Accessibility To And Utilization Of Primary Health Care In The Ga, Dangme East And Dangme West Districts Of The Greater Accra Region

ABSTRACT

The study examined the accessibility and other socio-economic forces that influence the

utilization o f primary health care services in the rural parts o f the Greater Accra Region o f

Ghana. Three administrative districts, Ga, Dangme West and Dangme East, were selected

for study. Both qualitative and quantitative data were used. Questionnaire and interview

schedules reinforced by focus group discussions and observations, were the main research

instruments. Descriptive and multivariate techniques are the analytical tools.

The main factors that influenced utilization as established by the empirical research, have

been income, distance, transport and service costs, waiting and travel times, educational

status in the analysis. The researcher establishes that, the main factors that influence

utilization o f primary health care services in the rural parts o f Greater Accra Region are

income and distance. The other factors are service costs, transport cost and waiting time.

Income shows a positive relationship with utilization, whilst service cost exhibits a

negative relationship to validate the hypotheses. Income makes a stronger impact than

distance, service cost and waiting time. The impact o f education, though statistically

significant, is weak.

There were differences by place o f residence, and also by health status (patient and nonpatient).

With regard to income, the impact at the Ga District is stronger than that o f the

Dangme West and Dangme East Districts, whilst non-patients are more affected than

patients. With regard to distance and utilization, the Dangme East and Dangme West

Districts show a stronger negative impact than the Ga District, whilst the impact o f patients

is stronger than non-patients. Waiting time and service costs have a greater impact in the

Ga District than in the Dangme West and Dangme East Districts. For health status,

patients are more affected by distance than non-patients.

Several recommendations have been made to enhance utilization and the quality o f health

and health care. These include among others the strengthening and upgrading o f primary

health care facilities in the rural districts, improvement o f the quantity and quality o f

medical and paramedical staff and the introduction o f a National Health Insurance Scheme.