Patterns and Predictors of Private and Public Health Care Utilization in an Informal Settlement in Nairobi, Kenya

Elvis Omondi Achach Wambiya, African Population and Health Research Center (APHRC)
Peter Otieno, African Population and Health Research Center (APHRC)
Martin K. Mutua, African Population and Health Research Center (APHRC)
Shukri Mohamed, African Population and Health Research Center (APHRC)
Hermann Donfuet, African Population and Health Research Center (APHRC)

Background: Inconclusive evidence exists on healthcare utilization in informal settlements in Kenya. This study assessed the patterns and predictors of private and public healthcare utilization in an urban informal settlement. Methods: This cross-sectional study was conducted in 300 randomly selected households. Data were collected for all household members who sought care in the 12 months preceding the study. Multinomial logistic regression was used to identify predictors of healthcare use. Results: Out of 364 individuals who sought care, 47%, 33% and 20% used private, public and other facilities, respectively. Health insurance coverage and having acute infection was associated with private facility use. Satisfaction with the quality of care was associated with lower use of public facilities while satisfaction with cost of care favoured their use. Conclusions: Healthcare utilization favours private health facility use. Interventions for healthcare access in informal settlements should consider enabling and need factors, particularly healthcare quality and financing.