UTILIZATION OF HEALTH-SERVICES AMONG RURAL WOMEN IN GUJARAT, INDIA

This study examined the effects of four sets of factors on use of cura tive health services among rural women living in Gujarat, India. The s ets of factors analyzed were as follows: (1) the demographic character istics of the women; (2) the characteristics of the household in which they lived; (3) the characteristics of the environment in which they lived; and (4) the price and convenience of care. The study focused on rural married women aged 17-45 who had at least one child. Nested mul tiple logistic regressions were computed on cross-sectional data to as sess the simultaneous influences of the independent variables on (1) r eports of episodes of illness (2) use of curative services among rural women who reported an illness and (3) use of a specific service. Four types of service were examined as outcomes of interest, namely, priva te doctors, Aga Khan Health Services centres, government health centre s, and traditional healers. Other things being equal, women's educatio n, income, family structure and kinship affiliation were significant p redictors of use of service. Women seemed to be more sensitive to trav el time to the health service and its associated costs (purdah restric tions, transportation and time costs) than to the direct costs of serv ice. Factors such as women's occupation and sanitation facilities, whi le associated with use of service in the expected direction, were not significant predictors of use of service. Implications for health plan ning are offered, including initiatives to implement health promotion and disease prevention programs in addition to increasing access to th e existing health services. Avenues for future studies are suggested, particularly in regard to decision-making processes affecting the heal th-seeking behavior of rural women. It is recommended that such polici es and studies should consider the cultural environment in addition to the existing pluralistic health system.