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Malaria Journal

, 11:55

First Online: 23 February 2012Received: 17 November 2011Accepted: 23 February 2012DOI: 10.1186-1475-2875-11-55

Cite this article as: Kizito, J., Kayendeke, M., Nabirye, C. et al. Malar J 2012 11: 55. doi:10.1186-1475-2875-11-55


BackgroundIncreasing access to health care services is considered central to improving the health of populations. Existing reviews to understand factors affecting access to health care have focused on attributes of patients and their communities that act as -barriers- to access, such as education level, financial and cultural factors. This review addresses the need to learn about provider characteristics that encourage patients to attend their health services.

MethodsThis literature review aims to describe research that has identified characteristics that clients are looking for in the providers they approach for their health care needs, specifically for malaria in Africa. Keywords of -malaria- and -treatment seek*- or -health seek*- and -Africa- were searched for in the following databases: Web of Science, IBSS and Medline. Reviews of each paper were undertaken by two members of the team. Factors attracting patients according to each paper were listed and the strength of evidence was assessed by evaluating the methods used and the richness of descriptions of findings.

ResultsA total of 97 papers fulfilled the inclusion criteria and were included in the review. The review of these papers identified several characteristics that were reported to attract patients to providers of all types, including lower cost of services, close proximity to patients, positive manner of providers, medicines that patients believe will cure them, and timeliness of services. Additional categories of factors were noted to attract patients to either higher or lower-level providers. The strength of evidence reviewed varied, with limitations observed in the use of methods utilizing pre-defined questions and the uncritical use of concepts such as -quality- -costs- and -access-. Although most papers 90% were published since the year 2000, most categories of attributes had been described in earlier papers.

ConclusionThis paper argues that improving access to services requires attention to factors that will attract patients, and recommends that public services are improved in the specific aspects identified in this review. It also argues that research into access should expand its lens to consider provider characteristics more broadly, especially using methods that enable open responses. Access must be reconceptualized beyond the notion of barriers to consider attributes of attraction if patients are to receive quality care quickly.

KeywordsAccess Treatment seeking Malaria Attracting factors Health care providers  Download fulltext PDF

Autor: James Kizito - Miriam Kayendeke - Christine Nabirye - Sarah G Staedke - Clare IR Chandler


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