Disparities in modern health service utilization across socio-demographic and economic inequalities among households in Gida Ayana district, Oromia Regional state, Ethiopia: a community-based cross-sectional study

Edosa Tesfaye Geta · Abebe Wakjira Bidika · Wase Benti Hailu

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Public Health and Social Inequalities Healthcare Systems and Reforms Health disparities and outcomes

Abstract

BACKGROUND: Health care disparities (HCD) occur across a broad range of dimensions and achieving equity in health care is a strenuous task. To overcome the disparities, countries worldwide have started implementing varies policies. HCD remains a challenge in the health care system of Ethiopia. Hence, the study aimed to estimate the disparities in health care utilization (HCU) among households. METHODS: A community-based cross-sectional study was conducted from February 01 to April 30, 2022, among households in Gida Ayana District, Ethiopia. A single population proportion formula was used to determine the 393sample size, and participants were selected using systematic sampling. Data was entered into Epi-data 4.6 and exported to SPSS 25 for analysis. Descriptive analysis and binary and multivariable logistic regressions were performed. RESULTS: Of the 356 households that participated in the study, 321 (90.2%) of them reported at least one member of their family perceived morbidity in the last six months. The overall level of HCU determined was 207(64.5%), 95% confidence interval (CI),59.0-69.7%. Urban residents (AOR = 3.68, 95% CI = 1.94-6.97), attending secondary school and above (AOR = 2.79, CI = 1.27-5.98), rich (AOR = 2.47, CI = 1.03-5.92), small families (AOR = 2.83, CI = 1.26-6.55), and insured (AOR = 4.27, CI = 2.36-7.71) significantly contributed to HCD. CONCLUSIONS: Households' overall level of HCU for perceived morbidity was moderate. However, significant disparities were observed in HCU across place of residence, wealth status, level of education, family size, and health insurance. Hence, strengthening the strategy of financial protection by implementing health insurance that focuses on the socio-demographic and economic status of households is recommended to reduce the disparities.

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