INTRODUCTION

We empirically analyze the nature and determinants of individuals’ decision to seek care on condition of sickness reporting using data from the Uganda National Household Survey in 2002/03. The main conclusions are that health-care costs are regressive, and that sustainability affects poorer people’s health-care utilization for any formal provider after controlling for other characteristics. To put it another way, even among public facilities, the expense of care remains a deterrent to using these services. Second, there is no question that implementing initiatives to improve the poor’s income will increase their use of health care facilities, however the impact will be greater for private care. Third, in addition to income and health-care costs, other factors such as service quality, education, and physical access, as measured by distance to facilities, are major drivers of health-care consumption. Four, while it is critical for the government to improve service delivery in public facilities, incentives should be implemented to encourage and strengthen the private sector’s engagement. At the same time, a regulatory structure, set of standards, and a monitoring framework are required to ensure quality of services and price control in the private sector, particularly in the private for profit sub-sector. Even after cost sharing was abolished, there is clearly a growing demand for the sector’s services.

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