Where do people with hypertension or type 2 diabetes seek care when ill? A cross-sectional study on sociodemographic correlates of utilization of healthcare facilities in rural Kenya

Abstract

Abstract Background Hypertension and type 2 diabetes are among the most common non-communicable diseases that contribute to a large number of adult morbidity and mortality in Kenya. The impact of these conditions may pose the greatest challenge in rural areas with limited access to care. The objective of the study was to assess utilization of healthcare facilities (Primary, Secondary and Tertiary levels) and associated sociodemographic factors among people with hypertension or type 2 diabetes and/or at risk of having these conditions in rural Kenya. Methods This study used data from the 2019 Baseline Assessment of the Prevention and Control of Non-Communicable Disease Project in Imenti South, Meru County conducted by the Kenya Red Cross Society. A community-based study using a cross-sectional design was conducted among four hundred and thirty-five participants in Imenti South Sub Country, Meru County in Kenya in November 2019. Chi-square test and logistic regression analyses were conducted to explore sociodemographic factors associated with utilization of healthcare facilities. Unadjusted and adjusted Odds Ratios with a 95% Confidence Interval (CI) were reported. Results The mean age of the participants was 49.1 years (standard deviation [SD] = 17.6 years). Of the 435 participants, 51.30% (n = 223), 36.30% (n = 158), and 42.50% (n = 185) utilized primary, secondary and tertiary healthcare facilities respectively. Factors significantly associated with the utilization of a primary healthcare facility were participants living in Mitunguu region (adjusted OR 2.74, 95% CI 1.65–4.60), and College or University education (adjusted OR 0.15, 95% CI 0.04–0.60). Factors significantly associated with the utilization of a tertiary healthcare facility included age group > 40 years (adjusted OR 2.41, 95% CI 1.45-4.00), living in Igoji region (adjusted OR 2.19, 95% CI 1.22–3.11), and Mitunguu region (adjusted OR 0.26, 95% CI 0.15–0.48), College or University education (adjusted OR 8.53, 95% CI 1.97–36.87) and average monthly income (adjusted OR 2.29, 95% CI 1.28–4.08). Conclusions The utilization of the primary healthcare facility was associated with ward and educational level, and the utilization of the tertiary healthcare facility was associated with age, ward, educational level, and average monthly income among rural Kenyans who had hypertension or type 2 diabetes and/or were at risk of having these conditions. These results provide insights regarding the sociodemographic factors associated with the utilization of healthcare facilities in rural Kenya that could contribute to evidence-based health policymaking. Additionally, the results highlight the relevance of taking sociodemographic factors into account when designing interventions for people with non-communicable diseases living in rural Kenya.