Factors influencing the use of public and private health care facilities among poor older people in rural Ghana

Objective: The choice of a particular health care facility is premised on certain factors which remain largely unknown in rural settings in Ghana. The purpose of this study was to explore issues influencing public and private health care facilities use among poor older people in rural Ghana. Methods: In-depth interviews and focus group discussions were conducted with 30 poor older persons, 15 caregivers, and 15 formal health care providers in the Atwima Nwabiagya District of the Ashanti Region of Ghana. A thematic analytical framework was used to analyze the data, which was then presented based on an a posteriori inductive reduction approach. Findings: Three key public health care facility use factors were identified: health insurance acceptance, perceived service affordability, and availability of well-trained professionals. For private health care facilities, five main use factors were found: distance and proximity, good interpersonal relationships, good quality health services, service responsiveness, and logistics availability. Conclusion: The findings of this study have implications for addressing attitudinal problems existing mainly in public health care facilities in Ghana. It also calls for policy intervention toward equitable access to public and private health facilities, especially for poor older persons.