Opportunities to catalyze improved healthcare access in pluralistic systems: a cross-sectional study in Haiti

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 f...