The Effect of Health Service Quality on Health Facility Choice and Health Outcomes in Malawi

Abstract

Purpose: We study the impact of health care service quality on health facility choice and health outcomes in Malawi.
 Originality: One of the key determinants of health outcomes in low income countries is the accessibility to health service. Previous studies have examined the association between health outcomes and the supply of health services. This study contributes to the existing literature by investigating the association between the demand for health service and the quality of health service. We also discuss the construction of the health care service quality measures.
 Methodology: We used Malawi Demographic and Health Survey (MDHS) 2015 and Malawi Service Provision Assessment (MSPA) 2013-2014 to examine the effect by using OLS regressions.
 Result: We created health care service quality measures to represent infrastructure quality, medical supplies quality and health facility management quality in order to examine the impact of these quality measures on the demand for health services and health outcomes. We find that people who live closer to health facilities with high quality are more likely to utilize health services. However, we do not find significant evidences that healthcare quality is associated with positive health outcomes.
 Conclusions and Implication: Although we empirically showed that health care service quality in Malawi has significant impact on the demand for health services, it is not translated into positive health outcomes. We further need to investigate why health service quality is not related to health outcomes in the context of a developing countries.