Background: Research on health services (HS) helps to improve delivery of care to different population
groups. The population of highly urbanized areas in developing countries face socioeconomic
inequalities in access and use of HS. We have assessed the recent use of different
types of HS among residents of urban slum and rural areas in Dhaka, Bangladesh. Methods: Baseline data from a current cohort study in Dhaka were used. Logistic regression
was applied to estimate effects of socioeconomic determinants on four dependent variables
(yes/no): recent use of governmental and private health services, pharmacies and qualified
medical doctors (MBBS). Results: A total of 57.5% of the sample consulted any type of HS recently; however, more than
one third of the respondents were unsatisfied with governmental and private HS. 78.4%
of the respondents would choose pharmacies in case of a minor and governmental HS
in case of a serious disease. In the logistic regression model better educated respondents
reported significantly less frequent use of self-medication (pharmacies) and more
frequent use of MBBS as well as private and governmental HS. Urban slum dwellers and
male respondents used pharmacies more often than rural residents (1.65; 95% CI 1.24–2.20)
and female respondents (1.53; 95% CI 1.12–2.10), respectively. As expected, respondents
with no or very low income reported the use of pharmacy more often (2.03; 95% CI 1.24–3.32)
than respondents with high income; higher income was associated with use of more expensive
private and MBBS HS. Conclusions: Education, residential status, income but also location of residence and access to
health services remain the key factors influencing choice and use of HS. Lower costs
and shorter waiting time lead to extensive use of pharmacies rather than qualified
providers. It is essential to continue health education as well as implement better
accessible and need-based HS in urban as well as rural areas.
