Abstract
INTRODUCTION: health service utilization remains a major challenge for achieving universal health coverage. However, in the Republic of Congo, few studies highlight the determinants of health service use. The purpose of our study is to estimate the health service utilization rate in Brazzaville and identify its determinants, focusing on households in the Moungali Health District in 2021. METHODS: we conducted an analytical cross-sectional study involving 800 household heads in the Moungali Health District during the month of September 2021. Data were collected using the CAPI (Computer Assisted Personal Interviewing) method through Kobo Collect and analyzed with R software version 4.2.0. Binary logistic regression was used to identify determinants. RESULTS: the health service utilization rate was 27.62%, 95% CI [24.62-30.83]. The determinants of health service utilization were: income above the minimum wage (SMIG - Guaranteed Minimum Interprofessional Salary), AOR (Adjusted Odds Ratio) =2.12 95% CI [1.30-3.48], p=0.003; low healthcare costs (AOR=1.73 95% CI [1.11-2.7], p=0.015) and short waiting time in health services (AOR=1.90 95% CI [1, 21-2.97], p=0.001). CONCLUSION: the health service utilization rate is low, remaining a significant challenge for achieving SDG 3 health targets and universal health coverage. Health insurance mechanisms and national solidarity initiatives should be implemented to improve access to healthcare and health services. These actions require multisectoral intervention.