06 Sep Is the utilization of healthcare facilities easy for young people in Burundi?

M. Merckling, L. Ntakarutimana, A. Labat

12th European congress on tropical medicine and international health, 28 sept- 1 oct 2021, Virtual from Bergen, Norway

Objective

Burundi has a very young population, with a median age of 17. Therefore, youth is a public health priority to be considered to achieve UHC. This 2019 study aims to identify the determinants and behaviors of youths (10-24years) in order to guide health policies, particularly regarding Healthcare Facilities (HF) utilization.

Methods

This descriptive study is a 4-stage survey design with 110 clusters. 2085 youths were interviewed in 11 of the 18 provinces of Burundi.

Results

79,2% of respondents judged HF pleasant/nice to use as youths. However, 22,5% of respondents didn’t use HF last time they had a severe disease. This proportion is higher for boys (25,5%) than girls (20,3%) and for adolescents (10-19y: 24,0%) than young adults (20-24y: 16,4%). The 3 major reasons given, all together representing 88,9% of the responses, are lack of money, distance to the HF and self-medication. HF utilization for a severe disease is correlated to education level: 81,4% of respondents able to read went to HF while only 66,2% of those who can’t (or can’t well) did. Besides, HF utilization shows a gradient according to the level of the last class attended among respondents who do not attend school anymore (low:67,6%, middle:76,5%, high:82,7%). When a disease occurs -regardless of severity-, girls are more likely than boys to attend HF (87,9% vs 81,7%). Self-medication is more used by boys (10,4%) than girls (6,9%).

Conclusion

More than 1/5 individuals of 10-24y doesn’t use HF when needed. Widespread self-medication appears as an inadequate substitution practice. Besides, gender, age and education level contribute to disparities in HF utilization. The health system provides free care for under 5 children but not much has been done to facilitate the access to care of the youths, specially for the youngest not yet able to afford their own care.