Geospatial Analysis of Parental Healthcare-Seeking Behavior in the Vicinity of Multispecialty Hospital in India.

Abstract

The healthcare-seeking behavior of vulnerable groups, such as children under five, depends on a multitude of factors, including the caregiver's decision making. Approximately 60% of Indians seek care from private hospitals. Recent health policy in India has favored the establishment of multispecialty hospitals. However, it remains unclear to what extent this policy has changed the number of Indians seeking healthcare from these government-established multispecialty hospitals. The study aims to assess the health-seeking behavior of parents of children under five in the vicinity of a public multispecialty tertiary care hospital. This was a community-based cross-sectional survey with geospatial mapping conducted among the parents of children under five using a semi-structured questionnaire in Epi-collect mobile app. The study site was an urban slum in a catchment area [within five kilometers (km)] of a multispecialty tertiary care public hospital in the central Indian state of Chhattisgarh. The study was conducted for one year duration from February 2019 to January 2020. A questionnaire was administered to the parents of the children under five (N = 353) after their household confirmation from the nearby Anganwadi center, the community level service providing center under the Integrated Child Development Scheme by the Ministry of Women and Child Development (WCD). The questionnaire included sections for demographic characteristics, the illness pattern among their children, health-seeking decision-making, and more. Descriptive analysis was presented with numbers and percentages. Univariate analysis was used to assess the association between sociodemographic variables and health-seeking characteristics. Statistical significance was considered at p value less than 0.05. We used geospatial mapping using coordinates collected and compiled using the Microsoft Excel version 2021 and analyzed using QGIS (Quantum Geographic Information System) software. Among the parents interviewed patients (N = 353), maternal literacy rates were over 85%. Approximately 54% of the families were below poverty line. Among 95.2% of the families, mothers were part of decision-making regarding their children's health-seeking. Over 92% of the families opted for consultation in a nearby private hospital or dispensary. Geospatial mapping of private hospitals was a favored place for healthcare-seeking by mothers, irrespective of their socioeconomic status or education rather than multispecialty hospital. The majority of the parents in the vicinity of public multispecialty hospitals seek care from private clinics for ailments for children under five. The establishment of public multispecialty tertiary care hospitals, which are mandated for tertiary level of care and research, cannot replace primary-level healthcare institutions, showed that private hospitals were the favored places healthcare seeking by mothers. These primary-level institutions are critical for the management of common ailments for children under five near home and reducing the financial burden on the family, even in the vicinity of a multispecialty hospital.