Health-care-seeking patterns in the emerging private sector in Burkina Faso: a population-based study of urban adult residents in Ouagadougou.
BACKGROUND
The private medical care sector is expanding in urban cities in Sub-Saharan Africa (SSA). However, people's health-care-seeking behaviors in this new landscape remain poorly understood; furthermore, distinguishing between public and private providers and among various types of private providers is critical in this investigation. This study assessed, by type, the healthcare providers urban residents in Burkina Faso visit, and their choice determinants.


METHODS
We conducted a population-based survey of a representative sample of 1,600 households in Ouagadougou from July to November 2011, consisting of 5,820 adults. We assessed the types of providers people typically sought for severe and non-severe conditions. We applied generalized estimating equations in this study.


RESULTS
Among those surveyed, 97.7% and 53.1% indicated that they seek a formal provider for treating severe and non-severe conditions, respectively. Among the formal provider seekers, 20.5% and 17.0% chose for-profit (FP) providers for treating severe and non-severe conditions, respectively. Insurance coverage was held by 2.0% of those surveyed. Possessing insurance was the strongest predictor for seeking FP, for both severe (odds ratio [OR]  = 1.15, 95% confidence interval [CI] = 1.04-1.28), and non-severe conditions (OR = 1.22, 95% CI = 1.07-1.39). Other predictors included being a formal jobholder and holding a higher level education. By contrast, we observed no significant difference in predisposing, enabling, or need characteristics between not-for-profit (NFP) provider seekers and public provider seekers. Proximity was the primary reason for choosing a provider.


CONCLUSIONS
The results suggested that FP providers play a crucial role in the urban healthcare market in SSA. Socioeconomic status and insurance status are significant predictors of provider choice. The findings can serve as a crucial reference for policymakers in response to the emergence of FP providers in SSA.
International Health Program, National Yang Ming University, Taipei, Taiwan; École Nationale de Santé Publique, Ouagadougou, Burkina Faso.
Idrissa
I
Beogo
School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
Chieh-Yu
CY
Liu
Institute of Public Health, School of Medicine, National Yang Ming University, Taipei, Taiwan.
Yiing-Jenq
YJ
Chou
Institute of Public Health, School of Medicine, National Yang Ming University, Taipei, Taiwan.
Chuan-Yu
CY
Chen
Institute of Hospital and Health Care Administration, School of Medicine, National Yang Ming University, Taipei, Taiwan.
Nicole
N
Huang
D000293:Adolescent; D000328:Adult; D000368:Aged; D002050:Burkina Faso; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D017149:Private Sector; D055815:Young Adult