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Although this finding shows a low level of service utilization, there is remarkable improvement as compared to the 2011 national rate.
In contrast, the level of service utilization was significantly higher among the Igbos (in the south) and the "minority" tribes compared to the Hausas.
We anticipate that the extent to which the performance-based incentives create expected changes in service quality will depend, positively or negatively, on the level of service utilization produced by the demand-side incentives.
In addition, women's low awareness on the advantages of skilled attendance at delivery, little role in making decisions (even when they want), and economic constraints during referral contribute to the low level of service utilization.
Because age plays such a large role in the severity of chronic disease and level of service utilization, predicted values were generated holding age constant at 25, 33.3 (average age of under 50 cohort), 45, 55, 65.7 (average age of 50 & over cohort) & 75.
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In the analysis above, we find that greater private sector participation is positively associated with higher levels of service utilization and negatively associated with rich-poor and urban-rural disparities in health care access and use.
There is also limited understanding of their effect on the quality of care received by clients and on levels of service utilization, especially among the poor and underserved.
There is limited understanding of their effect on the quality of care received by clients and on levels of service utilization, especially among the poor and underserved.
A study of similar 'informal' economic activities among PHC workers in Uganda (McPake et al. 1999) also showed that levying informal charges for services was associated with lower levels of health worker absenteeism and higher levels of service utilization.
Similar findings were demonstrated in a study examining barriers to services for rural and urban rape survivors which suggests that a lack of anonymity in rural areas might influence behavior, showing that levels of service utilization and rape reporting differ between rural and urban areas [ 55].
There are few studies on knowledge, attitude and practice of adolescents in relation to their RH in Ethiopia showing a significant discrepancy between knowledge about and the level of services utilization in particular and poor access to RH services in general [ 9- 12].
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