The impact of the health care sector and economic vitality plays a major role in the upliftment of the welfare of the society. A country's stability and sustainability will depend on how healthy its population is (Patry, Morris & Leatherman, 2010). Therefore, the reduction in mortality rate and an increase in healthy work force that performs work duties are likely to promote economic activities which will in turn increase the country's wealth. Clients seek health care services that can improve the state of their well-being. Since health care services are needed to promote well-being, clients are particular about how and where they purchase health care services from (Akponah, Mazibuko & Krüger, 2015:153). Numerous researchers have studied the factors that determine clients' decision-making in the utilization of health care services. Andersen and Newman (2005:14) put forward that predisposing, enabling and illness level influence the clients' decision to utilize health care services. Mekonnen and Mekonnen (2002:2) report that gender as a demographic factor influences the decision-making of clients regarding the utilization of health care services. However, Williams (2005:35) maintains that client attitudes regarding their decisions to utilize and access health care services from private health care institutions are influenced by their social structure, occupation, education, ethnicity, cultural, attitudes and beliefs relating to values, knowledge and attitudes from past experience. This study investigates and answers the following questions: What factors influences clients' decision-making regarding the utilization of private health care institutions?

Keywords: Health care services; decision-making process; health care institutions; health insurance; clients.