Health services utiliization among small scale enterpreneurs: a case study of medicare security in Dar es Salaam.

The main objective of this study was to examine the utilization of health care services under the Medicare Security for Small Scale Entrepreneurs. Methodological triangulation was used to collect information on the utilization of health care services. This involved the use of survey interviews, focus group discussions, in-depth interviews and documentary review. The results show that, (i) respondents had different background characteristics such as age, gender, educational level, marital statuses, religion, household size, income level, occupation and distance. (ii) Respondents used various health care providers as a source of their health care (Medicare Security, public health care providers, private health care providers, pharmacies and First Aid Kit). On the patterns of the utilization of the health care services under the Medicare Security for Small Scale Entrepreneurs, the results showed that lower income people utilized less health care services than high income people. Also findings on the factors that influence the utilization of health care services under the Medicare Security for Small Scale Entrepreneurs showed that predisposing and enabling variables had an influence on the utilization of health care services. Of these, enabling variables (income and quality of health care) were the most important predictors. Furthermore, the results on equity in access to health care showed that equity prevailed in respect to the use of health care services, medical care costs, and distance from home to the nearest health facility under the Medicare Security for Small Scale Entrepreneurs, availability of health care services, opening hours and days, satisfaction with health care services and quality of health care. However, inequities in access to health care under the Medicare Security for Small Scale Entrepreneurs were found in respect to members with different incomes, gender, marital status, and spatial distribution of health facilities. The study concludes by drawing policy and research implications of the findings.