Employment of Health Care Services by Rural Inhabitants

Considering conflicting reports on the success efficacy of health services, this study was carried out to determine the sty le of utilization of health and treatment services in health centers of rural areas in 1996. The descriptive and cross-sectional strategy of this research study was performed in health centers of 11 provinces and their villages were classified into high, intermediate, and low groups according to the quality of presented services. For this purpose, six physicians were involved with the project using similar questionnaires and methods of evaluation. In this regard, every one of them studied one or two provinces for a period of 1-3 months. They referred to 196 villages and had interview with 1064 families, 62 health assistants, and 27 physicians and completed the questionnaires. It was found out that the first place of refer for the villagers was rural health centers and then in order of impo11ance were doctor's office and health and tremment centers. In well-conditioned regions, the villagers rarely referred to rural health and treatment centers (6%) and the greatest reference was the office of physicians (34%). In this regard, most of them expressed the closeness of health center as the major cause of refer. The existence of free services especially drng, having trust to health assistants, and observance of referral system were the other causes ofrefer. On the basis of their views, the availability of the necessary drugs was 45.5%, 76.6% and 57.2% in poor, moderate and well-conditioned regions respectively. The suggestions of health assistants for the improvement of health service presentation in order of frequency were the availability of the approved drugs, holding courses of training and re-education, establishing the rural health and treatment centers in line with the existing health centers and continuous or intermittent presence of physicians in rural areas. According to the views of physicians in less than half of the cases, there is enough supply of the necessary drugs and in 74.1 % of cases, the existence of the necessary equipments has satisfied the physicians. Meanwhile, in none of the studied villages, there did not exist all of the 41 approved drugs completely, but the contraceptive pill existed in 96.5% of cases. Furthermore, considering the list of necessary equipments, the necessary items did not exist in many of the cases.