The impacts of decentralization on health care seeking behaviors in Uganda.
This paper examines the impacts of a public sector decentralization program on health care seeking behaviors in Uganda in the 1990s. Shifting priorities by local governments in Uganda's decentralized health system away from provision of primary health care, in particular the provision of public goods or goods with substantial consumption externalities, and toward provision of private health goods such as curative care are linked to shifts in individual-level care utilization behaviors. This analysis finds that, while the country has been undergoing a multitude of changes in recent years, decentralization appears to have led to increases in the use of curative services with largely private benefits, perhaps at the expense of the use of primary health care services and services with consumption externalities. A longer period of analysis is required to determine the persistence of these effects.
Hutchinson
Paul
P
Department of International Health and Development, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, Suite 2200, New Orleans, LA 70112, USA. phutchin@tulane.edu
Akin
John
J
Ssengooba
Freddie
F
D018166:Health Care Reform; D019538:Health Care Surveys; D006292:Health Priorities; D006801:Humans; D010342:Patient Acceptance of Health Care; D011057:Politics; D011320:Primary Health Care; D011332:Privatization; D012040:Regional Health Planning; D014454:Uganda