Determinants of choosing public or private health care among patients with sexually transmitted infections in Uganda

Sex Transm Dis. 2006 Jul;33(7):422-7. doi: 10.1097/01.olq.0000204574.78135.9f.


Objectives: To identify variables that distinguish patients with sexually transmitted infections (STIs) who seek care in public or private health units.

Goal: To recommend measures for improved care of patients with STIs.

Study design: Patients with STIs were interviewed at public (n = 101) or private health units (n = 124). Information was collected on attitudinal, normative, and self-efficacy beliefs; STI symptoms; health-seeking behavior; sociodemographic characteristics, and on partner referral.

Results: Choosing private health units is favored by age >25 years, favorable beliefs towards private health units (e.g., they cure or prevent STIs and give adequate drug doses); unfavorable beliefs towards public health units (such as they make STIs chronic and have corrupt staff); not being influenced by sexual partner(s) in choice of treatment site, being likely to chose a treatment site if sexual partners were not treated free, and being likely to choose a treatment site if not recommend by a friend. This 9-variable model correctly classified 214 (95%) of the 225 patients (model chi squared = 192, 9 degrees of freedom, P <0.001).

Conclusions: Psychosocial variables markedly influence choice of health care provider. Improving quality of care will enhance STI management and help to modify the unfavorable psychosocial beliefs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attitude to Health*
  • Decision Making
  • Female
  • Health Care Costs
  • Health Care Surveys
  • Health Facilities / standards
  • Health Facilities / statistics & numerical data*
  • Humans
  • Male
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Private Sector*
  • Public Sector*
  • Quality of Health Care
  • Sexually Transmitted Diseases / etiology
  • Sexually Transmitted Diseases / therapy*
  • Uganda