Understanding the underutilisation of healthcare interventions in low- and middle-income countries: demand-side and supply-side factors

Abstract

Poor accessibility of healthcare interventions in low- and middle-income countries (LMICs) has resulted in increased suffering and lower health benefits. This is caused by a host of demand-side and supply-side barriers that need to be investigated to design effective strategies. The rate of underutilisation of healthcare interventions is high in LMICs and the utilisation is lower at the lowest tier of the population ladder. The supply-side factors include inefficient resources, inappropriate allocations and inadequate quality. The demand-side factors include income, price, non-price cost, location, nature of household decision-making and broader cultural influences. Policy interventions at the demand and supply side should be aligned together to achieve balanced progress. This can be achieved by exploring options of financial rewards, pre-payment schemes, supporting community-based financing, influencing household preferences, addressing cultural and societal sensitivities and empowering healthcare professionals, especially in the rural areas.