The determinants of health services utilization in southern Iraq: a household interview survey

A household survey was conducted in 1982-83 in a sample of 324 households served by five health centres in two different areas of Southern Iraq. Information from each household was collected on socioeconomic factors, access to curative health services, sickness within the previous four weeks and the subsequent use of health services. Thirty seven per cent of people reported some sickness during the four-week recall period, giving an average of 40 episodes per 100 people per four weeks. The average consultation rate was 33 per 100 people and the annual estimated rate was 4.3 consultations per person per year. There was an average of 82 consultations per 100 sickness episodes with the highest rates for infectious and parasitic diseases (111) and hypertension and heart diseases (108), and the lowest for eye and ear diseases (52). The most important factors affecting utilization were level of perceived sickness in the household and the distance to the nearest health centre. Household income did not appear to be an important factor except for attendance at private clinics. The study suggests that the overall rate of utilization is sufficient for curative services but that now it is the quality of this care that needs to be examined.