Availability and Utilization of Some Primary Health Care Services in Adults Aged 20-60 in Bihsud District of Nangarhar Province, Afghanistan

Abstract

Availability and utilization of primary health care is the best measure to evaluate the existent status of health care services of a community. The aim of this study was to assess the utilization of some available primary health care services among adults aged 20-60 in, Bihsud District of Nangarhar Province of Afghanistan. In this cross sectional survey, the data were gathered via a structured pre-tested questionnaire form. Responses from 880 participants were analyzed by using IBM SPSS Statistics 21 Program, and the findings were presented in marginal and contingency tables. Mainly Chi Square test was used with α=0.05 to find out significance level of differences and then binary logistic regression was used to assess the strength of association, between utilization health services and independent factors of the participants. 91.2% utilized improved water source; utilization of sanitary latrine was low as 51.1%. Primary health care services were available in the survey district. 75.3% of people utilized only public health center, 13.3% only private and 11.4% utilized public and private center for obtaining health services. Mean distance from the nearest health center was 4.6 ± 2.2 km, 44.7% used public transportation and mean time to travel to the health center was about 29.8 ± 9.9 minutes. Of the women who had at least one pregnancy 63.0% were utilized ANC services (54.7% at least once 17.1% at least 4 visits) during their last pregnancy, while 50% PNC services, 68.5% were delivered at home, and 31.5% of the deliveries was assisted by health personal. 29.5% of the participants were using a contraceptive method; prevalence of contraceptive use in males was 23.6%, and in females 36.4%; the more frequently used method in males was condom, in female’s oral pill. Overall 69.8% of the participants were satisfied from the cost of the health services, 67.4% from distance to the health center, 54.2% form travel time to reach the services; and 23.1% was satisfied from the existed health services. Economic limitations, traditional barriers, poor services and inaccessibility were the most common reasons for not utilizing MH services.