Publisher: African Studies Association

Responding To Crisis: Patterns of Health Care Utilization In Central Kenya Amid Economic Decline

Paul N. Mbatia, York W. Bradshaw
KEYWORDS: Responding to Crisis: Patterns of Health Care Utilization in Central Kenya Amid Economic Decline


African states have become increasingly unable to provide adequate health care to their citizens due to debt, structural adjustment, poverty, and mismanagement. The health crisis is worsening in many areas and driving up mortality rates after decades of decline. This article investigates how African communities and their citizens respond in light of state inability to deliver health-related services. Drawing on a survey of more than five hundred rural Kenyans, our analysis shows that people are dissatisfied with government facilities and are turning to mission clinics and hospitals as well as to private clinics. A number of factors determine choice of health-care facility, including cost, level of education, socioeconomic background, the time taken to reach a facility, the type of disease requiring treatment, and agro-ecological zones. These findings have profound theoretical implications for health and development models, which normally are biased in favor of developed Western countries.

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