Health Inequity In Uganda: The Role Of Financial And Non-Financial Barriers

Abstract

Inequality in health is known to be rampant among different socio-economic groups, with the poor typically suffering more ill-health and facing greater economic cost of ill-health than the rich. Yet a number of other non-economic factors are also known to concurrently operate, in a complex way, to further ration healthcare in favour of the rich. Measuring, monitoring and understanding the influences these factors pose in determining health-seeking behaviour at district and sub district levels are necessary to guide policy. Policies based on intuition alone can be misleading. The household survey was an attempt to understand the level and direction of disparities in health by socio-economic differentials in Uganda; and the roles of both financial and non barriers to healthcare use. A total of 843 households were sampled (by probability proportionate to size technique) from four health sub districts. We found that the poorest quintiles were 2.4 times more likely to suffer ill-health than the richest quintiles, with a greater proportion of them lacking access to publicly-provided health services than the richest counter-parts. There were no rich-poor differences in the types of illnesses/injuries. Although the findings of this survey confirm the conventional wisdom, they also reveal healthcare use patterns that reflect, not only the importance of financial barriers, but also the opportunity costs in travel (and possibly waiting) time, and other important factors including the availability, affordability and the perceived quality of services.