The study aims to analyze the determinants of health care seeking in households in Abidjan during an episode of illness. The data for this study came from a household survey in the city of Abidjan. Based on the data collected, univariate and multivariate analyses provided explanatory elements for the population’s health care utilization behaviors and the use and non-use of health services. The results of this research show the predominance of self-medication in the therapeutic use of young people and adults. The use of modern health care services is delayed and only occurs when the disease becomes very serious. The therapeutic itinerary is thus long, difficult, and costly, especially for adults. In addition, we focused on residence throughout the analysis because we believe that this factor influences household use of care. The results of the univariate analyses often highlighted the role of the “neighborhood” factor at the expense of the subdivision and building density criteria. To continue this approach, we constructed a logistic regression model with this location variable. If at first the fact of residing in a given neighborhood was associated with the use of health care, by integrating other independent variables such as religion, level of equipment, etc., the association disappeared. The association disappeared. With the same level of equipment or the same religious affiliation, there is less of a neighborhood effect. We have therefore demonstrated a composition effect (individual socio-demographic factors) rather than a context effect (location factors). Further multilevel analyses would be necessary to investigate this question further and to assess the actual role of contextual factors in the use of health care in Abidjan.
Cite this paper
Ymba, M. (2022). Determinant of Health Care Utilization Behavior in Households in the City of Abidjan during an Episode of Illness. Open Access Library Journal, 9, e8913. doi: http://dx.doi.org/10.4236/oalib.1108913.
Willems, M., Masuy-Stoobant, G. and Tonglet, R. (1999) La santé des enfants de moins de 5 ans et les recours thérapeutiques dans un district sanitaire urbain de Ouagadougou. Chaire Quételet, Population et défis urbains.
Ryan, G.W. (1998) What Do Sequential Behavioral Patterns Suggest about the Medical Decision-Making Process? Modeling Home Case Management of Acute Illness in a Rural Cameroonian Village. Social Science and Medicine, 46, 209-225.
https://doi.org/10.1016/S0277-9536(97)00151-2
Goldman, N. and Heuveline, P. (2000) Health-Seeking Behavior for Child Illness in Guatemala. Tropical Medicine and International Health, 5, 145-155.
https://doi.org/10.1046/j.1365-3156.2000.00527.x
Amat-Roze, J.-M. (2003) La santé en Afrique, un continent, deux mondes. In: Lesourd, M., Ed., Afrique, Vulnérabilités et Défis, Editions du Temps, Paris, 22 p.
Caldwell, J.C., Findley, S.E., Caldwell, P., Santos, G., Cosford, W., Braid, J. and Broers, F.D. (1990) What We Know about Health Transition: The Cultural, Social and Behavioral Determinants of Health. Proceedings of an International Workshop, Vol. 2, 500-933.
Ymba, M. (2013) Accès et recours aux soins de santé modernes en milieu urbain: Le cas de la ville d’Abidjan—Côte d’Ivoire. Thèse de Doctorat, University of Artois, Arras, 510 p.
Mariko, M. and Cissé, B. (1999) Equité dans l’accès aux soins et l’utilisation des services de santé: Cas de cinq capitales ouest africaines. IRD, UNICEF, Coopération française, Abidjan.
Marconot, J.-M. (2003) La fin des villes, la durée des quartiers. Natures Sciences Sociétés, 11, 266-275. https://doi.org/10.1016/S1240-1307(03)00083-9
Kouassi, B. (2008) Pauvreté des ménages et accès aux soins de santé en Afrique de l’Ouest: Burkina Faso, Côte d’Ivoire, Ghana, Mali, et Togo. Karthala, Paris, 281 p.
Keoula, Y. (2000) Niveau de vie et recours aux soins d’après les enquêtes de niveau de vie financées par la Banque Mondiale en Côte d’Ivoire. Rapport de stage intermédiaire, ENSEA, IRD, 101 p.
Touré, B. (1993) Analyse de la morbidité déclarée et le recours aux soins des ménages de Yopougon au cours de la période allant d’octobre 1991 à mai 1992. Ecole Nationale Supérieure de Statistique et d’Economie Appliquée (ENSEA), 48 p.
Harang, M. (2007) Système de soins et croissance urbaine dans une ville en mutation Le cas de Ouagadougou (Burkina Faso). Thèse de doctorat en géographie de la santé, Université Paris-X-Nanterre, Paris, 507 p.
Diakité, B. (1993) Problèmes des nomades au Gourma. In: Brunet-Jailly, J., Ed., Se soigner au Mali: Une construction des sciences sociales, douze expérience de Terrain, Karthala, Orstom, Paris, 193-209.
Dorier-Apprill, E. (1995) Pour une géographie du pluralisme thérapeutique dans les grandes villes d’Afrique Noire. Espace, Populations et Sociétés, 1, 135-141.
https://doi.org/10.3406/espos.1995.1681
Andersen, R. and Newman, J. (1972) Societal and Individual Determinants of Medical Care Utilization in the United States. The Milbank Memorial Fund Quarterly. Health and Society, 51, 95-124. https://doi.org/10.2307/3349613
Andersen, R. (1995) Revisiting the Behavioral Model and Access to Medical Care: Does It Matter? Journal of Health and Social Behavior, 36, 1-10.
https://doi.org/10.2307/2137284
Wyss, K. (1994) Utilisation des services de santé en milieu urbain à N’Djaména (Tchad): étude des déterminants et des interactions. Basel/Suisse, 243 p.
Kroeger, A. (1983) Anthropological and Socio-Medical Health Care Research in Developing Countries. Social Science and Medicine, 17, 147-161.
https://doi.org/10.1016/0277-9536(83)90248-4
Kroeger, A. (1983) Health Interview Surveys in Developing Countries: A Review of Methods and Results. International Journal of Epidemiology, 12, 465-481.
https://doi.org/10.1093/ije/12.4.465
Becker, S., Maiman, L.A., Kirscht, J.P., Haefner, D.P. and Drachman, R.H. (1977) The Health Belief Model and Prediction of Dietary Compliance: A Field Experiment. Journal of Health and Social Behavior, 18, 348-366.
https://doi.org/10.2307/2955344
Timaeus, I., Harpharm, T., Price, M. and Gilson, L. (1988) Health Surveys in Developing Countries: The Objectives and Design of an International Program. Social Science and Medicine, 27, 359-368. https://doi.org/10.1016/0277-9536(88)90270-5
Develay, A. (1993) Repérage des modes et des facteurs d’utilisation des différents types de soins par la population de la ville de Ouagadougou. Thèse de doctorat en médecine, Université René Descartes, Paris, 131 p.
Kroeger, A. (1985) Responses Errors and Other Problems of Health Interview Surveys in Developing Countries. World Health Statistics Quarterly, 38, 15-37.
Ross, D.A. and Vaughan, J.P. (1986) Health Interview Surveys in Developing Countries: A Methodological Review. Studies in Family Planning, 17, 78-94.
https://doi.org/10.2307/1967068
Leyva-Flores, R., Kageyama, M.L. and Erviti-Erice, J. (2001) How People Respond to Illness in Mexico: Self-Care or Medical Care? Health Policy, 57, 15-26.
https://doi.org/10.1016/S0168-8510(00)00136-6
Taffa, N. and Chepngeno, G. (2005) Determinants of Health Care Seeking for Childhood Illness in Nairobi Slums. Tropical Medicine and International Health, 10, 240-245. https://doi.org/10.1111/j.1365-3156.2004.01381.x
Chaix, B. and Chauvin, P. (2002) L’apport des modèles multiniveaux dans l’analyse contextuelle en épidémiologie sociale: Une revue de littérature. Revue d’épidémiologie et de Santé Publique, 50, 489-499.
Bouyer, J., Hemon, D., Cordier, S., Derriennic, F., Stucker, B., Stengel, B. and Clavel, J. (1995) épidémiologie. Principes et méthodes quantitative. Inserm, Paris, 498 p.
Sauerborn, R., Nougtara, A. and Hien, M. (1996) Seasonal Variations of Household Costs of Illness in Burkina Faso. Social Science and Medicine, 43, 281-290.
https://doi.org/10.1016/0277-9536(95)00374-6
Aye, M., Champagne, F. and Contandriopoulos, A.P. (2002) Economic Role of Solidarity and Social Capital in Accessing Modern Health Care Services in the Ivory Coast. Social Science and Medicine, 55, 1929-1946.
https://doi.org/10.1016/S0277-9536(01)00322-7
Baltussen, R. and Ye, Y. (2006) Quality of Care of Modern Health Services as Perceived by Users and Non-Users in Burkina Faso. International Journal of Quality in Health Care, 18, 30-34. https://doi.org/10.1093/intqhc/mzi079
Fournier, P. and Haddad, S. (1995) Les facteurs associés à l’utilisation des services de santé dans les pays en développement. In: Gerard, H. and Piché, V., Eds., Sociologie des populations, PUM/AUPELF-UREF, Montréal, 289-325.