Health Service Utilization in Amhara Region of Ethiopia

Background: Information on health service utilization is crucial for planning, organizing and evaluation of health services. Objective: Assess perceived morbidity and examine the factors associated with utilization of health services by a sample of the population of the Amhara Region. Methods: Questionnaire was administered in 7 urban and 14 rural kebeles in four administrative zones. A total of 17780 people were included in the study. Results: Of the 200 reported deaths 118 (59%) visited health institutions for the killer disease. Over the two weeks period preceding the survey, 995 (5.6%) people claimed that they were sick and 38.7% of them visited health institutions. The most important reasons for not visiting health institutions were believed that the disease did not need treatment in health institutions (31.9%), bought drugs from drug vendors (27.2) and visited traditional healers (20.2%). In multivariate analysis urban residence (OR= 2.8, 95%CI 1.8, 4.5) and educational status of head of household (OR =3.4 95%CI 2.1,5.5) were significantly related to utilization of modern health institutions. Teenagers and persons above the age of 60 were less likely to visit modern health services. Conclusion: There is a wide gap between perceived morbidity, mortality, and modern health service utilization. In addition to the problems of accessibility and illiteracy of household heads, assumptions that modern health institutions are not helpful for certain disease conditions appear to be the main reason for low utilization of health services. [Ethiop. J. Health Dev. 2003;17(2):141-147]