Official websites use. Share sensitive information only on official, secure websites. Address correspondence to Margaret E. Kruk, M. Peter C. Rockers, M. Tornorlah Varpilah, M. Rose Macauley, M. To quantify the influence of health system attributes, particularly quality of care, on preferences for health clinics in Liberia, a country with a high burden of disease that is rebuilding its health system after 14 years of civil war.
Informed by focus group discussions, a discrete choice experiment DCE was designed to assess preferences for structure and process of care at health clinics. The DCE was fielded in rural, northern Liberia as part of a population-based survey on health care utilization. The survey response rate was 98 percent with DCE data available for 1, respondents. Mixed logit models were used to estimate the influence of six attributes on choice of hypothetical clinics for a future illness.
Participants' choice of clinic was most influenced by provision of a thorough physical exam and consistent availability of medicines. Respectful treatment and government versus NGO management marginally increased utility, whereas waiting time was not significant.
Liberians value technical quality of care over convenience, courtesy, and public management in selecting clinics for curative care. This suggests that investments in improved competence of providers and availability of medicines may increase population utilization of essential services as well as promote better clinical outcomes.
Keywords: Postconflict, health system strengthening, discrete choice, clinical care, quality of care. Liberia has recently emerged from 14 years of civil war, which killed tens of thousands, destroyed livelihoods of many survivors, and obliterated the health care system National Transitional Government of Liberia Eighty percent of clinics across the country were shuttered during the war by looting, destruction, and flight of health personnel National Transitional Government of Liberia Liberians suffer from high mortality and morbidity, resulting from a combination of poor living conditions and lack of quality health care.
