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

<p><b>Introduction. </b>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.</p> <p><b>Methods.</b> 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.</p> <p><b>Results.</b> 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 for 35% (n=220) and treated with home remedies for 44% (n=277). The odds of seeking care increased 217% for severe events (aOR=3.17; 95%CI 1.99-5.05; p&lt; 0.001). The odds of seeking care from a conventional provider increased by 37% with increasing distance (aOR=1.37; 95%CI 1.06-1.79; p=0.016). Despite stating an intention to seek care from conventional providers, there was a lack of congruence in practice that favored non-conventional providers (McNemar's Chi-squared Test p&lt;0.001). Care was sought from primary providers for 68% (n=150) of cases within a three-tiered network; 25% (n=38/150) were non-conventional.</p> <p><b>Conclusion.</b> Addressing geographic barriers, possibly with technology solutions, should be prioritized to meet healthcare seeking intentions while developing approaches to connect non-conventional providers into healthcare networks when geographic barriers cannot be overcome.</p>