ArticleBMC health services research2018
Bypassing health facilities in rural Mozambique: spatial, institutional, and individual determinants.
Article in BMC health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers.
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Who cites it
36 citing papers in PubMed, 75 citations in OpenAlex.
- Bypassing primary healthcare facilities for maternal and child health services in low- and middle-income countries: a scoping review.Reproductive health · 2026Article
- Healthcare workers' perspectives on patient bypassing of Primary Health Care facilities in Mpumalanga province, South Africa.African journal of primary health care & family medicine · 2026Article
- Stigma-driven bypassing of ART services in Northern Ghana: a qualitative case study.Primary health care research & development · 2026Article
- Irrigation Challenges, Water Access, and Adaptation Strategies in Smallholder Farming: Evidence From Gaza Province, Mozambique.Global challenges (Hoboken, NJ) · 2026Article
- Inequalities and factors associated with maternal healthcare services utilisation in Mozambique: evidence from the Demographic and Health Survey 2022-2023.BMJ global health · 2025Article
- Extreme geographic misalignment of healthcare resources and HIV treatment deserts in Malawi.Nature medicine · 2025Article
- Beyond physical accessibility, bypassing health facilities offering caesarean section: insights from women in Dakar's slums.BMJ open · 2025Article
- Inter-regional patient outmigration to Seoul in South Korea: the role of regional healthcare quality perceptions.BMC health services research · 2025Article
- Men's Migration and Women's Health in Rural Sub-Saharan Africa: The Role of Migration's Economic Returns and Spousal Communication.The International migration review · 2025Article
- Does the reduction in obstetric hospitals result in an unintended decreased in-hospital delivery utilisation? A causal multilevel analysis in China.BMJ public health · 2025Article
- Bypassing primary antiretroviral therapy centres in Sub-Saharan Africa: An integrative review of the theoretical and empirical literature.Journal of virus eradication · 2024Review
- Quantifying the impact of hospital catchment area definitions on hospital admissions forecasts: COVID-19 in England, September 2020-April 2021.BMC medicine · 2024Article
- Voting with their feet: Primary care provider choice and its implications for public sector primary care services in India.Social science & medicine (1982) · 2024Article
- Impact of mobile Internet use on health-seeking behaviors: evidence from China.Frontiers in public health · 2024Article
- Capturing What Matters with Patients' Bypass Behavior? Evidence from a Cross-Sectional Study in China.Patient preference and adherence · 2023Article
- Difference in bypass for inpatient care and its determinants between rural and urban residents in China.International journal for equity in health · 2022Article
- Factors Associated with Underutilization of Maternity Health Care Cascade in Mozambique: Analysis of the 2015 National Health Survey.International journal of environmental research and public health · 2022Article
- Geospatial distribution and bypassing health facilities among National Health Insurance Scheme enrollees: implications for universal health coverage in Nigeria.International health · 2022Article
- Does Provider Bias Affect Choice of a Facility for Family Planning Services by Women in Urban Senegal?Studies in family planning · 2022Article
- Status and associated factors of cross-regional healthcare-seeking among patients with advanced colorectal cancer in China: a multicenter cross-sectional study.Annals of translational medicine · 2022Article
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundAccess to sexual and reproductive health (SRH) services is critical for such outcomes as pregnancy and birth, prenatal and neonatal mortality, maternal morbidity and mortality, and prevention of vertical transmission of infections like HIV. Health facilities are typically set up where they can efficiently serve the nearby targeted population. However, the actual utilization of health care can be complicated as people sometimes bypass the closest or nearby facilities for various reasons such as service quality. A better understanding of how people actually utilize health services can benefit future health resource allocation as well as health program planning.
methodsIn this study, we use prenatal care as an example of a basic, widely available service to investigate women's choice and bypassing of SRH facilities as well as potential influencing factors at the geographic, clinic, household, and individual levels. The data come from a population-based survey of women of reproductive age in rural Mozambique. The spatial pattern of utilization of health clinics for prenatal care is explored by geographical information system (GIS)-based spatial analysis. Logistic regression is fitted to test the hypotheses regarding the effect of distance, service quality, and household/individual-level factors on the bypassing of the nearest clinic.
resultsThe results indicate that most women living near clinics tend to utilize the closest facilities for prenatal care and those who travel farther mainly do so to seek better services. Further, for women who live far from a clinic (> 5.5 km), service quality still plays an important role in the facility bypassing while the effect of distance is no longer significant. The bypassing of nearest facility is also affected by individual characteristics such as age, HIV status, and household economic conditions.
conclusionsThe findings help to better understand health facility choice and bypassing in developing settings, in general, and in resource-limited Sub-Saharan settings, in particular. They offer valuable guidance for future health resource allocation and health service planning.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.