men. A relative lack of access to household resources explains why fever duration parameter estimates for women and men differ.
Highlights
The outcome of health systems is a central policy focus in many low and middle countries (LMIC) as governments strive to provide universal health coverage
In light of the limited data and empirical analysis concerning healthcare provider behaviour in the formal and informal sectors, patients’ heterogeneous preferences and social structures, further analysis of the health systems in LMIC is required before constructive, progressive regulatory reform is possible
This study indicates that women in north India are less likely to access outpatient fever care
Summary
The outcome of health systems is a central policy focus in many low and middle countries (LMIC) as governments strive to provide universal health coverage. In many LMIC contexts, the further development of health systems to achieve strong health and societal goals will require regulatory reform of current institutions, policies and mechanisms.[1] in light of the limited data and empirical analysis concerning healthcare provider behaviour in the formal and informal sectors, patients’ heterogeneous preferences and social structures, further analysis of the health systems in LMIC is required before constructive, progressive regulatory reform is possible. The interrelationship between provider and patient behaviours is central to understanding any health system. Knowledge of this relationship is important in LMIC where regulatory regimes are often weak.
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