Demand for medical care : an economic analysis of Kala Azar in Nepal

Abstract

This study contributes to the literatures by measuring in quantitative terms the potential effects of poverty-alleviation programs on the incidence of disease; exploring road map of decision making process for health seeking; examining utilization patterns of health services based on first consultation and factor influencing multiple consultations to the providers. For empirical analysis, the sophisticated statistical tools are applied to recently collected data from secondary and primary sources in Nepal. The study focuses on Kala Azar (KA) - a neglected tropical disease, also known as disease of poor. The results of demand analysis suggest that absolute poor are highly price sensitive, although health services are provided free of cost at the public hospitals. Provision of free health care may not be sufficient to encourage utilization of health services by the poor patients or households. Based on empirical model, this study has also explored the implication of introducing demand side financing and better access to information on the utilization of public hospitals. The utilization of public hospital can be increased from 16 percent up to 63 percent due to price effects; however, the effect of income on utilization rate is relatively small. Better access to information reduces likely of using self-care or home care; drug stores and private clinics and increases the utilization of public hospitals. A holistic approach rather than traditional disease-centered approach can break the links between poverty and KA; and expansion of KA care in public and private providers and better access to information can help to control of KA in Nepal