DOI: 10.5061/dryad.wpzgmsbkm
title: Data from: Opportunities to catalyze improved healthcare access in pluralistic systems: a cross-sectional study in Haiti

description: Introduction. Gains to ensure global healthcare access are at risk of
 stalling because some old resilient challenges require new solutions. Our
 objective was to identify determinants of intended versus actual
 care-seeking behaviors in a pluralistic healthcare system that is reliant
 on both conventional and non-conventional providers and discover
 opportunities to catalyze improved healthcare access. Methods. A
 cross-sectional study was conducted among households with children less
 than 5 years of age in Haiti. Households were randomly sampled
 geographically with stratifications for population density. Household
 questionnaires with standardized cases (intentions) were compared to
 self-recall of health events (behaviors). The connectedness of households
 and their providers was determined by network analysis. Results. A total
 of 568 households (incorporating 2900 members) and 65 providers were
 enrolled. Households reported 636 health events in the prior month.
 Households sought care for 35% (n=220) and treated with home remedies for
 44% (n=277). The odds of seeking care increased 217% for severe events
 (aOR=3.17; 95%CI 1.99-5.05; p&lt; 0.001). The odds of seeking care
 from a conventional provider increased by 37% with increasing distance
 (aOR=1.37; 95%CI 1.06-1.79; p=0.016). Despite stating an intention to seek
 care from conventional providers, there was a lack of congruence in
 practice that favored non-conventional providers (McNemar’s Chi-squared
 Test p&lt;0.001). Care was sought from primary providers for 68%
 (n=150) of cases within a three-tiered network; 25% (n=38/150) were
 non-conventional. Conclusion. Addressing geographic barriers, possibly
 with technology solutions, should be prioritized to meet healthcare
 seeking intentions while developing approaches to connect non-conventional
 providers into healthcare networks when geographic barriers cannot be
 overcome.
description: <b>Data Collection. </b>Data were collected by one
 enumerator and one nurse. Survey instruments included two thirty-minute
 in-person questionnaires administered with REDCap mobile version 9.1.1 and were
 piloted with non-participant households. A household questionnaire
 collected demographic and socio-economic data, and healthcare seeking
 behavior for standardized cases and health events. A health event was
 defined as any illness a household member experienced in the previous
 month, regardless of whether care was sought. The standardized respiratory
 and diarrhoeal cases consisted of hypothetical scenarios involving an ill
 child at 10 PM with typical symptoms of acute respiratory infection or
 diarrhoea. A provider questionnaire captured details about the
 facility/business, personnel qualifications and resources available.
 Conventional providers were licensed persons who worked at a licensed
 facility. For large facilities with greater than 200 patients per month,
 the facility itself was defined as a ‘provider’. Non-conventional
 providers were licensed or non-licensed providers at non-licensed
 facilities, or mobile non-licensed providers. The dataset was deidentified
 in a manner that allows for the connectedness of households and providers
 to be preserved.
description: Lists of variables and codes are attached for questionnaire
 data and provider network data.