FROM HOW MANY TO WHY - HEALTH-SERVICES UT ILIZATION FROM THE USERS PERSPECTIVE

Parallel to the National Health Survey-ii, in 1994 a qualitative study was conducted on the patterns and microsocial determinants of health services utilization. The study was conducted in eight urban areas fro m all over the country among middle class and middle-low class sectors . A total of 192 individual open-ended interviews and eight focus grou ps were completed among users of health services; 61 service providers both from public and private services were also interviewed. This pap er reports the main findings regarding the users' perspective,The firs t part sumarizes the conceptual and methodological design. The second part presents the results from the users' point of view. Individuals d istinguish between ''becoming sick'' and ''falling sick''; preventive measures are adopted when becoming sick, in order to avoid falling sic k, Another finding refers to the population tendency to add up differe nt and even contradictory curative paradigms, as opossed to the modern medical paradigm which tends to exclude any competing alternative kno wledge. A third series of findings refers to the dilemmas that utilizi ng health services poses for the population, given the high costs, and the low quality that characterize these services, according to the us ers' point of view. This paper concludes with a series of recommendati ons for policies,aimed at improving the quality of the health services provided to the population.