The determinants of primary health care utilization: A comparison of three rural clinics in southern Honduras

Primary health care utilization is poorly understood in many parts of the developing world. This is especially true in rural places, such as Santa Lucia, Intibuca, Honduras, where there are only three primary health care facilities servicing almost 12,000 people, and generally speaking access to care is limited. This study examines the factors that can be used to explain primary health care utilization, and aims to improve the understanding of patient utilization behavior. A better understanding of utilization can be used by health service planners to improve primary health care delivery in this and similar locations. The findings of this research indicate that utilization can be explained, to a large extent, by factors relating to economic status and walking time to clinic. These findings are consistent with findings from prior research. In addition, a home territory variable is used to examine spatial variations of utilization behavior. This variable has not been considered in previous utilization research, and is found to be a very significant determinant of health facility utilization in the study area. © 2006 Springer Science+Business Media, Inc.