title: Increasing the utilization of cost-effective health services through changes in demand.
abstract: Attaining efficiency in a health care system with a budget constraint involves increasing the utilization of the most cost-effective services. This can be achieved by adjustments to prices, cost curves, or demand curves. In this paper, the potential for demand curve adjustments is examined by selecting two apparently cost-effective services (prenatal care and childhood immunization against tuberculosis), and analyzing the factors explaining their utilization. Data from recent household surveys in Burkina Faso and Niger are used. A multivariate analysis of utilization employs income, price, and taste variables. Utilization is highly sensitive to the distance which must be travelled to the health facility, a price, and taste variables. Utilization is highly sensitive to the distance which must be travelled to the health facility, a price variable. Members of certain ethnic groups tend to use the services less, other things being equal. The importance of demand-side factors like ethnicity points to certain kinds of policy interventions like information, education and communication activities which could increase the utilization of cost-effective services.
authors.affiliation: School of Public Health, University of Michigan, Ann Arbor 48109, USA.
authors.forename: R
authors.initials: R
authors.lastname: Barlow
authors.forename: F
authors.initials: F
authors.lastname: Diop
mesh_terms: D002050:Burkina Faso; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000458:organization & administration*; D017598:Efficiency, Organizational; D005006:Ethnicity; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D007223:Infant; D015999:Multivariate Analysis; D009548:Niger; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D011635:Public Health Administration / Q000191:economics; D014376:Tuberculosis / Q000517:prevention & control