Background
The Ugandan health system
Methods
Data sources
Region | District |
---|---|
Central 1 | Kalangala, Masaka, Mpigi, Rakai, Lyantonde, Sembabule, and Wakiso |
Central 2 | Kayunga, Kiboga, Luwero, Nakaseke, Mubende, Mityana, Mukono, and Nakasongola |
Kampala | Kampala |
East Central | Jinja, Iganga, Namutumba, Kamuli, Kaliro, Bugiri, and Mayuge |
Mid-eastern | Kapchorwa, Bukwa, Mbale, Bududa, Manafwa, Tororo, Butaleja, Sironko, Pallisa, Budaka, and Busia |
North-east | Kotido, Abim, Kaabong, Moroto, Nakapiripirit, Katakwi, Amuria, Bukedea, Soroti, Kumi, and Kaberamaido |
Mid-northern | Gulu, Amuru, Kitgum, Pader, Apac, Oyam, Lira, Amolatar, and Dokolo |
West Nile | Moyo, Adjumani, Yumbe, Arua, Koboko, Nyadri, and Nebbi |
Mid-western | Masindi, Buliisa, Hoima, Kibaale, Bundibugyo, Kabarole, Kasese, Kyenjojo, and Kamwenge |
South-western | Bushenyi, Rukungiri, Kanungu, Kabale, Kisoro, Mbarara, Ibanda, Isingiro, Kiruhura, and Ntungamo |
Descriptive statistics
Number | % | |
---|---|---|
Child was ill with a fever in the last 2 weeks? | ||
No | 2,092 | 55.8 |
Yes | 1,657 | 44.2 |
Total | 3,749 | 100 |
Did child seek treatment from anywhere? | ||
No | 294 | 17.74 |
Yes | 1,363 | 82.26 |
1,657 | 100.0 | |
Place first sought treatment for fever? | ||
Public | 686 | 50.33 |
Private | 660 | 48.42 |
Traditional | 15 | 1.1 |
Other | 2 | 0.15 |
Total | 1,363 | 100 |
Analysis frame
Limitations of the study
Results
Fever and health care seeking behaviour
Background characteristics | % with fever | # | % seek advice or treatment | % seek from one source | Place first sought treatment | ||||
---|---|---|---|---|---|---|---|---|---|
Public | Private | Traditional | Other | Total | |||||
Rural - Urban | |||||||||
Urban | 47.8 | 396 | 68.5 | 97.2 | 26.8 | 73.2 | 0.0 | 0.0 | 100 |
Rural | 44.3 | 3,353 | 83.9 | 92.0 | 46.8 | 51.7 | 1.5 | 0.1 | 100 |
Sub-region | |||||||||
Central 1 | 33.9 | 319 | 85.2 | 95.1 | 41.6 | 58.4 | 0.0 | 0.0 | 100 |
Central 2 | 54.3 | 332 | 83.4 | 91.0 | 37.6 | 59.4 | 3.0 | 0.0 | 100 |
Kampala | 22.4 | 211 | 87.2 | 100.0 | 43.0 | 57.0 | 0.0 | 0.0 | 100 |
East Central | 56.3 | 468 | 60.1 | 95.3 | 33.0 | 66.9 | 0.2 | 0.0 | 100 |
Mid-eastern | 30.1 | 402 | 83.5 | 87.9 | 43.6 | 47.0 | 9.1 | 0.3 | 100 |
North-east | 52.4 | 415 | 90.6 | 92.3 | 45.7 | 54.4 | 0.0 | 0.0 | 100 |
Mid-northern | 66.1 | 422 | 91.2 | 91.1 | 47.7 | 52.2 | 0.0 | 0.1 | 100 |
West Nile | 51.8 | 461 | 81.4 | 89.5 | 46.6 | 50.6 | 2.8 | 0.0 | 100 |
Mid-western | 36.4 | 407 | 77.7 | 94.3 | 59.9 | 40.1 | 0.0 | 0.0 | 100 |
South-western | 22.3 | 312 | 96.9 | 98.3 | 47.6 | 52.5 | 0.0 | 0.0 | 100 |
Mother's education level | |||||||||
No education | 46.1 | 861 | 79.7 | 91.7 | 56.3 | 42.7 | 1.0 | 0.0 | 100 |
Primary | 45.8 | 2,281 | 82.1 | 92.6 | 43.0 | 55.5 | 1.5 | 0.1 | 100 |
Secondary | 40.0 | 541 | 81.3 | 94.3 | 36.0 | 62.7 | 1.0 | 0.2 | 100 |
Higher | 32.7 | 66 | 95.4 | 90.2 | 18.4 | 80.6 | 1.0 | 0.0 | 100 |
Wealth index | |||||||||
Poorest | 55.1 | 971 | 82.9 | 91.5 | 51.4 | 47.6 | 1.1 | 0.0 | 100 |
Poorer | 45.2 | 727 | 85.4 | 92.7 | 42.4 | 54.5 | 3.0 | 0.1 | 100 |
Middle | 44.0 | 730 | 75.7 | 91.0 | 47.9 | 51.2 | 0.7 | 0.2 | 100 |
Richer | 40.4 | 695 | 87.6 | 91.7 | 37.6 | 62.3 | 0.1 | 0.0 | 100 |
Richest | 35.9 | 626 | 75.7 | 98.6 | 37.1 | 61.6 | 1.4 | 0.0 | 100 |
Total | 44.7 | 3,749 | 81.8 | 92.6 | 44.4 | 54.2 | 1.3 | 0.1 | 100 |
Likelihood of out-of-pocket expenditure
Binary comparisons
Background characteristics | Any | Consultation | Medicine | Transport | Hospitalization |
---|---|---|---|---|---|
Urban | 82.2 | 47.9 | 56.1 | 27.1 | 1.8 |
Rural | 69.4 | 23.1 | 53.7 | 13.6 | 3.0 |
Sub-region | |||||
Central 1 | 63.1 | 13.7 | 51.6 | 17.0 | 0.8 |
Central 2 | 80.9 | 19.9 | 57.4 | 28.3 | 3.1 |
Kampala | 89.4 | 27.3 | 59.0 | 30.9 | 5.0 |
East central | 73.6 | 51.5 | 55.7 | 17.5 | 1.4 |
Mid-eastern | 81.6 | 37.4 | 69.5 | 19.0 | 6.3 |
North-east | 62.8 | 8.0 | 58.0 | 2.4 | 0.3 |
Mid- northern | 68.4 | 21.9 | 48.6 | 9.3 | 3.0 |
West Nile | 68.0 | 14.5 | 57.1 | 8.5 | 4.9 |
Mid-western | 66.1 | 26.2 | 50.6 | 13.3 | 3.8 |
South-western | 71.4 | 37.7 | 41.1 | 33.1 | 3.1 |
Mother's education level | |||||
No education | 64.4 | 25.8 | 46.7 | 13.5 | 5.5 |
Primary | 69.7 | 21.6 | 53.4 | 13.0 | 2.2 |
Secondary | 84.0 | 42.3 | 66.4 | 23.8 | 2.5 |
Higher | 94.3 | 65.4 | 73.5 | 45.4 | 0.0 |
Wealth index | |||||
Poorest | 59.7 | 12.5 | 49.7 | 8.5 | 3.2 |
Poorer | 74.9 | 27.8 | 58.2 | 13.8 | 3.4 |
Middle | 72.3 | 27.4 | 49.3 | 17.4 | 2.9 |
Richer | 73.5 | 34.5 | 55.5 | 15.2 | 2.6 |
Richest | 82.5 | 38.3 | 60.7 | 28.5 | 1.7 |
Total | 70.9 | 26.0 | 54.0 | 15.2 | 2.9 |
Multivariate comparison
Paid out of pocket | Coef | Odds ratio | Std Err | z | P>z | |
---|---|---|---|---|---|---|
Wealth Index(Poorest) | ||||||
Poorer | 0.42 | 1.5 | 0.20 | 2.05 | 0.040 | * |
Middle | 0.41 | 1.5 | 0.22 | 1.88 | 0.060 | |
Richer | 0.43 | 1.5 | 0.24 | 1.77 | 0.076 | |
Richest | 0.95 | 2.6 | 0.31 | 3.02 | 0.003 | * |
Rural | −0.14 | 0.9 | 0.37 | −0.37 | 0.714 | |
Place first sought treatment | ||||||
(public facility)$ | ||||||
Private | 2.60 | 13.4 | 0.17 | 15.53 | 0.000 | ** |
Don’t know | 0.23 | 1.3 | 0.66 | 0.36 | 0.721 | |
Sought treatment from one source | −2.08 | 0.1 | 0.31 | −6.78 | 0.000 | ** |
Highest educational level | ||||||
(no education) | ||||||
Primary | −0.02 | 1.0 | 0.17 | −0.1 | 0.921 | |
Secondary | 0.51 | 1.7 | 0.28 | 1.83 | 0.068 | |
Higher | 1.46 | 4.3 | 1.16 | 1.26 | 0.207 | |
Sub-region(Central 1) | ||||||
Central 2 | 1.24 | 3.4 | 0.35 | 3.56 | 0.000 | ** |
Kampala | 1.44 | 4.2 | 0.69 | 2.09 | 0.036 | * |
East central | 1.28 | 3.6 | 0.35 | 3.63 | 0.000 | ** |
Mid-eastern | 1.31 | 3.7 | 0.38 | 3.46 | 0.001 | ** |
North-east | 0.69 | 2.0 | 0.34 | 2.05 | 0.040 | * |
Mid-northern | 0.82 | 2.3 | 0.33 | 2.47 | 0.013 | * |
West Nile | 0.67 | 2.0 | 0.33 | 2.03 | 0.043 | * |
Mid-western | 1.35 | 3.9 | 0.36 | 3.73 | 0.000 | ** |
South-western | 1.00 | 2.7 | 0.43 | 2.31 | 0.021 | * |
Normal duties disrupted | 0.78 | 2.2 | 0.16 | 4.79 | 0.000 | ** |
Constant | 0.44 | 1.6 | 0.87 | 0.51 | 0.610 | |
Number of observations | 1,357 | |||||
Pseudo R2 | 0.2645 | |||||
LR chi2(21) | 444.63 |
Levels and patterns of out-of-pocket expenditure
Background characteristics | Total | Consultation | Medicine | Transport | Hospitalization |
---|---|---|---|---|---|
Residence | |||||
Urban | 7.26 | 4.85 | 4.35 | 1.65 | 7.05 |
Rural | 3.39 | 2.85 | 2.06 | 2.35 | 7.69 |
Sub-region | |||||
Central 1 | 4.57 | 2.14 | 3.88 | 1.91 | 17.24 |
Central 2 | 4.73 | 4.28 | 3.07 | 2.15 | 9.94 |
Kampala | 5.06 | 2.96 | 5.04 | 1.10 | 8.03 |
East central | 5.90 | 4.09 | 2.86 | 1.61 | 4.79 |
Mid-eastern | 4.91 | 4.24 | 2.09 | 2.89 | 5.86 |
North-east | 2.60 | 2.42 | 2.26 | 5.47 | 0.49 |
Mid-northern | 1.58 | 1.14 | 0.98 | 2.79 | 3.13 |
West Nile | 1.68 | 1.81 | 1.02 | 1.22 | 3.40 |
Mid-western | 5.24 | 2.02 | 3.01 | 2.98 | 23.46 |
South-western | 7.05 | 5.69 | 4.44 | 1.94 | 13.46 |
Mother's education level | |||||
No education | 3.92 | 2.85 | 2.56 | 2.13 | 4.89 |
Primary | 3.17 | 2.83 | 1.86 | 2.33 | 10.02 |
Secondary | 6.65 | 5.03 | 4.07 | 2.30 | 7.04 |
Higher | 4.12 | 2.73 | 2.27 | 0.93 | - |
Wealth index | |||||
Poorest | 2.42 | 2.33 | 1.53 | 2.73 | 4.33 |
Poorer | 3.03 | 2.80 | 1.68 | 2.82 | 3.70 |
Middle | 3.59 | 2.98 | 2.29 | 1.61 | 11.76 |
Richer | 4.17 | 3.46 | 2.28 | 2.14 | 8.19 |
Richest | 7.87 | 4.63 | 5.02 | 1.91 | 23.92 |
Total | 3.87 | 3.28 | 2.34 | 2.20 | 7.64 |
ln(out-of-pocket) | Coef | Std. Err | t-stat | P>t | |
---|---|---|---|---|---|
Wealth Index(Poorest) | |||||
Poorer | 0.20 | 0.12 | 1.69 | 0.091 | |
Middle | 0.03 | 0.13 | 0.26 | 0.798 | |
Richer | 0.10 | 0.14 | 0.75 | 0.453 | |
Richest | 0.43 | 0.17 | 2.53 | 0.011 | * |
Rural | -0.28 | 0.19 | -1.48 | 0.140 | |
Place first sought treatment (Public facility)$ | |||||
Private | -0.10 | 0.09 | -1.17 | 0.243 | |
Traditional healer | -1.73 | 0.33 | -5.20 | 0.000 | ** |
Dont Know | -0.06 | 0.50 | -0.11 | 0.909 | |
Sought treatment from one source | -0.56 | 0.13 | -4.42 | 0.000 | ** |
Highest educational level (no education) | |||||
Primary | -0.26 | 0.10 | -2.66 | 0.008 | * |
Secondary | 0.19 | 0.15 | 1.25 | 0.213 | |
Higher | -0.05 | 0.33 | -0.14 | 0.885 | |
Sub-region (Central 1) | |||||
central 2 | -0.13 | 0.20 | -0.64 | 0.522 | |
Kampala | -0.24 | 0.32 | -0.74 | 0.458 | |
east central | -0.39 | 0.21 | -1.86 | 0.063 | |
mid eastern | -0.22 | 0.21 | -1.04 | 0.299 | |
north east | -0.56 | 0.21 | -2.68 | 0.007 | * |
mid northern | -1.02 | 0.20 | -4.98 | 0.000 | ** |
west nile | -0.96 | 0.21 | -4.64 | 0.000 | ** |
mid western | 0.25 | 0.22 | 1.13 | 0.261 | |
south western | 0.31 | 0.24 | 1.31 | 0.192 | |
Normal duties disrupted | 0.49 | 0.09 | 5.70 | 0.000 | ** |
Constant | 9.44 | 0.48 | 19.73 | 0.000 | |
Number of observations | 936 | ||||
Adj R-squared | 0.21 | ||||
F(22, 913) | 12.6 |