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Responding to Crisis: Patterns of Health Care Utilization in Central Kenya Amid Economic Decline

Published online by Cambridge University Press:  23 May 2014

Paul N. Mbatia  and
York W. Bradshaw
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Abstract:

African states have become increasingly unable to provide adequate health care to their citizens due to debt, structural adjustment, poverty, and mismanagement. The health crisis is worsening in many areas and driving up mortality rates after decades of decline. This article investigates how African communities and their citizens respond in light of state inability to deliver health-related services. Drawing on a survey of more than five hundred rural Kenyans, our analysis shows that people are dissatisfied with government facilities and are turning to mission clinics and hospitals as well as to private clinics. A number of factors determine choice of health-care facility, including cost, level of education, socioeconomic background, the time taken to reach a facility, the type of disease requiring treatment, and agro-ecological zones. These findings have profound theoretical implications for health and development models, which normally are biased in favor of developed Western countries.

Résumé:

Résumé:

À cause de la dette, de l'ajustement structurel, de la pauvreté et d'une mauvaise gestion, les états africains sont devenus de plus en plus incapables d'offrir une couverture médicale adéquate à leurs citoyens. La crise de la santé s'aggrave dans de nombreuses régions et fait grimper les taux de mortalité après des années de régression. Cet article examine comment les communautés africaines et leurs citoyens réagissent au vu de l'incapacité de l'état à leur offrir des services liés à la santé. En s'inspirant d'une enquête effectuée sur plus de cinq cent Kenyans ruraux, notre analyse montre que la population n'est pas satisfaite des structures offertes par le gouvernement et qu'elle se tourne vers les cliniques et hôpitaux de mission ainsi que vers les cliniques privées. Un nombre de facteurs détermine le choix de ces structures médicales, comme par exemple le coût, le niveau d'instruction, le milieu socio-économique, le temps nécessaire pour atteindre une structure, le type de maladie à traiter, et les zones agro-écologiques. Ces résultats ont de profondes implications théoriques sur les modèles de santé et de développement qui d'habitude sont influencés en faveur des pays occidentaux développés.

Type
Articles
Information
African Studies Review , Volume 46 , Issue 1 , April 2003 , pp. 69 - 92
Copyright
Copyright © African Studies Association 2003

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