Determinants of Patient’s Choice of Healthcare Providers in Zambia

Abstract Background Universal health coverage (UHC) remains a critical objective for low- and middle-income countries, including Zambia. To promote UHC, Zambia has implemented National Health Insurance (NHI) schemes that aim to provide equitable access to essential health services, particularly for marginalized communities. Here, we investigate the determinants of patients’ choices among public, private, and faith-based healthcare providers in Zambia, utilizing data from the 2014 Zambia Household Health Expenditure and Utilization Survey. Methods We applied Kroeger’s theoretical model of healthcare utilization and performed multinomial logistic regression to assess the influence of patient characteristics, health system access factors, and illness types on healthcare provider choice. Results We found that wealthier patients were significantly more likely to choose private providers, while patients in urban areas and those with positive perceptions of drug availability and shorter waiting times also favored private providers. Conversely, faith-based providers were preferred by rural residents and those with chronic illnesses, with perceived availability of qualified staff serving as a strong determinant. Conclusion Our findings highlight the critical role of socioeconomic and health system factors in shaping healthcare choices. By addressing disparities in healthcare access and quality, particularly in public facilities, Zambia can enhance the equitable utilization of services under the NHI scheme and support the broader goal of UHC