Distance as a predominant factor in the utilisation of health services in the Kumasi metropolis, Ghana.

The research primarily aims at testing a model, adapted form existing models, on the influence of distance on the use of health services in the Kumasi metropolis, an expanding urban centre in Ghana. Primary data, collected between August 2000 and February 2001, were used for the study. The data were analysed using a multiple regression model and compound bar graphs. A sample of 250, drawn through systematic random and stratified procedures, was used for the cross-sectional retrospective survey. Data were collected through formal interview schedules, after preliminary observational survey. The survey has established three principal findings. First, distance shows a strong inverse relationship with the utilisation of heath services in the metropolis. Second, travel time and transport cost, variables that are related to distance, exhibit a weak negative and positive associations repectivesly with the use of health services. Third, the vulnerable groups of women, the aged, the sickly, the illiterate and the poor are not affected by distance decay in the utilisation of thealth services. Finally, independent variables that are statistically significant in influencing utilisation, alongside distance, are education, service cost, quality of service and health status. Recomendations ofr locational modelling of health services at the deprived periphery, an introduction of an insurance scheme to facilitate health care use, and recommendations for further research have been made. (aut. ref.)