An Equity-Focused Approach to Health Services and Its Influence on Health-Seeking Behaviour Patterns in Peri-urban Communities: A Study of Matero, Lusaka, Zambia

Health equity remains a central concern in achieving universal health coverage in Zambia.Despite reforms such as the abolition of user fees and the introduction of the National Health Insurance Management Authority (NHIMA), disparities in healthcare access and utilisation persist.This study examined the influence of an equity-focused approach to health services on health-seeking behaviour among residents of Matero Township in Lusaka, Zambia.A cross-sectional comparative design using mixed methods was employed, involving 252 respondents from public and private health facilities.Findings revealed that while 58.3% of respondents reported access to healthcare services, 41.7% still lacked access, indicating persistent inequities.Systemic barriers were reported by 65.5% of participants, while 57.4% perceived inequalities in service delivery.Key determinants of health-seeking behaviour included distance to health facilities (25.6%), availability of medication (23.3%), and cost of services (22.0%).Although 70.4% expressed confidence in local health services, utilisation remained irregular.The study concludes that while equity-focused reforms have improved access, structural barriers continue to limit optimal utilisation.