3.1. Recruitment
Among Cambodian forest goers, 21 initial seeds recruited 654 study participants over 3–6 waves of recruitment. In Vietnam, 15 initial seeds recruited 633 study participants over 3–5 waves of recruitment. In both countries 90% of coupons were returned.
All participants had spent a night in forest in the last one week or at least four nights per month in the last three months. Most participants were recruited by their friends (Cambodia 96.9% and Vietnam 92.3%) who they had known for more than a year (Cambodia 91.6% and Vietnam 79.3%). The forest goers in Cambodia reported knowing fewer forest goers compared to Vietnam, with 40% of forest goers in Cambodia knowing five or fewer, while 48.9% of forest goers in Vietnam knew 10 or more other forest goers. Table 1 shows the unweighted analysis of recruitment patterns in Cambodia and Vietnam.
Table 1
Unweighted Analysis of Recruitment Patterns
|
Cambodia
|
Vietnam
|
|
Unweighted Proportion
(N = 675)
|
Unweighted Proportion
(N = 648)
|
Reasons for Participation
|
|
|
Interested in study topic
|
57.8
|
28.2
|
Wanted to help the community
|
14.1
|
59.7
|
My friend wanted me to participate
|
25.0
|
1.4
|
Incentive/gift
|
3.0
|
10.7
|
Others
|
0.2
|
-
|
Known the person
|
|
|
< 6 months
|
4.4
|
11.4
|
6–12 months
|
0.9
|
1.9
|
More than a year
|
91.6
|
79.3
|
Missing
|
3.1
|
7.4
|
Number of other forest goers known
|
|
|
Five or less
|
40.0
|
26.1
|
6 to 10
|
34.5
|
24.1
|
More than 10
|
25.5
|
48.9
|
Don’t know
|
-
|
0.9
|
Mean
|
12.04
|
21.04
|
3.2. Demographics
The majority of the forest goers in Cambodia were married (84.3%), male (85.5%), less than 40 years years (73.2%), and had completed primary level education (47.8%). Almost 80% of the forest goers earned their living through forest related work but made very little with 95.4% earning less than USD 500 per month and 18.3% reporting being part of an Identification of Poor (IDPoor) household (22). IDPoor is a mechanism developed by Cambodia Ministry of planning to identify poor and vulnerable households for development programs in Cambodia.
In Vietnam, a majority of the sampled forest goers were married (84.8%), male (95.2%), and between the age of 25–34 years (52.5%). In Vietnam, forest goers under 35 years constituted over 70% of all forest goers sampled, while the age distribution in the Cambodian forest goers was more evenly spread across the age groups. A majority of forest goers in Vietnam made their living through agriculture, and similar to Cambodia, almost all (99.7%) made less than USD 500 per month.
Forest goers in Vietnam were long-standing residents of their villages, with a majority (96.6%) having lived there for more than 10 years. In Cambodia, there was variation in length of stay, with 25.5% of residents living in their village less than 10 years and 29.2% living in there for 30 years or more. Table 2 shows the weighted demographic characteristics of forest goers in Cambodia and Vietnam.
Table 2
Weighted Demographic Characteristics of Forest Goers
|
Cambodia
|
Vietnam
|
|
Weighted Population Proportion
(Bootstrapped 95% CI)
|
Unweighted Sample
N
|
Weighted Population Proportion
(Bootstrapped 95% CI)
|
Unweighted Sample
N
|
Gender
|
|
|
|
|
Male
|
85.5 (80.9–89.1)
|
591
|
95.2 (91.5–98.0)
|
633
|
Female
|
14.5(10.9–19.1)
|
84
|
4.8 (2.0-8.5)
|
15
|
Age
|
|
|
|
|
< 25
|
20.1 (16.3–24.2)
|
133
|
21.2 (16.4–25.9)
|
120
|
25–29
|
18.6 (15.2–22.3)
|
127
|
23.0 (18.5–27.5)
|
162
|
30–34
|
17.1 (13.5–20.8)
|
115
|
29.5 (24.3–34.6)
|
196
|
35–39
|
17.4 (13.8–21.0)
|
120
|
13.8 (8.7–18.9)
|
88
|
40+
|
26.7 (22.2–31.5)
|
180
|
12.6 (9.3–15.8)
|
82
|
Education
|
|
|
|
|
Never attended school
|
14.4 (11.2–18.1)
|
100
|
6.0 (3.8–8.4)
|
38
|
Attended school,
but never completed
|
24.8 (20.8–29.4)
|
198
|
35.5 (28.5–42.7)
|
148
|
Primary school
|
47.8 (42.5–52.7)
|
300
|
12.9 (9.6–16.3)
|
96
|
Lower Secondary school
|
11.7 (8.6–15.0)
|
70
|
11.6 (8.5–15.3)
|
121
|
Upper
Secondary or Higher
|
1.3 (0.4–2.4)
|
7
|
13.0 (10.1–16.3)
|
140
|
No response
|
-
|
-
|
21.1 (13.8–302,)
|
105
|
Income
|
|
|
|
|
<$500
|
95.4 (93.6–97.1)
|
637
|
99.7 (99.1–99.9)
|
640
|
>$500
|
3.9 (2.4–5.5)
|
33
|
0.3 (.05-.9)
|
8
|
Don’t know
|
0.8 (0.1–1.7)
|
5
|
-
|
-
|
ID Poor[1]
|
|
|
|
|
No
|
81.7 (77.5–85.9)
|
558
|
-
|
-
|
Yes
|
18.3 (14.1–22.5)
|
117
|
-
|
-
|
Occupation
|
|
|
|
|
Agriculture
|
16.3 (13.0–20.0)
|
125
|
58.3 (51.1–64.3)
|
389
|
Forest related
|
77.9 (73.6–81.8)
|
507
|
26.9 (21.6–32.9)
|
165
|
Others
|
5.7 (3.6–8.6)
|
43
|
15.0 (11.1–19.7)
|
94
|
Marital Status
|
|
|
|
|
Currently married
|
84.3 (80.5–87.7)
|
568
|
84.8 (79.8–89.2)
|
571
|
Single or formerly married
|
15.7 (12.3–19.5)
|
107
|
15.2 (10.8–20.2)
|
77
|
Time at place of residence
|
|
|
|
|
10 yrs or less
|
25.3 (20.8–30.1)
|
156
|
3.4 (1.8–5.8)
|
39
|
11–20 yrs
|
26.9 (22.6–31.6)
|
184
|
8.6 (5.7–11.7)
|
79
|
21–30 yrs
|
27.9 (23.4–32.5)
|
199
|
44.5 (38.7–50.5)
|
267
|
More than 30 yrs
|
29.9 (15.6–24.5)
|
135
|
43.5 (37.8–49.2)
|
263
|
[1] IDPoor is a mechanism developed by Cambodia Ministry of planning to identify poor and vulnerable households for development programs in Cambodia
3.3. Forest going and activities in the forest
The primary reason for going to the forest was cutting wood (85%) for Cambodian forest goers while only 17.9% went for wood in Vietnam. Bamboo (15.4%) and Charcoal (14.7%) were other reasons for going to forest in Cambodia. In Vietnam, plantation work was the main reason for going to forest, 28% worked in cashew plantation while 27.7% went for wheat plantation and 19.4% went for Rubber plantation. In Cambodia, 78.4% went to the forest for one reason only and 18% went for two or more reasons. Forest goers in Vietnam reported spending more nights in the forest in the last 30 days compared to forest goers in Cambodia. Almost two-thirds (71.1%) of forest goers in Cambodia and more than half (54.2%) in Vietnam reported spending seven nights or fewer in the forest in the last 30 days. Forest goers in Vietnam reported spending a longer time in the forest, with 23.6% in Vietnam spending 8–14 nights and 22.3% spending 15 nights or more in the forest in the last 30 days. Comparatively only 8.5% of forest goers in Cambodia spent 15 nights or in the forest. The interval between forest visits was longer in Cambodia. Almost one-fifth (19.8%) of the forest goers in Cambodia had an interval of 15 or more days since the most recent forest visit compared to 14% in Vietnam. A majority of forest goers in Cambodia and Vietnam reported having been to the forest in the last 7 days (69.8% and 76.6% respectively).
Table 3
Weighted Forest Going and Activities in Forest
|
Cambodia
|
Vietnam
|
|
Weighted Population Proportion
(Bootstrapped 95% CI)
|
Unweighted Sample N
|
Weighted Population Proportion
(Bootstrapped 95% CI)
|
Unweighted Sample N
|
Reasons for going to the forest*
|
|
|
|
|
Wood
|
85.1 (80.9–88.8)
|
675
|
17.9 (14.3–22.1)
|
648
|
Charcoal
|
14.7 (10.3–20.1)
|
675
|
-
|
-
|
Bamboo
|
15.4 (10.7–21.0)
|
675
|
-
|
-
|
Fishing
|
-
|
-
|
14.5 (11.4–17.9)
|
648
|
Rubber plantation
|
-
|
-
|
19.4 ( 14.1–25.6)
|
648
|
Cashew plantation
|
-
|
-
|
28.0 (21.8–34.4)
|
648
|
Wheat plantation
|
-
|
-
|
27.7 (22.4–33.3)
|
648
|
Others
|
7.5 (5.3–10.3)
|
675
|
35.5 (28.7–42.8)
|
648
|
Number of reasons for going to forest
|
|
|
|
|
One
|
78.4 (73.9–82.7)
|
524
|
49.7 (43.8–55.6)
|
292
|
Two
|
18.6 (14.6–22.7)
|
123
|
41.7 (35.9–47.4)
|
250
|
Three or more
|
3.0 (1.6–4.6)
|
28
|
8.6 (6.0-11.2)
|
106
|
Nights spent in forest in last 30 days
|
|
|
|
|
Short ( < = 7 days)
|
71.1 (66.8–74.8)
|
434
|
54.2 (47.5–60.8)
|
401
|
Medium (8–14 days)
|
20.5 (16.9–24.3)
|
161
|
23.6 (18.6–29.0)
|
138
|
Long (15 + days)
|
8.5 (6.4–10.9)
|
80
|
22.3 (16.7–28.3)
|
109
|
Last time in forest
|
|
|
|
|
7 days or less
|
69.8 (65.0-74.7)
|
471
|
76.6 (71.1–82.1)
|
471
|
8–14 days
|
10.4 (7.6–13.1)
|
71
|
9.4 (4.8–14.0)
|
56
|
15 + days
|
19.8 (15.9–24.0)
|
133
|
14.0 (10.4–17.6)
|
121
|
*Multiple response question |
3.4. Health care seeking behavior
All respondents from Cambodia and 65.8% of respondents from Vietnam reported having febrile illness in the last 30 days. More than half (52.2%) of respondents in Cambodia reported suspecting that their febrile illness was malaria, 13.4 % had a cold, 10.1% had Krunkdov/kdovkhlounr (general fever) and 9.5% had typhoid. In Vietnam, 41.6% of the cases were flu, followed by malaria (30.1%), cold (15.5%) and other febrile illnesses (11.9%). Less than half (42.9%) of the forest goers in Vietnam had a blood test following the febrile illnesses with almost all who did (94.5%) visiting a public health or community health facility for the blood test. In Cambodia, 66.5% of the forest goers went for a blood test with 36.7% seeking testing from community health workers, followed by private health facility (33.6%) and public health facility – mostly health centers (28.0%). In Vietnam, 73.1% of those who received a blood test were tested positive for malaria, while 62.5% tested positive for malaria in Cambodia.
The majority of the forest goers in both countries sought treatment for illness. Bivariable analysis showed that seeking treatment from any source was significantly associated with age (χ2 = 9.7, P < .001) and gender (χ2 = 27.3, P < 001) for Vietnam while results were not significant for Cambodia. Three-fourths (75%) of the forest goers in Cambodia sought treatment outside of their home for febrile illness, 17.4% did not seek any treatment and 7.6% were treated in their home. In Vietnam, 65.3% of those with febrile illness sought treatment outside of their home and 7.3% sought treatment at their home. However, more than a quarter (27.4%) of those with febrile illness did not seek any treatment.
In Cambodia, 39% of those seeking care for febrile illness first sought treatment from the private sector, followed by community health workers (32.4%) and public health facilities (24.1%). For Vietnam, 62.3% sought care from community facilities and 29.3% from the private sector, while only 6.9% went to a public facility. The comparison between place for blood test and first place of treatment suggests that some forest goers in Vietnam opted to go to the private sector after getting blood test in the public sector. The first place of treatment was significantly associated with age (χ2 = 2.4, P < .05) and perceived malaria infection (χ2 = 9.0, P < .001) for Cambodia. Associations were not significant for Vietnam. A similar shift between community health workers and private health facilities was observed in Cambodia. Amongst Cambodian forest goers who sought care, 33.1% did so within 24 hours, 38.4% sought care within 24–48 hours and 28.5% waited for three or more days before seeking care for the febrile illness. In Vietnam, more than half (51.6%) of those who sought care for febrile illness did so within 24 hours, 13.4% sought care in 24–48 hours and 35% sought care after 48 hours. Time to seeking treatment was associated with age (χ2 = 3.4, P < .01) in Cambodia. Results were not significant for gender or education.
69.4% of the forest goers in Cambodia sought treatment for their illness from one place while 30.6% went to two or more places. In Vietnam, a majority (58.2%) of forest goers visited more than one place. Table 4 shows key variables in health seeking behavior of forest goers in Cambodia and Vietnam.
Table 4
Health Care Seeking Behavior of Forest Goers
|
Cambodia
|
Vietnam
|
|
Weighted Population Proportion
(Bootstrapped 95% CI)
|
Unweighted Sample N
|
Weighted Population Proportion
(Bootstrapped 95% CI)
|
Unweighted Sample N
|
Fever in last 30 days
|
|
|
|
|
Yes
|
100
|
675
|
65.8 (60.0-71.3)
|
427
|
No
|
-
|
-
|
34.2 (28.7–40.0)
|
221
|
Kind of febrile illness suspected by forest goers
|
|
|
(n = 427)
|
|
Malaria
|
52.2 (47.3–57.2)
|
334
|
30.1 (23.1–38.1)
|
124
|
Dengue
|
4.8 (2.9-7.0)
|
29
|
1.0 (0.2–2.2)
|
6
|
Typhoid
|
9.5 (7.0-12.3)
|
70
|
-
|
|
Cold
|
13.4 (10.0-17.3)
|
97
|
15.5 (10.8–21.0)
|
115
|
Flu
|
2.8 (1.4–4.2)
|
17
|
41.6 (33.4–50.1)
|
155
|
Krunkdov/kdovkhlounr (general fever)
|
10.1 (7.4–13.2)
|
79
|
-
|
|
Other/Don’t know
|
7.3 (5.0 -9.8)
|
51
|
11.9 (4.6–19.6)
|
27
|
Blood testing
|
|
|
(n = 427)
|
|
Yes
|
66.5 (61.8–71.7)
|
459
|
42.9 (34.8–51.2)
|
199
|
No
|
33.5 (28.3–38.2)
|
216
|
50.6 (42.7–58.8)
|
211
|
Don’t know
|
-
|
-
|
6.5 (3.0-10.7)
|
17
|
Place of blood testing
|
(n = 459)
|
|
(n = 199)
|
|
Public health facility
|
28.0 (20.4–36.7)
|
105
|
94.5 (89.7–98.2)
|
175
|
Private health facility
(includes pharmacy/ chemist / drug shop)
|
33.8 (26.5–41.2)
|
181
|
n/a
|
n/a
|
Community health worker
|
36.7 (27.9–45.8)
|
162
|
-
|
-
|
Others
|
1.5 (0.5–2.6)
|
11
|
5.5 (1.8–10.3)
|
24
|
Result of blood test
|
(n = 459)
|
|
(n = 199)
|
|
Positive for malaria
|
62.5 (55.4–69.7)
|
253
|
73.1 (54.7–90.3)
|
116
|
Negative/inconclusive for malaria
|
21.2 (15.7–27.0)
|
114
|
20.3 (3.2–39.5)
|
12
|
Non-malaria diagnosis
|
15.5 (10.2–21.4)
|
85
|
6.6 (2.1–12.6)
|
71
|
No response
|
0.8 (0.1–2.4)
|
7
|
-
|
-
|
Sought treatment for illness from any source
|
|
|
(n = 427)
|
|
Yes
|
82.6 (78.9–85.9)
|
526
|
67.8 (59.4–75.4)
|
303
|
No
|
17.4 (14.1–21.1)
|
149
|
27.6 (20.6–35.4)
|
111
|
No response
|
-
|
-
|
4.6 (1.6–8.2)
|
13
|
Sought treatment for illness outside of home
|
|
|
(n = 427)
|
|
Yes
|
75.0 (70.9–79.2)
|
481
|
65.3 (57.0-72.9)
|
279
|
No
|
7.6 (5.2–10.3)
|
45
|
7.3 (4.0-11.3)
|
37
|
Did not seek treatment for illness
|
17.4 (14.1–20.9)
|
149
|
27.4 (20.7–35.2)
|
111
|
First place sought treatment from
|
(n = 526)
|
|
(n = 303)
|
|
Public health facility
|
24.1 (17.9–30.6)
|
111
|
6.9 (3.7–10.5)
|
21
|
Private health facility
(includes pharmacy/ chemist / drug shop)
|
39.0 (32.2–45.6)
|
252
|
29.3 (18.9–40.2)
|
81
|
Community health Worker
|
32.4 (25.9–39.4)
|
138
|
-
|
-
|
Community health Facility
|
-
|
-
|
62.3 (51.4–72.5)
|
187
|
Other
|
4.6 (2.6–6.9)
|
25
|
1.5 (0.3–4.1)
|
14
|
Time to seek treatment
|
(n = 526)
|
|
(n = 303)
|
|
≤ 24 hours (0–1 days)
|
33.1 (27.2–39.3)
|
174
|
51.6 (36.0-65.8)
|
81
|
48 hours (2 days)
|
38.4 (32.7–44.2)
|
205
|
13.4 (8.0-20.2)
|
75
|
> 48 hours (≥ 3 days)
|
28.5 (22.9–34.4)
|
146
|
35.0 (23.4–48.4)
|
147
|
Number of places sought treatment from
|
(n = 525)
|
|
(n = 303)
|
|
One place
|
69.4 (63.6–74.6)
|
380
|
41.8 (33.0-50.2)
|
172
|
More than one
|
30.6 (25.4–36.3)
|
145
|
58.2 (49.8–67.0)
|
260
|
Second place of treatment
|
(n = 525)
|
|
|
|
Public health facility
|
6.0 (3.7-9.0)
|
30
|
n/a
|
n/a
|
Private health facility
(includes pharmacy, chemist, and drug shop)
|
22.0 (17.1–27.5)
|
104
|
n.a
|
n.a
|
Others
|
2.5 (0.9–4.6)
|
11
|
n/a
|
n/a
|
Sought treatment at one place only
|
69.4 (63.1–74.5)
|
380
|
n/a
|
n/a
|
3.5. Preferred place of treatment
Private health facilities (41.2%) were the most preferred place of treatment for febrile illness, followed by community health workers (31.4%) and public health facilities (25.3%) among forest goers in Cambodia (Table 5). In Vietnam, 44.5% preferred community health facilities, followed by private health facilities (39.3%) and public health facilities (10.8%). Table 6 shows the breakdown of forest goers’ preferred place of treatment in Cambodia and Vietnam. In both countries preferred place of treatment was significantly associated with age of the forest goers (Cambodia: χ2 = 3.3, P < .05; Vietnam: χ2 = 12.5, P < .001). The results were not significant for education, income and gender.
Table 5
Preferred Place of Treatment
|
Cambodia
|
Vietnam
|
|
Weighted Population Proportion
(Bootstrapped 95% CI)
|
Unweighted Sample N
|
Weighted Population Proportion
(Bootstrapped 95% CI)
|
Unweighted Sample N
|
Preferred place of treatment
|
|
|
|
|
Public health facility
|
25.3 (20.3–30.7)
|
155
|
10.8 (7.9–13.9)
|
97
|
Private health facility
(includes pharmacy, chemist, and drug shop)
|
41.2 (35.7–46.7)
|
337
|
39.3 (32.6–46.2)
|
208
|
Community health Worker
|
31.4 (25.6–37.6)
|
168
|
-
|
-
|
Community health facility
|
-
|
-
|
44.5 (38.2–50.9)
|
308
|
Other
|
2.1 (0.8–3.7)
|
15
|
5.4 (3.3–8.1)
|
35
|
The forest goers were asked to rank their top three reasons for preferring a particular health facility. Forest goers in Cambodia reported a mix of reasons for preferring a particular facility (Table 6). Proximity (37.7%), quality of service (16.3%) and trust in provider (15.2%) were some of the ranked top reasons for preferring a facility in Cambodia.. Forest goers in Vietnam were asked to rank their reasons for provider preferences – this resulted in more clearly articulated drivers of provider preferences. Perceived proximity to provider (87.8% of forest goers) was the top ranked reason for facility choice. Cost (68% of forest goers) was the second ranked and availability of services (45.8%) a third top reason for choice of facility. Quality of service and trust in provider were not as prominent as reasons for preferring a facility in Vietnam as in Cambodia.
Table 6
|
Cambodia
|
Vietnam
|
|
Weighted Population Proportion
(Bootstrapped 95% CI)
|
Unweighted Sample N
|
Weighted Population Proportion
(Bootstrapped 95% CI)
|
Unweighted Sample N
|
Top ranked reasons for place of preference
|
|
|
|
|
Proximity
|
37.7 (32.7–43.1)
|
239
|
87.8 (84.2–91.0)
|
549
|
Cost
|
14.6 (11.3–18.0)
|
97
|
4.7 (3.0-6.8)
|
38
|
Previous experience
|
7.8 (5.3–10.4)
|
56
|
3.4 (1.8–5.2)
|
32
|
Recommended provider
|
-
|
-
|
1.3 (0.5–2.3)
|
18
|
Quality of Service
|
16.3 (12.6–20.4)
|
102
|
1.9 (0.4- 4.0)
|
6
|
Friendliness of service
|
5.4 (3.4–7.6)
|
38
|
0.8 (0.1–2.4)
|
5
|
Trust in provider
|
15.2 (11.9–18.8)
|
121
|
-
|
-
|
Others
|
3.2 (1.8–4.8)
|
22
|
-
|
-
|
Second ranked reasons for place of preference
|
|
|
|
|
Proximity
|
10.1 (7.2–13.3)
|
66
|
-
|
-
|
Cost
|
36.5 (31.7–41.2)
|
208
|
68.0 (62.6–73.4)
|
417
|
Previous experience
|
6.0 (3.8–8.7)
|
44
|
16.3 (12.2–20.6)
|
107
|
Recommended provider
|
-
|
-
|
4.7 (2.9-7.0)
|
32
|
Quality of Service
|
15.8 (12.4–19.7)
|
96
|
6.3 (4.4–8.5)
|
72
|
Friendliness of service
|
10.0 (7.0–13.0)
|
56
|
1.9 (0.4–3.8)
|
6
|
Availability of service
|
-
|
|
2.8 (1.2–5.2)
|
14
|
Trust in provider
|
16.8 (13.0-21.1)
|
112
|
-
|
-
|
Others
|
4.7 (2.7-7.0)
|
30
|
-
|
-
|
Third ranked reasons for place of preference
|
|
|
|
|
Proximity
|
11.1 (7.9–14.7)
|
64
|
-
|
-
|
Cost
|
18.1 (14.2–22.3)
|
95
|
-
|
-
|
Previous experience
|
5.4 (3.1–8.4)
|
34
|
16.5 (12.5–20.8)
|
163
|
Recommended provider
|
-
|
-
|
2.5 (1.4–3.8)
|
28
|
Quality of Service
|
11.6 (8.2–15.2)
|
68
|
5.6 (3.5–7.9)
|
52
|
Friendliness of service
|
10.3 (7.0-13.9)
|
64
|
13.4 (10.3–16.8)
|
102
|
Availability of service
|
-
|
-
|
45.8 (39.4–52.2)
|
168
|
Trust in provider
|
38.8 (32.8–44.9)
|
194
|
16.1 (12.4–20.0)
|
131
|
Others
|
4.7 (2.2–8.3)
|
27
|
0
|
4
|
In Cambodia, cost (OR = 5.19, P < .001), quality of service (OR = 2.28, p < 0.001), friendliness of service (OR = 2.48, p < 0.001) and availability of service (OR = 6.42, p < 0.001) were positively associated with the preference of public health facility while trust in provider (OR = 0.38, p < 0.001) was negatively associated with the preference (Table 7).
Trust in provider (OR = 1.58, p < 0.05) and other reasons (OR = 4.01, p < 0.05) were positively associated with preference of private facility. Cost (OR = 0.25, p < 0.001), proximity (OR = 0.33, p < 0.001), recommended provider (OR = 0.11, p < 0.01) and availability of service were negatively associated with preference of private facility in Cambodia.
Proximity (OR = 4.81, p < 0.01), recommended provider (OR = 9.84, p < 0.001) and trust in provider (OR = 1.68, p < 0.05) were associated positively with the preference of community health workers in Cambodia. Quality of services and friendliness of service were negatively associated with the preference of community health workers.
In Vietnam, cost (OR = 5.36, p < 0.01), and recommended provider (OR = 3.94, p < 0.01) were positively associated with the preference of public health facility while only availability of service (OR = 3.19, p < 0.001) was positively associated with the private health facility. Quality of the service was not included in the public health facility analysis due to low number of mentions as reasons for preference. Proximity, cost, quality of service and friendliness of service were negatively associated with the private providers. Despite being the preferred place of almost half of the forest goers, none of the factors were positively associated with the choice of community health facility. There could be other factors associated with choice which is not captured by this study.
Table 7
Weighted Odds Ratios for the Reasons for Choice of Facility
Cambodia
|
Odds Ratio
|
p-value
|
Public Facility
|
|
|
Cost
|
5.19
|
< 0.001
|
Quality of service
|
2.28
|
< 0.001
|
Friendliness of service
|
2.48
|
< 0.001
|
Availability of service
|
6.42
|
< 0.001
|
Trust in provider
|
0.38
|
< 0.001
|
Private Facility
|
|
|
Proximity
|
0.33
|
< 0.001
|
Cost
|
0.25
|
< 0.001
|
Recommended provider
|
0.11
|
< 0.001
|
Availability of service
|
0.37
|
0.004
|
Trust in provider
|
1.58
|
0.012
|
Others
|
4.01
|
0.012
|
Community Health Workers
|
|
|
Proximity
|
4.81
|
< 0.001
|
Recommended provider
|
9.84
|
0.001
|
Quality of service
|
0.35
|
< 0.001
|
Friendliness of service
|
0.39
|
0.002
|
Trust in provider
|
1.68
|
0.027
|
Vietnam
|
Odds Ratio
|
p-value
|
Public Facility
|
|
|
Cost
|
5.36
|
0.005
|
Recommended provider
|
3.94
|
0.009
|
Availability of service
|
0.26
|
0.021
|
Private Facility
|
|
|
Proximity
|
0.16
|
< 0.001
|
Cost
|
0.57
|
0.011
|
Quality of service
|
0.15
|
< 0.001
|
Friendliness of service
|
0.17
|
< 0.001
|
Availability of service
|
3.19
|
< 0.001
|
Community Health Facility
|
|
|
Cost
|
0.11
|
< 0.001
|
Previous experience
|
0.09
|
0.001
|
Recommended provider
|
0.08
|
< 0.001
|
Quality of service
|
0.01
|
< 0.001
|
Friendliness of service
|
0.24
|
0.006
|
Availability of service
|
0.02
|
< 0.001
|
Trust in provider
|
0.06
|
0.012
|