Table 3.

How quality influences the utilization of health services

Attribute of quality	Group most affected	Effect on utilization
Negative attitudes of health workers	The poor, ethnic minorities	They decide not to seek services eg, antenatal and delivery services
		They don’t receive services such as drugs, proper examination
		They go to traditional providers/herbalists
Long waiting times	Those seeking care from public facilities especially those from lower social classes	Self medication
		They go to drug shops, private clinics or traditional healers
Long distances to health facilities	Pregnant women	Deliver with traditional birth attendants who are located closer to them
	The poor	Seek care from facilities that are closer irrespective of the quality of care provided
		Decide not to seek formal care
Poor infrastructure and hygiene	Those using public facilities	They go to private providers
Lack of equipment for theatre, drugs, and qualified staff	Both the poor and rich	Go to the facilities that have the equipment, drugs depending on severity of the condition. For minor illness private clinics, for severe illnesses government or PNFP hospitals
		Seek no care
		Self medication
Good interpersonal relations	Both the poor and rich	Use private facilities

Abbreviation: PNFP, private not-for-profit.