Patient Preferences in Healthcare Seeking Choices in Rwanda: A Discrete Choice Experiment

Abstract

Rwanda is frequently recognized as a success story for universal healthcare with over 90% of Rwandans having health insurance. 1 To further strengthen primary care, the Society for Family Health (SFH), in partnership with the Rwandan government, has built health posts across the country with goals to construct 1000 of them. Despite these efforts, there has been limited research on the utilization of these health posts and on patient preferences for their services.To address this gap, a discrete choice experiment (DCE) was conducted to understand patient preferences for health post service packages. Study attributes were identified through a literature review and informal consultations with SFH, resulting in six key factors: distance, type of clinic, cost, medication availability, appointment availability, and wait time.The results demonstrate that both financial and non-financial factors significantly influence healthcare preferences. Respondents expressed strong preferences for the availability of medication and appointments, as well as for lower costs, while distance and wait times were comparatively less influential. The findings also revealed substantial heterogeneity across individuals, highlighting considerable variation in healthcare priorities within the population.As a stated-preference survey, this DCE captures hypothetical choices rather than actual behavior, so the real-world impact of implementing these service packages remains uncertain. Nevertheless, this study contributes valuable insights into healthcare service preferences in Rwanda and provides evidence to inform strategies aimed at improving access and quality of care.